Identification
NameDegarelix
Accession NumberDB06699
TypeSmall Molecule
GroupsApproved
Description

Degarelix is used for the treatment of advanced prostate cancer. Degarelix is a synthetic peptide derivative drug which binds to gonadotropin-releasing hormone (GnRH) receptors in the pituitary gland and blocks interaction with GnRH. This antagonism reduces luteinising hormone (LH) and follicle-stimulating hormone (FSH) which ultimately causes testosterone suppression. Reduction in testosterone is important in treating men with advanced prostate cancer. Chemically, it is a synthetic linear decapeptide amide with seven unnatural amino acids, five of which are D-amino acids. FDA approved on December 24, 2008.

Structure
Thumb
SynonymsNot Available
External IDs FE200486
Product Ingredients
IngredientUNIICASInChI KeyDetails
Degarelix acetate hydrateEXT215F4ZU 934246-14-7AUTFSFUMNFDPLH-KYMMNHPFSA-NDetails
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
FirmagonPowder, for solution80 mgSubcutaneousFerring Pharmaceuticals2009-11-24Not applicableCanada
FirmagonInjection, powder, for solution120 mgSubcutaneousFerring Pharmaceuticals2009-02-17Not applicableEu
FirmagonKitFerring Pharmaceuticals2009-03-02Not applicableUs
FirmagonPowder, for solution120 mgSubcutaneousFerring Pharmaceuticals2009-11-24Not applicableCanada
FirmagonInjection, powder, for solution80 mgSubcutaneousFerring Pharmaceuticals2009-02-17Not applicableEu
FirmagonInjection, powder, for solution80 mgSubcutaneousFerring Pharmaceuticals2009-02-17Not applicableEu
FirmagonKitFerring Pharmaceuticals2009-03-02Not applicableUs
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixturesNot Available
Categories
UNIISX0XJI3A11
CAS number214766-78-6
WeightAverage: 1632.29
Monoisotopic: 1630.748797
Chemical FormulaC82H103ClN18O16
InChI KeyMEUCPCLKGZSHTA-XYAYPHGZSA-N
InChI
InChI=1S/C82H103ClN18O16/c1-45(2)35-60(72(107)92-59(16-9-10-33-87-46(3)4)80(115)101-34-12-17-68(101)79(114)88-47(5)70(84)105)93-74(109)63(38-51-23-30-58(31-24-51)91-81(85)116)95-76(111)64(39-50-21-28-57(29-22-50)90-71(106)66-42-69(104)100-82(117)99-66)97-78(113)67(44-102)98-77(112)65(41-53-13-11-32-86-43-53)96-75(110)62(37-49-19-26-56(83)27-20-49)94-73(108)61(89-48(6)103)40-52-18-25-54-14-7-8-15-55(54)36-52/h7-8,11,13-15,18-32,36,43,45-47,59-68,87,102H,9-10,12,16-17,33-35,37-42,44H2,1-6H3,(H2,84,105)(H,88,114)(H,89,103)(H,90,106)(H,92,107)(H,93,109)(H,94,108)(H,95,111)(H,96,110)(H,97,113)(H,98,112)(H3,85,91,116)(H2,99,100,104,117)/t47-,59+,60+,61-,62-,63-,64+,65-,66+,67+,68+/m1/s1
IUPAC Name
(4S)-N-{4-[(2S)-2-{[(1R)-2-[4-(carbamoylamino)phenyl]-1-{[(1S)-1-{[(2S)-1-[(2S)-2-{[(1R)-1-carbamoylethyl]carbamoyl}pyrrolidin-1-yl]-1-oxo-6-[(propan-2-yl)amino]hexan-2-yl]carbamoyl}-3-methylbutyl]carbamoyl}ethyl]carbamoyl}-2-[(2S)-2-[(2R)-2-[(2R)-3-(4-chlorophenyl)-2-[(2R)-2-acetamido-3-(naphthalen-2-yl)propanamido]propanamido]-3-(pyridin-3-yl)propanamido]-3-hydroxypropanamido]ethyl]phenyl}-2,6-dioxo-1,3-diazinane-4-carboxamide
SMILES
CC(C)C[[email protected]](NC(=O)[C@@H](CC1=CC=C(NC(N)=O)C=C1)NC(=O)[[email protected]](CC1=CC=C(NC(=O)[C@@H]2CC(=O)NC(=O)N2)C=C1)NC(=O)[[email protected]](CO)NC(=O)[C@@H](CC1=CC=CN=C1)NC(=O)[C@@H](CC1=CC=C(Cl)C=C1)NC(=O)[C@@H](CC1=CC=C2C=CC=CC2=C1)NC(C)=O)C(=O)N[C@@H](CCCCNC(C)C)C(=O)N1CCC[[email protected]]1C(=O)N[[email protected]](C)C(N)=O
Pharmacology
Indication

