GtoPdb Ligand ID: 9150

Synonyms: compound 9k [PMID: 30446313] | S-297,995 | S-297995
naldemedine is an approved drug (FDA (2017), EMA (2019))
Compound class: Synthetic organic
Comment: Naldemedine (S-297995) is a dual μ/δ opioid receptor antagonist, designed to act peripherally (peripherally acting mu-opioid receptor antagonist or PAMORA) [1]. It is used clinically for its ability to counteract opioid agonist-induced adverse effects such as constipation, nausea, and vomiting. Naldemedine was developed by Shionogi Inc. It is the compound claimed in patent WO2013172297 with formula IA (17-(cyclopropylmethyl)-6,7-didehydro-4,5α-epoxy-3,6,14-trihydroxy-N-[2-(3-phenyl-1,2,4-oxadiazol-5-yl)propan-2-yl]morphinan-7-carboxamide 4-methylbenzenesulfonic acid) [2].
2D Structure
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Physico-chemical Properties
Hydrogen bond acceptors 6
Hydrogen bond donors 4
Rotatable bonds 7
Topological polar surface area 141.18
Molecular weight 570.25
XLogP 3.31
No. Lipinski's rules broken 0
Canonical SMILES O=C(C1=C(O)C2C34C(C1)(O)C(Cc1c4c(O2)c(O)cc1)N(CC3)CC1CC1)NC(c1onc(n1)c1ccccc1)(C)C
Isomeric SMILES O=C(C1=C(O)[C@H]2[C@]34[C@](C1)(O)[C@@H](Cc1c4c(O2)c(O)cc1)N(CC3)CC1CC1)NC(c1onc(n1)c1ccccc1)(C)C
InChI InChI=1S/C32H34N4O6/c1-30(2,29-33-27(35-42-29)18-6-4-3-5-7-18)34-28(39)20-15-32(40)22-14-19-10-11-21(37)25-23(19)31(32,26(41-25)24(20)38)12-13-36(22)16-17-8-9-17/h3-7,10-11,17,22,26,37-38,40H,8-9,12-16H2,1-2H3,(H,34,39)/t22-,26+,31+,32-/m1/s1
No information available.
Summary of Clinical Use
Naldemedine is delivered clinically as the tosylate salt (PubChem CID 56837137). The drug has completed Phase 3 clinical trials to evaluate its efficacy in treating opioid-induced constipation (OIC) in patients receiving opioid analgesics for chronic pain. Click here to link to all naldemedine trials registered at Positive outcomes from a Phase 3 trial (called the COMPOSE I trial) as part of the COMPOSE program translated to US FDA approval (in 2017) as a once-daily treatment for opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain.