Details of the Drug

General Information of Drug (ID: DM0HXDS)

Drug Name

Pentostatin

Synonyms

Coforin; Covidarabine; Deoxycoformycin; Nipent; Oncopent; Vidarbine; Vira A deaminase inhibitor; CL-67310465; CO-Vidarabine; Co-V; Nipent (TN); PD-81565; PD-ADI; Pentostatin (JAN/USAN/INN); (8R)-3-(2-deoxy-beta-D-erythro-pentofuranosyl)-3,6,7,8-tetrahydroimidazo[4,5-d][1,3]diazepin-8-ol; (8R)-3-[(2R,4S,5R)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]-7,8-dihydro-4H-imidazo[4,5-d][1,3]diazepin-8-ol; (R)-3-(2-Deoxy-.beta.-D-erythro-pentofuranosyl)-3,6,7,8-tetrahydroimidazo(4,5-d)(1,3)diazepin-8-ol; 2'-DCF; 2'-Deoxycoformycin; 2'-Dexoycoformycin

Indication

Disease Entry	ICD 11	Status	REF
Acute graft versus host disease	4B24.0	Approved	[1]
Hairy cell leukaemia	2A82.2	Approved	[2]
Leukemia	N.A.	Approved	[1]
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Therapeutic Class

Anticancer Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 1

Molecular Weight (mw)

268.27

Logarithm of the Partition Coefficient (xlogp)

-2.1

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

Absorption: The drug is not orally absorbed and can cross the blood-brain barrier []
BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [3]
Clearance: The drug present in the plasma can be removed from the body at the rate of 1.63 mL/min/kg [4]
Elimination: 80% of drug is excreted from urine in the unchanged form [3]
Half-life: The concentration or amount of drug in body reduced by one-half in 5.7 hours [4]
Metabolism: The drug is metabolized via the hepatic []
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.24863 micromolar/kg/day [5]
Unbound Fraction: The unbound fraction of drug in plasma is 0.96% [4]
Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.59 L/kg [4]
Water Solubility: The ability of drug to dissolve in water is measured as 30 mg/mL [3]

Chemical Identifiers

Formula: C11H16N4O4
IUPAC Name: (8R)-3-[(2R,4S,5R)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]-7,8-dihydro-4H-imidazo[4,5-d][1,3]diazepin-8-ol
Canonical SMILES: C1[C@@H]([C@H](O[C@H]1N2C=NC3=C2NC=NC[C@H]3O)CO)O
InChI: InChI=1S/C11H16N4O4/c16-3-8-6(17)1-9(19-8)15-5-14-10-7(18)2-12-4-13-11(10)15/h4-9,16-18H,1-3H2,(H,12,13)/t6-,7+,8+,9+/m0/s1
InChIKey: FPVKHBSQESCIEP-JQCXWYLXSA-N

Cross-matching ID

PubChem CID: 439693
CAS Number: 53910-25-1
DrugBank ID: DB00552
TTD ID: D0T3AD
ACDINA ID: D01335

Combinatorial Drugs (CBD)

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Repurposed Drugs (RPD)

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Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Adenosine deaminase (ADA)	TTLP57V	ADA_HUMAN	Inhibitor	[6]

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Molecular Interaction Atlas (MIA)