Degaralix is used for the management of advanced prostate cancer.

Structured Indications
Pharmacodynamics

Degarelix is a synthetic derivative of GnRH decapeptide, the ligand of the GnRH receptor. Gonadotropin and androgen production result from the binding of endogenous GnRH to the GnRH receptor. Degarelix antagonizes the GnRH receptor which in turn blocks the release of LH and FSH from the pituitary. LF and FSH decreases in a concentration-dependent manner. The reduction in LH leads to a decrease in testosterone release from the testes.

Mechanism of action

GnRH antagonists compete with natural GnRH for binding to GnRH receptors in the pituitary gland. This reversible blinding blocks the release of LH and FSH from the pituitary. The reduction in LH subsequently leads to a rapid and sustained suppression of testosterone release from the testes and subsequently reduces the size and growth of the prostate cancer.

TargetKindPharmacological actionActionsOrganismUniProt ID
Gonadotropin-releasing hormone receptorProteinyes
antagonist
HumanP30968 details
Related Articles
Absorption

Degarelix forms a depot at the site of injection after subcutaneous administration from which the drug slowly released into circulation. After a single bolus dose of 2mg/kg, peak plasma concentrations of degarelix occured within 6 hours at a concentration of 330 ng/mL. Ki = 0.082 ng/mL and 93% of receptors were fully suppressed; MRT = 4.5 days.

Volume of distribution

Central compartment: 8.88 - 11.4 L; Peripheral compartment: 40.9 L

Protein binding

90% of the drug is bound to plasma proteins.

Metabolism

70% - 80% of degarelix is subject to peptide hydrolysis during its passage through the hepatobiliary system and then fecally eliminated. No active or inactive metabolites or involvement of CYP450 isozymes.

Route of elimination

Fecal (70% to 80%) and renal (20%-30% of unchanged drug)

Half life

Terminal half-life: 41.5 - 70.2 days; Absorption half-life: 32.9 hours; Half-life from injection site: 1.17 days.

Clearance

Following subcutaneous administration of degarelix to prostate cancer patients the clearance is approximately 9 L/hr.

Toxicity

The most commonly observed adverse reactions (> 10%) during degarelix therapy included injection site reactions (e.g., pain, erythema, swelling, or induration), hot flashes, increased weight, and increases in serum levels of transaminases and gamma-glutamyltransferase (GGT).

