Benznidazole

Identification

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Name
Benznidazole
Accession Number
DB11989
Type
Small Molecule
Groups
Approved, Investigational
Description

Benznidazole was granted accelerated approval for the treatment of Chagas disease in children 2-12 years of age by the FDA on August 29, 2017 [9]. It is the first treatment made available in the United States for Chagas disease.

Structure
Thumb
Synonyms
  • benznidazol
  • Benznidazole
External IDs
NSC-299972 / RO 07-1051
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
BenznidazoleTablet100 mg/1OralExeltis Usa, Inc.2018-03-30Not applicableUs
BenznidazoleTablet12.5 mg/1OralExeltis Usa, Inc.2018-03-30Not applicableUs
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Categories
UNII
YC42NRJ1ZD
CAS number
22994-85-0
Weight
Average: 260.253
Monoisotopic: 260.090940262
Chemical Formula
C12H12N4O3
InChI Key
CULUWZNBISUWAS-UHFFFAOYSA-N
InChI
InChI=1S/C12H12N4O3/c17-11(14-8-10-4-2-1-3-5-10)9-15-7-6-13-12(15)16(18)19/h1-7H,8-9H2,(H,14,17)
IUPAC Name
N-benzyl-2-(2-nitro-1H-imidazol-1-yl)ethanimidic acid
SMILES
OC(CN1C=CN=C1N(=O)=O)=NCC1=CC=CC=C1

Pharmacology

Indication

For use in the treatment of Chagas disease in children 2-12 years of age [9].

Associated Conditions
Pharmacodynamics

Benznidazole is a trypanocidal agent which kills the causative organism in Chagas disease, Trypanosoma cruzi [1].

Mechanism of action

Benznidazole is thought to be reduced to various electrophilic metabolites by nitroreductases present in Trypanosoma cruzi [1]. These metabolites likely bind to proteins, lipids, DNA, and RNA resulting in damage to these macromolecules. Benznidazole has been found to increase trypanosomal death through interferon-γ which is likely present in increased amounts due to inflammation caused by macromolecule damage [3]. DNA in parasites affected by benznidazole has been found to undergo extensive unpacking with overexpression of DNA repair proteins supporting the idea of DNA damage contributing to the mechanism of the drug [2].

Additional Data Available
Adverse Effects

Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.

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Additional Data Available
Contraindications

Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

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Additional Data Available
Blackbox Warnings

Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

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Absorption

Benznidazole has a bioavailability of 91.7% and a Tmax of 2.93 h [4, 5].

Volume of distribution

The apparent volume of distribution is 39.19 L [5].

Protein binding
Not Available
Metabolism

Benznidazole is metabolized by nitroreductases in Trypanosoma cruzi and by cytochrome P450 enzymes [5, 6].

Route of elimination

The metabolites of benznidazole appear to be primarily exreted in the urine [6].

Half life

The half life of elimination is 13.27 h [5].

Clearance

The apparent oral clearance is 2.04 L/h [5].

Toxicity

At clinically relevant dosages, benznidazole can produce hepatotoxicity, peripheral neuropathy, and angioedema [7, 8].

Affected organisms
  • Trypanosoma cruzi
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcarboseAcarbose may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Benznidazole which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcrivastineAcrivastine may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Benznidazole which could result in a higher serum level.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

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  • Severity
    Severity

    A severity rating for each drug interaction, from minor to major.

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  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

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  • Action
    Evidence Level

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

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Food Interactions
Not Available

