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Identification
NameAxitinib
Accession NumberDB06626
TypeSmall Molecule
GroupsApproved, Investigational
Description

Axitinib is an oral, potent, and selective inhibitor of vascular endothelial growth factor receptors (VEGFR) 1, 2, and 3. Axitinib is marketed under the name Inlyta®, and if one previous systemic therapy for kidney cell cancer has failed, axitinib is indicated.

Structure
Thumb
SynonymsNot Available
External Identifiers
  • AG-013736
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Inlytatablet, film coated1 mg/1oralPfizer Laboratories Div Pfizer Inc2012-01-27Not applicableUs 0a2ef1ad1c84951dc1392a8bbe1f3cb241c91ed59e44ad8268635315440d978c
Inlytatablet7 mgoralPfizer Canada IncNot applicableNot applicableCanada 5f16b84899037e23705f146ff57e3794121879cb055f0954756d94bc690476b4
Inlytatablet3 mgoralPfizer Canada IncNot applicableNot applicableCanada 5f16b84899037e23705f146ff57e3794121879cb055f0954756d94bc690476b4
Inlytatablet5 mgoralPfizer Canada Inc2012-08-17Not applicableCanada 5f16b84899037e23705f146ff57e3794121879cb055f0954756d94bc690476b4
Inlytatablet1 mgoralPfizer Canada Inc2012-08-17Not applicableCanada 5f16b84899037e23705f146ff57e3794121879cb055f0954756d94bc690476b4
Inlytatablet, film coated5 mg/1oralU.S. Pharmaceuticals2012-01-27Not applicableUs 0a2ef1ad1c84951dc1392a8bbe1f3cb241c91ed59e44ad8268635315440d978c
Inlytatablet, film coated1 mg/1oralU.S. Pharmaceuticals2012-01-27Not applicableUs 0a2ef1ad1c84951dc1392a8bbe1f3cb241c91ed59e44ad8268635315440d978c
Inlytatablet, film coated5 mg/1oralPfizer Laboratories Div Pfizer Inc2012-01-27Not applicableUs 0a2ef1ad1c84951dc1392a8bbe1f3cb241c91ed59e44ad8268635315440d978c
Generic Prescription ProductsNot Available
Over the Counter ProductsNot Available
International BrandsNot Available
Brand mixturesNot Available
SaltsNot Available
CategoriesNot Available
UNIIC9LVQ0YUXG
CAS number319460-85-0
WeightNot Available
Chemical FormulaNot Available
InChI KeyNot Available
InChINot Available
IUPAC NameNot Available
SMILESNot Available
Taxonomy
ClassificationNot classified
Pharmacology
IndicationUsed in kidney cell cancer and investigated for use/treatment in pancreatic and thyroid cancer.
PharmacodynamicsAxitinib prevents the progression of cancer by inhibiting angiogenesis and blocking tumor growth.
Mechanism of actionAxitinib selectively blocks the tyrosine kinase receptors VEGFR-1 (vascular endothelial growth factor receptor), VEGFR-2, and VEGFR-3.
AbsorptionAfter one 5 mg dose of axitinib, it takes about 2.5 to 4.1 hours to reach maximum plasma concentration.
Volume of distribution

The volume of distribution is 160 L.

Protein bindingPlasma protein binding for axitinib is high at over 99% with most protein binding to albumin followed by α1-acid glycoprotein.
Metabolism

Axitinib undergoes mainly hepatic metabolism. CYP3A4 and CYP3A5 are the main hepatic enzymes while CYP1A2, CYP2C19, and UGT1A1 enzymes are secondary.

Route of eliminationAxitinib is mainly eliminated unchanged in the feces (41%) with 12% of the original dose as unchanged axitinib. There is also 23% eliminated in the urine, most of which are metabolites.
Half lifeAxitinib has a half life of 2.5 to 6.1 hours.
Clearance

The average clearance of axitinib is 38 L/h.

ToxicitySome of the more serious toxic effects seen in patients taking axitinib include, but are not limited to, hypertension, thrombotic events, hemorrhage, and GI perforation.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal AbsorptionNot AvailableNot Available
Blood Brain BarrierNot AvailableNot Available
Caco-2 permeableNot AvailableNot Available
P-glycoprotein substrateNot AvailableNot Available
P-glycoprotein inhibitor INot AvailableNot Available
P-glycoprotein inhibitor IINot AvailableNot Available
Renal organic cation transporterNot AvailableNot Available
CYP450 2C9 substrateNot AvailableNot Available
CYP450 2D6 substrateNot AvailableNot Available
CYP450 3A4 substrateNot AvailableNot Available
CYP450 1A2 substrateNot AvailableNot Available
CYP450 2C9 inhibitorNot AvailableNot Available
CYP450 2D6 inhibitorNot AvailableNot Available
CYP450 2C19 inhibitorNot AvailableNot Available
CYP450 3A4 inhibitorNot AvailableNot Available
CYP450 inhibitory promiscuityNot AvailableNot Available
Ames testNot AvailableNot Available
CarcinogenicityNot AvailableNot Available
BiodegradationNot AvailableNot Available
Rat acute toxicityNot AvailableNot applicable
hERG inhibition (predictor I)Not AvailableNot Available
hERG inhibition (predictor II)Not AvailableNot Available
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
Tabletoral1 mg
Tabletoral3 mg
Tabletoral5 mg
Tabletoral7 mg
Tablet, film coatedoral1 mg/1
Tablet, film coatedoral5 mg/1
PricesNot Available
PatentsNot Available
Properties
StateSolid
Experimental Properties
PropertyValueSource
water solubilityIn aqueous media with a pH between 1.1 to 7.8, axitinib has a solubility of over 0.2 μg/mL. From FDA label.
pKa4.8From FDA label.
Predicted PropertiesNot Available
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
References
Synthesis Reference

Hu-Lowe D, Hallin M, Feeley R, Zou H, Rewolinski D, Wickman G, Chen E, Kim Y, Riney S, Reed J, Heller D, Simmons B, Kania R, McTigue M, Niesman M, Gregory S, Shalinsky D, Bender S. Characterization of potency and activity of the VEGF/PDGF receptor tyrosine kinase inhibitor AG013736. Proc Am Assoc Cancer Res. 2002;43:A5357.