Affected organisms
  • Humans and other mammals
PathwaysNot Available
Pharmacogenomic Effects/ADRs Not Available
Interactions
Drug Interactions
DrugInteractionDrug group
AmiodaroneDegarelix may increase the QTc-prolonging activities of Amiodarone.Approved, Investigational
AnagrelideDegarelix may increase the QTc-prolonging activities of Anagrelide.Approved
Arsenic trioxideDegarelix may increase the QTc-prolonging activities of Arsenic trioxide.Approved, Investigational
ArtemetherDegarelix may increase the QTc-prolonging activities of Artemether.Approved
AsenapineDegarelix may increase the QTc-prolonging activities of Asenapine.Approved
AzithromycinDegarelix may increase the QTc-prolonging activities of Azithromycin.Approved
BedaquilineDegarelix may increase the QTc-prolonging activities of Bedaquiline.Approved
CeritinibDegarelix may increase the QTc-prolonging activities of Ceritinib.Approved
ChloroquineDegarelix may increase the QTc-prolonging activities of Chloroquine.Approved, Vet Approved
ChlorpromazineDegarelix may increase the QTc-prolonging activities of Chlorpromazine.Approved, Vet Approved
CiprofloxacinDegarelix may increase the QTc-prolonging activities of Ciprofloxacin.Approved, Investigational
CisaprideDegarelix may increase the QTc-prolonging activities of Cisapride.Approved, Investigational, Withdrawn
CitalopramDegarelix may increase the QTc-prolonging activities of Citalopram.Approved
ClarithromycinDegarelix may increase the QTc-prolonging activities of Clarithromycin.Approved
ClozapineDegarelix may increase the QTc-prolonging activities of Clozapine.Approved
CrizotinibDegarelix may increase the QTc-prolonging activities of Crizotinib.Approved
DisopyramideDegarelix may increase the QTc-prolonging activities of Disopyramide.Approved
DofetilideDegarelix may increase the QTc-prolonging activities of Dofetilide.Approved
DolasetronDegarelix may increase the QTc-prolonging activities of Dolasetron.Approved
DomperidoneDegarelix may increase the QTc-prolonging activities of Domperidone.Approved, Investigational, Vet Approved
DronedaroneDegarelix may increase the QTc-prolonging activities of Dronedarone.Approved
DroperidolDegarelix may increase the QTc-prolonging activities of Droperidol.Approved, Vet Approved
EliglustatDegarelix may increase the QTc-prolonging activities of Eliglustat.Approved
ErythromycinDegarelix may increase the QTc-prolonging activities of Erythromycin.Approved, Vet Approved
EscitalopramDegarelix may increase the QTc-prolonging activities of Escitalopram.Approved, Investigational
FlecainideDegarelix may increase the QTc-prolonging activities of Flecainide.Approved, Withdrawn
FluoxetineDegarelix may increase the QTc-prolonging activities of Fluoxetine.Approved, Vet Approved
FlupentixolDegarelix may increase the QTc-prolonging activities of Flupentixol.Approved, Withdrawn
Gadobenic acidDegarelix may increase the QTc-prolonging activities of Gadobenic acid.Approved
GemifloxacinDegarelix may increase the QTc-prolonging activities of Gemifloxacin.Approved, Investigational
GoserelinDegarelix may increase the QTc-prolonging activities of Goserelin.Approved
GranisetronDegarelix may increase the QTc-prolonging activities of Granisetron.Approved, Investigational
HaloperidolDegarelix may increase the QTc-prolonging activities of Haloperidol.Approved
IbutilideDegarelix may increase the QTc-prolonging activities of Ibutilide.Approved