References

General References
  1. Maya JD, Cassels BK, Iturriaga-Vasquez P, Ferreira J, Faundez M, Galanti N, Ferreira A, Morello A: Mode of action of natural and synthetic drugs against Trypanosoma cruzi and their interaction with the mammalian host. Comp Biochem Physiol A Mol Integr Physiol. 2007 Apr;146(4):601-20. Epub 2006 Mar 12. [PubMed:16626984]
  2. Rajao MA, Furtado C, Alves CL, Passos-Silva DG, de Moura MB, Schamber-Reis BL, Kunrath-Lima M, Zuma AA, Vieira-da-Rocha JP, Garcia JB, Mendes IC, Pena SD, Macedo AM, Franco GR, de Souza-Pinto NC, de Medeiros MH, Cruz AK, Motta MC, Teixeira SM, Machado CR: Unveiling benznidazole's mechanism of action through overexpression of DNA repair proteins in Trypanosoma cruzi. Environ Mol Mutagen. 2014 May;55(4):309-21. doi: 10.1002/em.21839. Epub 2013 Dec 18. [PubMed:24347026]
  3. Romanha AJ, Alves RO, Murta SM, Silva JS, Ropert C, Gazzinelli RT: Experimental chemotherapy against Trypanosoma cruzi infection: essential role of endogenous interferon-gamma in mediating parasitologic cure. J Infect Dis. 2002 Sep 15;186(6):823-8. Epub 2002 Aug 16. [PubMed:12198617]
  4. Raaflaub J, Ziegler WH: Single-dose pharmacokinetics of the trypanosomicide benznidazole in man. Arzneimittelforschung. 1979;29(10):1611-4. [PubMed:583230]
  5. Wiens MO, Kanters S, Mills E, Peregrina Lucano AA, Gold S, Ayers D, Ferrero L, Krolewiecki A: Systematic Review and Meta-analysis of the Pharmacokinetics of Benznidazole in the Treatment of Chagas Disease. Antimicrob Agents Chemother. 2016 Nov 21;60(12):7035-7042. Print 2016 Dec. [PubMed:27550362]
  6. Perin L, Moreira da Silva R, Fonseca KD, Cardoso JM, Mathias FA, Reis LE, Molina I, Correa-Oliveira R, Vieira PM, Carneiro CM: Pharmacokinetics and Tissue Distribution of Benznidazole after Oral Administration in Mice. Antimicrob Agents Chemother. 2017 Mar 24;61(4). pii: e02410-16. doi: 10.1128/AAC.02410-16. Print 2017 Apr. [PubMed:28167558]
  7. Miller DA, Hernandez S, Rodriguez De Armas L, Eells SJ, Traina MM, Miller LG, Meymandi SK: Tolerance of benznidazole in a United States Chagas Disease clinic. Clin Infect Dis. 2015 Apr 15;60(8):1237-40. doi: 10.1093/cid/civ005. Epub 2015 Jan 18. [PubMed:25601454]
  8. Davies C, Dey N, Negrette OS, Parada LA, Basombrio MA, Garg NJ: Hepatotoxicity in mice of a novel anti-parasite drug candidate hydroxymethylnitrofurazone: a comparison with Benznidazole. PLoS Negl Trop Dis. 2014 Oct 16;8(10):e3231. doi: 10.1371/journal.pntd.0003231. eCollection 2014 Oct. [PubMed:25329323]
  9. FDA: Benznidazole Announcement [Link]
External Links
PubChem Compound
31593
PubChem Substance
347828309
ChemSpider
29299
BindingDB
50089916
ChEBI
133833
ChEMBL
CHEMBL110
Wikipedia
Benznidazole
ATC Codes
P01CA02 — Benznidazole
MSDS
Download (133 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentChagas Disease1
2Active Not RecruitingTreatmentChagas Disease1
2CompletedTreatmentChagas Disease2
2Unknown StatusTreatmentChronic Chagas Disease, Indeterminate1
2, 3RecruitingTreatmentChagas Disease1
3CompletedTreatmentChagas Disease1
3Not Yet RecruitingTreatmentChagas Disease1
3Unknown StatusTreatmentChagas Disease / Heart Diseases / Trypanosomiasis1
4CompletedDiagnosticChagas Disease1
4CompletedTreatmentChagas Disease1
Not AvailableCompletedNot AvailableChagas Disease1
Not AvailableCompletedBasic ScienceChagas Disease1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
TabletOral100 mg/1
TabletOral12.5 mg/1
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
PropertyValueSource
melting point (°C)190-192MSDS
Predicted Properties
PropertyValueSource
Water Solubility0.306 mg/mLALOGPS
logP1.32ALOGPS
logP1.64ChemAxon
logS-2.9ALOGPS
pKa (Strongest Acidic)2.28ChemAxon
pKa (Strongest Basic)4.37ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area96.23 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity68.65 m3·mol-1ChemAxon
Polarizability25.16 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSNot Available
MS/MS Spectrum - , positiveLC-MS/MSsplash10-00kf-7921100000-e7c8d6322a8bca6ef40f

Taxonomy

Description
This compound belongs to the class of organic compounds known as nitroaromatic compounds. These are c-nitro compounds where the nitro group is C-substituted with an aromatic group.
Kingdom
Organic compounds
Super Class
Organic 1,3-dipolar compounds
Class
Allyl-type 1,3-dipolar organic compounds
Sub Class
Organic nitro compounds
Direct Parent
Nitroaromatic compounds
Alternative Parents
N-substituted imidazoles / Benzene and substituted derivatives / Heteroaromatic compounds / Secondary carboxylic acid amides / Propargyl-type 1,3-dipolar organic compounds / Organic oxoazanium compounds / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Organic zwitterions
show 3 more
Substituents
Nitroaromatic compound / Monocyclic benzene moiety / Benzenoid / N-substituted imidazole / Azole / Imidazole / Heteroaromatic compound / Carboxamide group / Secondary carboxylic acid amide / Carboxylic acid derivative
show 14 more
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
Not Available

Drug created on October 20, 2016 15:08 / Updated on December 16, 2018 06:59