General References
  1. Cohen EE, Rosen LS, Vokes EE, Kies MS, Forastiere AA, Worden FP, Kane MA, Sherman E, Kim S, Bycott P, Tortorici M, Shalinsky DR, Liau KF, Cohen RB: Axitinib Is an Active Treatment for All Histologic Subtypes of Advanced Thyroid Cancer: Results From a Phase II Study. J Clin Oncol. 2008 Jun 9. Pubmed
  2. Inai T, Mancuso M, Hashizume H, Baffert F, Haskell A, Baluk P, Hu-Lowe DD, Shalinsky DR, Thurston G, Yancopoulos GD, McDonald DM: Inhibition of vascular endothelial growth factor (VEGF) signaling in cancer causes loss of endothelial fenestrations, regression of tumor vessels, and appearance of basement membrane ghosts. Am J Pathol. 2004 Jul;165(1):35-52. Pubmed
  3. Rugo HS, Herbst RS, Liu G, Park JW, Kies MS, Steinfeldt HM, Pithavala YK, Reich SD, Freddo JL, Wilding G: Phase I trial of the oral antiangiogenesis agent AG-013736 in patients with advanced solid tumors: pharmacokinetic and clinical results. J Clin Oncol. 2005 Aug 20;23(24):5474-83. Epub 2005 Jul 18. Pubmed
  4. Rini BI: SU11248 and AG013736: current data and future trials in renal cell carcinoma. Clin Genitourin Cancer. 2005 Dec;4(3):175-80. Pubmed
  5. Gilbert JA, Adhikari LJ, Lloyd RV, Halfdanarson TR, Muders MH, Ames MM: Molecular markers for novel therapeutic strategies in pancreatic endocrine tumors. Pancreas. 2013 Apr;42(3):411-21. doi: 10.1097/MPA.0b013e31826cb243. Pubmed
  6. FDA label.
External Links
ATC CodesL01XE17
AHFS Codes
  • 10:00
PDB EntriesNot Available
FDA labelDownload (307 KB)
MSDSDownload (36.8 KB)
Interactions
Drug Interactions
Drug
AprepitantThe serum concentration of Axitinib can be increased when it is combined with Aprepitant.
AtazanavirThe serum concentration of Axitinib can be increased when it is combined with Atazanavir.
BexaroteneThe serum concentration of Axitinib can be decreased when it is combined with Bexarotene.
BoceprevirThe serum concentration of Axitinib can be increased when it is combined with Boceprevir.
BosentanThe serum concentration of Axitinib can be decreased when it is combined with Bosentan.
CarbamazepineThe serum concentration of Axitinib can be decreased when it is combined with Carbamazepine.
CeritinibThe serum concentration of Axitinib can be increased when it is combined with Ceritinib.
ClarithromycinThe serum concentration of Axitinib can be increased when it is combined with Clarithromycin.
CobicistatThe serum concentration of Axitinib can be increased when it is combined with Cobicistat.
ConivaptanThe serum concentration of Axitinib can be increased when it is combined with Conivaptan.
DabrafenibThe serum concentration of Axitinib can be decreased when it is combined with Dabrafenib.
DarunavirThe serum concentration of Axitinib can be increased when it is combined with Darunavir.
DasatinibThe serum concentration of Axitinib can be increased when it is combined with Dasatinib.
DeferasiroxThe serum concentration of Axitinib can be decreased when it is combined with Deferasirox.
DexamethasoneThe serum concentration of Axitinib can be decreased when it is combined with Dexamethasone.
EfavirenzThe serum concentration of Axitinib can be decreased when it is combined with Efavirenz.
EnzalutamideThe serum concentration of Axitinib can be decreased when it is combined with Enzalutamide.
Eslicarbazepine acetateThe serum concentration of Axitinib can be decreased when it is combined with Eslicarbazepine acetate.
EtravirineThe serum concentration of Axitinib can be decreased when it is combined with Etravirine.
FluconazoleThe metabolism of Axitinib can be decreased when combined with Fluconazole.
FosaprepitantThe serum concentration of Axitinib can be increased when it is combined with Fosaprepitant.
FosphenytoinThe serum concentration of Axitinib can be decreased when it is combined with Fosphenytoin.
Fusidic AcidThe serum concentration of Axitinib can be increased when it is combined with Fusidic Acid.
IdelalisibThe serum concentration of Axitinib can be increased when it is combined with Idelalisib.
IndinavirThe serum concentration of Axitinib can be increased when it is combined with Indinavir.
ItraconazoleThe serum concentration of Axitinib can be increased when it is combined with Itraconazole.
IvacaftorThe serum concentration of Axitinib can be increased when it is combined with Ivacaftor.
KetoconazoleThe serum concentration of Axitinib can be increased when it is combined with Ketoconazole.
LuliconazoleThe serum concentration of Axitinib can be increased when it is combined with Luliconazole.
MifepristoneThe serum concentration of Axitinib can be increased when it is combined with Mifepristone.
MitotaneThe serum concentration of Axitinib can be decreased when it is combined with Mitotane.
ModafinilThe serum concentration of Axitinib can be decreased when it is combined with Modafinil.
NafcillinThe serum concentration of Axitinib can be decreased when it is combined with Nafcillin.
NefazodoneThe serum concentration of Axitinib can be increased when it is combined with Nefazodone.
NelfinavirThe serum concentration of Axitinib can be increased when it is combined with Nelfinavir.
NetupitantThe serum concentration of Axitinib can be increased when it is combined with Netupitant.
PalbociclibThe serum concentration of Axitinib can be increased when it is combined with Palbociclib.
PamidronateThe risk or severity of adverse effects can be increased when Axitinib is combined with Pamidronate.
PhenobarbitalThe serum concentration of Axitinib can be decreased when it is combined with Phenobarbital.
PhenytoinThe serum concentration of Axitinib can be decreased when it is combined with Phenytoin.
PosaconazoleThe serum concentration of Axitinib can be increased when it is combined with Posaconazole.
PrimidoneThe serum concentration of Axitinib can be decreased when it is combined with Primidone.
RifabutinThe serum concentration of Axitinib can be decreased when it is combined with Rifabutin.
RifampicinThe serum concentration of Axitinib can be decreased when it is combined with Rifampicin.
RifapentineThe serum concentration of Axitinib can be decreased when it is combined with Rifapentine.
RitonavirThe serum concentration of Axitinib can be increased when it is combined with Ritonavir.
SaquinavirThe serum concentration of Axitinib can be increased when it is combined with Saquinavir.
SiltuximabThe serum concentration of Axitinib can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Axitinib can be increased when it is combined with Simeprevir.
St. John's WortThe serum concentration of Axitinib can be decreased when it is combined with St. John's Wort.
StiripentolThe serum concentration of Axitinib can be increased when it is combined with Stiripentol.
TelaprevirThe serum concentration of Axitinib can be increased when it is combined with Telaprevir.
TelithromycinThe serum concentration of Axitinib can be increased when it is combined with Telithromycin.
TocilizumabThe serum concentration of Axitinib can be decreased when it is combined with Tocilizumab.
VoriconazoleThe serum concentration of Axitinib can be increased when it is combined with Voriconazole.
Food Interactions
  • Avoid combination with strong CYP3A4 inhibitors such as grapefruit juice due to the likely increased levels of axitinib. If the combination cannot be avoided, reduce axitinib dose by 50%.
  • Axitinib can be taken with or without food.