IloperidoneDegarelix may increase the QTc-prolonging activities of Iloperidone.Approved
LenvatinibDegarelix may increase the QTc-prolonging activities of Lenvatinib.Approved
LeuprolideDegarelix may increase the QTc-prolonging activities of Leuprolide.Approved, Investigational
LevofloxacinDegarelix may increase the QTc-prolonging activities of Levofloxacin.Approved, Investigational
LopinavirDegarelix may increase the QTc-prolonging activities of Lopinavir.Approved
LumefantrineDegarelix may increase the QTc-prolonging activities of Lumefantrine.Approved
MethadoneDegarelix may increase the QTc-prolonging activities of Methadone.Approved
MifepristoneMifepristone may increase the QTc-prolonging activities of Degarelix.Approved, Investigational
MoxifloxacinDegarelix may increase the QTc-prolonging activities of Moxifloxacin.Approved, Investigational
NilotinibDegarelix may increase the QTc-prolonging activities of Nilotinib.Approved, Investigational
OfloxacinDegarelix may increase the QTc-prolonging activities of Ofloxacin.Approved
OndansetronDegarelix may increase the QTc-prolonging activities of Ondansetron.Approved
PaliperidoneDegarelix may increase the QTc-prolonging activities of Paliperidone.Approved
PanobinostatDegarelix may increase the QTc-prolonging activities of Panobinostat.Approved, Investigational
PazopanibDegarelix may increase the QTc-prolonging activities of Pazopanib.Approved
PentamidineDegarelix may increase the QTc-prolonging activities of Pentamidine.Approved
PerflutrenDegarelix may increase the QTc-prolonging activities of Perflutren.Approved
PimozideDegarelix may increase the QTc-prolonging activities of Pimozide.Approved
PrimaquineDegarelix may increase the QTc-prolonging activities of Primaquine.Approved
ProcainamideDegarelix may increase the QTc-prolonging activities of Procainamide.Approved
PromazineDegarelix may increase the QTc-prolonging activities of Promazine.Approved, Vet Approved
PropafenoneDegarelix may increase the QTc-prolonging activities of Propafenone.Approved
QuetiapineDegarelix may increase the QTc-prolonging activities of Quetiapine.Approved
QuinidineDegarelix may increase the QTc-prolonging activities of Quinidine.Approved
QuinineDegarelix may increase the QTc-prolonging activities of Quinine.Approved
SaquinavirDegarelix may increase the QTc-prolonging activities of Saquinavir.Approved, Investigational
SotalolDegarelix may increase the QTc-prolonging activities of Sotalol.Approved
SulfisoxazoleDegarelix may increase the QTc-prolonging activities of Sulfisoxazole.Approved, Vet Approved
TelavancinDegarelix may increase the QTc-prolonging activities of Telavancin.Approved
TelithromycinDegarelix may increase the QTc-prolonging activities of Telithromycin.Approved
TetrabenazineDegarelix may increase the QTc-prolonging activities of Tetrabenazine.Approved
ThioridazineDegarelix may increase the QTc-prolonging activities of Thioridazine.Withdrawn
ToremifeneDegarelix may increase the QTc-prolonging activities of Toremifene.Approved, Investigational
VandetanibDegarelix may increase the QTc-prolonging activities of Vandetanib.Approved
VemurafenibDegarelix may increase the QTc-prolonging activities of Vemurafenib.Approved
ZiprasidoneDegarelix may increase the QTc-prolonging activities of Ziprasidone.Approved
ZuclopenthixolDegarelix may increase the QTc-prolonging activities of Zuclopenthixol.Approved, Investigational
Food InteractionsNot Available
References
Synthesis Reference

Carin WINDERSTROM, "KIT AND METHOD FOR PREPARATION OF A DEGARELIX SOLUTION." U.S. Patent US20100286603, issued November 11, 2010.

US20100286603
General References
  1. Steinberg M: Degarelix: a gonadotropin-releasing hormone antagonist for the management of prostate cancer. Clin Ther. 2009;31 Pt 2:2312-31. doi: 10.1016/j.clinthera.2009.11.009. [PubMed:20110043 ]
  2. Persson BE, Kold Olesen T, Jensen JK: Degarelix: a new approach for the treatment of prostate cancer. Neuroendocrinology. 2009;90(3):235-44. doi: 10.1159/000228832. Epub 2009 Jul 14. [PubMed:19602868 ]
External Links
ATC CodesL02BX02 — Degarelix
AHFS Codes
  • 10:00
PDB EntriesNot Available
FDA labelDownload (448 KB)
MSDSDownload (479 KB)
Clinical Trials
Clinical Trials
PhaseStatusPurposeConditionsCount
1Active Not RecruitingBasic ScienceMalignant Neoplasm of Prostate1
1Active Not RecruitingBasic ScienceNormal Healthy Volunteers1
1RecruitingNot AvailableMalignant Neoplasm of Prostate1
1, 2Active Not RecruitingTreatmentProstate Cancer Adenocarcinoma in Situ1
1, 2RecruitingTreatmentAdenocarcinoma, Prostate / Stage I Prostate Cancer / Stage IIA Prostate Cancer / Stage IIB Prostate Cancer / Stage III Prostate Cancer1
2Active Not RecruitingTreatmentBreast Cancer Invasive Nos1
2Active Not RecruitingTreatmentMalignant Neoplasm of Prostate4
2Active Not RecruitingTreatmentMetastatic Castration Sensitive Prostate Cancer1
2CompletedTreatmentBenign Prostatic Hypertrophy (BPH)1
2CompletedTreatmentLower Urinary Tract Symptoms (LUTS)1
2CompletedTreatmentMalignant Neoplasm of Prostate12
2CompletedTreatmentProstatic Neoplasms1
2Not Yet RecruitingTreatmentAndrogen Antagonists / Malignant Neoplasm of Prostate / Neoadjuvant Therapy / Prostatectomy1
2RecruitingSupportive CareAdenocarcinoma of the Prostate / Recurrent Prostate Cancer / Stage III Prostate Cancer / Stage IV Prostate Cancer1
2RecruitingTreatmentAdenocarcinoma, Prostate1
2RecruitingTreatmentMalignant Neoplasm of Prostate2
2RecruitingTreatmentMetastatic Prostatic Adenocarcinoma1
2RecruitingTreatmentProstatic Neoplasms1
2RecruitingTreatmentStage III Prostate Adenocarcinoma / Stage III Prostate Cancer / Stage IV Prostate Adenocarcinoma / Stage IV Prostate Cancer1
2TerminatedTreatmentMalignant Neoplasm of Prostate3
2TerminatedTreatmentProstatic Neoplasms1
2Unknown StatusTreatmentProstate Neoplasms1
2WithdrawnTreatmentLocalized Prostate Cancer / Malignant Neoplasm of Prostate1
2, 3CompletedTreatmentMalignant Neoplasm of Prostate3
3CompletedTreatmentEndometriosis1
3CompletedTreatmentInfertilities / OHSS / Polycystic Ovarian Syndrome1
3CompletedTreatmentMalignant Neoplasm of Prostate14
3RecruitingTreatmentMalignant Neoplasm of Prostate3
3TerminatedTreatmentMalignant Neoplasm of Prostate2
3WithdrawnTreatmentMalignant Neoplasm of Prostate1
4RecruitingNot AvailableCardiovascular Disease (CVD) / Prostatic Neoplasms1
4RecruitingOtherMalignant Neoplasm of Prostate1
4RecruitingTreatmentMalignant Neoplasm of Prostate1
4TerminatedTreatmentProstate Cancer Recurrent1
Not AvailableActive Not RecruitingNot AvailableAdvanced Hormone Dependent Prostate Cancer1
Not AvailableActive Not RecruitingNot AvailableAdvanced Hormone Sensitive Prostate Cancer1
Not AvailableActive Not RecruitingTreatmentMalignant Neoplasm of Prostate / Prostatic Adenocarcinoma1
Not AvailableActive Not RecruitingTreatmentStage IV Prostate Cancer1
Not AvailableCompletedTreatmentAdenocarcinoma, Prostate / Stage IIA Prostate Cancer / Stage IIB Prostate Cancer / Stage III Prostate Cancer / Stage IV Prostate Cancer1
Not AvailableCompletedTreatmentMalignant Neoplasm of Prostate1
Not AvailableRecruitingNot AvailableAdvanced Prostate Cancer1
Not AvailableRecruitingNot AvailableMalignant Neoplasm of Prostate2
Not AvailableRecruitingDiagnosticBMI >30 kg/m2 / Fertility1
Not AvailableUnknown StatusNot AvailableMalignant Neoplasm of Prostate1
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
Injection, powder, for solutionSubcutaneous120 mg