Targets

1. Vascular endothelial growth factor receptor 1

Kind: Protein

Organism: Human

Pharmacological action: yes

Actions: inhibitor

Components

Name UniProt ID Details
Vascular endothelial growth factor receptor 1 P17948 Details

References:

  1. Cohen EE, Rosen LS, Vokes EE, Kies MS, Forastiere AA, Worden FP, Kane MA, Sherman E, Kim S, Bycott P, Tortorici M, Shalinsky DR, Liau KF, Cohen RB: Axitinib Is an Active Treatment for All Histologic Subtypes of Advanced Thyroid Cancer: Results From a Phase II Study. J Clin Oncol. 2008 Jun 9. Pubmed

2. Vascular endothelial growth factor receptor 2

Kind: Protein

Organism: Human

Pharmacological action: yes

Actions: inhibitor

Components

Name UniProt ID Details
Vascular endothelial growth factor receptor 2 P35968 Details

References:

  1. Cohen EE, Rosen LS, Vokes EE, Kies MS, Forastiere AA, Worden FP, Kane MA, Sherman E, Kim S, Bycott P, Tortorici M, Shalinsky DR, Liau KF, Cohen RB: Axitinib Is an Active Treatment for All Histologic Subtypes of Advanced Thyroid Cancer: Results From a Phase II Study. J Clin Oncol. 2008 Jun 9. Pubmed

3. Vascular endothelial growth factor receptor 3

Kind: Protein

Organism: Human

Pharmacological action: yes

Actions: inhibitor

Components

Name UniProt ID Details
Vascular endothelial growth factor receptor 3 P35916 Details

References:

  1. Cohen EE, Rosen LS, Vokes EE, Kies MS, Forastiere AA, Worden FP, Kane MA, Sherman E, Kim S, Bycott P, Tortorici M, Shalinsky DR, Liau KF, Cohen RB: Axitinib Is an Active Treatment for All Histologic Subtypes of Advanced Thyroid Cancer: Results From a Phase II Study. J Clin Oncol. 2008 Jun 9. Pubmed

Enzymes

1. Cytochrome P450 3A4

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Cytochrome P450 3A4 P08684 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

2. Cytochrome P450 3A5

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Cytochrome P450 3A5 P20815 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

3. Cytochrome P450 1A2

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Cytochrome P450 1A2 P05177 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

4. Cytochrome P450 2C19

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Cytochrome P450 2C19 P33261 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

5. UDP-glucuronosyltransferase 1-1

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
UDP-glucuronosyltransferase 1-1 P22309 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

Transporters

1. Multidrug resistance protein 1

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Multidrug resistance protein 1 P08183 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed
  2. Chen Y, Tortorici MA, Garrett M, Hee B, Klamerus KJ, Pithavala YK: Clinical Pharmacology of Axitinib. Clin Pharmacokinet. 2013 May 16. Pubmed

2. Solute carrier organic anion transporter family member 1B1

Kind: Protein

Organism: Human

Pharmacological action: no

Actions: substrate

Components

Name UniProt ID Details
Solute carrier organic anion transporter family member 1B1 Q9Y6L6 Details

References:

  1. Brennan M, Williams JA, Chen Y, Tortorici M, Pithavala Y, Liu YC: Meta-analysis of contribution of genetic polymorphisms in drug-metabolizing enzymes or transporters to axitinib pharmacokinetics. Eur J Clin Pharmacol. 2012 May;68(5):645-55. doi: 10.1007/s00228-011-1171-8. Epub 2011 Dec 15. Pubmed

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Drug created on March 19, 2008 10:41 / Updated on January 15, 2016 17:38