Injection, powder, for solutionSubcutaneous80 mg
Kit
Powder, for solutionSubcutaneous120 mg
Powder, for solutionSubcutaneous80 mg
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
CA2286190 No2007-01-092018-04-13Canada
US5925730 No2001-05-182021-05-18Us
Properties
StateSolid
Experimental PropertiesNot Available
Predicted Properties
PropertyValueSource
Water Solubility0.0041 mg/mLALOGPS
logP2.66ALOGPS
logP0.18ChemAxon
logS-5.6ALOGPS
pKa (Strongest Acidic)10.55ChemAxon
pKa (Strongest Basic)11.16ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count18ChemAxon
Hydrogen Donor Count17ChemAxon
Polar Surface Area512.87 Å2ChemAxon
Rotatable Bond Count41ChemAxon
Refractivity431.13 m3·mol-1ChemAxon
Polarizability168.98 Å3ChemAxon
Number of Rings8ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.8352
Blood Brain Barrier-0.953
Caco-2 permeable-0.7556
P-glycoprotein substrateSubstrate0.8461
P-glycoprotein inhibitor INon-inhibitor0.6672
P-glycoprotein inhibitor IINon-inhibitor0.7791
Renal organic cation transporterNon-inhibitor0.8579
CYP450 2C9 substrateNon-substrate0.7299
CYP450 2D6 substrateNon-substrate0.8156
CYP450 3A4 substrateSubstrate0.6482
CYP450 1A2 substrateNon-inhibitor0.8566
CYP450 2C9 inhibitorNon-inhibitor0.6493
CYP450 2D6 inhibitorNon-inhibitor0.8566
CYP450 2C19 inhibitorNon-inhibitor0.7291
CYP450 3A4 inhibitorNon-inhibitor0.5961
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8478
Ames testNon AMES toxic0.652
CarcinogenicityNon-carcinogens0.7848
BiodegradationNot ready biodegradable1.0
Rat acute toxicity2.7005 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.8534
hERG inhibition (predictor II)Inhibitor0.5235
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as polypeptides. These are peptides containing ten or more amino acid residues.
KingdomOrganic compounds
Super ClassOrganic Polymers
ClassPolypeptides
Sub ClassNot Available
Direct ParentPolypeptides
Alternative ParentsPeptides / Phenylalanine and derivatives / Leucine and derivatives / Proline and derivatives / N-acyl-alpha amino acids and derivatives / Alpha amino acid amides / Serine and derivatives / Alanine and derivatives / Amphetamines and derivatives / N-phenylureas
SubstituentsPolypeptide / Alpha peptide / Phenylalanine or derivatives / Leucine or derivatives / Proline or derivatives / N-acyl-alpha amino acid or derivatives / Alpha-amino acid amide / Serine or derivatives / Alanine or derivatives / N-substituted-alpha-amino acid
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Peptide binding
Specific Function:
Receptor for gonadotropin releasing hormone (GnRH) that mediates the action of GnRH to stimulate the secretion of the gonadotropic hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This receptor mediates its action by association with G-proteins that activate a phosphatidylinositol-calcium second messenger system. Isoform 2 may act as an inhibitor of GnRH-R signaling.
Gene Name:
GNRHR
Uniprot ID:
P30968
Molecular Weight:
37730.355 Da
References
  1. Steinberg M: Degarelix: a gonadotropin-releasing hormone antagonist for the management of prostate cancer. Clin Ther. 2009;31 Pt 2:2312-31. doi: 10.1016/j.clinthera.2009.11.009. [PubMed:20110043 ]
  2. Kirby RS, Fitzpatrick JM, Clarke N: Abarelix and other gonadotrophin-releasing hormone antagonists in prostate cancer. BJU Int. 2009 Dec;104(11):1580-4. doi: 10.1111/j.1464-410X.2009.08924.x. [PubMed:20053189 ]
  3. Anderson J: Degarelix: a novel gonadotropin-releasing hormone blocker for the treatment of prostate cancer. Future Oncol. 2009 May;5(4):433-43. doi: 10.2217/fon.09.24. [PubMed:19450172 ]
  4. Samant MP, Miller C, Hong DJ, Koerber SC, Croston G, Rivier CL, Rivier JE: Synthesis and biological activity of GnRH antagonists modified at position 3 with 3-(2-methoxy-5-pyridyl)-alanine. J Pept Res. 2005 Feb;65(2):284-91. [PubMed:15705170 ]
Drug created on May 06, 2010 10:15 / Updated on July 22, 2017 18:09