MIA Detail

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Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Pentostatin (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Roflumilast	DMPGHY8	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Roflumilast.	Asthma [CA23]	[7]
Ofloxacin	DM0VQN3	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Ofloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Trovafloxacin	DM6AN32	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Trovafloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Sparfloxacin	DMB4HCT	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Sparfloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Gemifloxacin	DMHT34O	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Gemifloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Norfloxacin	DMIZ6W2	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Norfloxacin.	Bacterial infection [1A00-1C4Z]	[8]
ABT-492	DMJFD2I	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by ABT-492.	Bacterial infection [1A00-1C4Z]	[8]
Levofloxacin	DMS60RB	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Levofloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Lomefloxacin	DMVRH9C	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Lomefloxacin.	Bacterial infection [1A00-1C4Z]	[8]
Teriflunomide	DMQ2FKJ	Major	Additive myelosuppressive effects by the combination of Pentostatin and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[9]
Nelarabine	DMB6VEG	Moderate	Decreased metabolism of Pentostatin caused by Nelarabine mediated inhibition of non-CYP450 enzyme.	Leukaemia [2A60-2B33]	[10]
Denosumab	DMNI0KO	Moderate	Additive myelosuppressive effects by the combination of Pentostatin and Denosumab.	Low bone mass disorder [FB83]	[11]
Thalidomide	DM70BU5	Major	Additive thrombogenic effects by the combination of Pentostatin and Thalidomide.	Multiple myeloma [2A83]	[12]
Tecfidera	DM2OVDT	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Tecfidera.	Multiple sclerosis [8A40]	[13]
Siponimod	DM2R86O	Major	Additive immunosuppressive effects by the combination of Pentostatin and Siponimod.	Multiple sclerosis [8A40]	[14]
Fingolimod	DM5JVAN	Major	Additive immunosuppressive effects by the combination of Pentostatin and Fingolimod.	Multiple sclerosis [8A40]	[15]
Ocrelizumab	DMEZ2KH	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Ocrelizumab.	Multiple sclerosis [8A40]	[16]
Ozanimod	DMT6AM2	Major	Additive immunosuppressive effects by the combination of Pentostatin and Ozanimod.	Multiple sclerosis [8A40]	[7]
Omacetaxine mepesuccinate	DMPU2WX	Moderate	Additive myelosuppressive effects by the combination of Pentostatin and Omacetaxine mepesuccinate.	Myeloproliferative neoplasm [2A20]	[17]
Gatifloxacin	DMSL679	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[8]
Canakinumab	DM8HLO5	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Canakinumab.	Rheumatoid arthritis [FA20]	[18]
Rilonacept	DMGLUQS	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Rilonacept.	Rheumatoid arthritis [FA20]	[18]
Golimumab	DMHZV7X	Major	Additive immunosuppressive effects by the combination of Pentostatin and Golimumab.	Rheumatoid arthritis [FA20]	[19]
Leflunomide	DMR8ONJ	Major	Additive myelosuppressive effects by the combination of Pentostatin and Leflunomide.	Rheumatoid arthritis [FA20]	[9]
Anthrax vaccine	DM9GSWY	Moderate	Antagonize the effect of Pentostatin when combined with Anthrax vaccine.	Sepsis [1G40-1G41]	[20]
Azathioprine	DMMZSXQ	Moderate	Additive immunosuppressive effects by the combination of Pentostatin and Azathioprine.	Transplant rejection [NE84]	[14]
Cinoxacin	DM4EWNS	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Cinoxacin.	Urinary tract infection [GC08]	[8]
Nalidixic acid	DMRM0JV	Minor	Decreased absorption of Pentostatin due to intestinal mucosa variation caused by Nalidixic acid.	Urinary tract infection [GC08]	[8]
Ganciclovir	DM1MBYQ	Moderate	Additive myelosuppressive effects by the combination of Pentostatin and Ganciclovir.	Virus infection [1A24-1D9Z]	[14]
Valganciclovir	DMS2IUH	Moderate	Additive myelosuppressive effects by the combination of Pentostatin and Valganciclovir.	Virus infection [1A24-1D9Z]	[14]
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Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Hydrochloric acid	E00015	313	Acidulant
Mannitol	E00103	6251	Diluent; Flavoring agent; Lyophilization aid; Plasticizing agent; Tonicity agent
Sodium hydroxide	E00234	14798	Alkalizing agent
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Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Pentostatin 10mg/vial injectable	10mg/vial	Injectable	Injection

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References

1	Pentostatin FDA Label
2	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 4805).
3	BDDCS applied to over 900 drugs
4	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
5	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
6	Purine nucleoside analogs in indolent non-Hodgkin's lymphoma. Oncology (Williston Park). 2000 Jun;14(6 Suppl 2):13-5.
7	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
8	Johnson EJ, MacGowan AP, Potter MN, et al "Reduced absorption of oral ciprofloxacin after chemotherapy for haematological malignancy." J Antimicrob Chemother 25 (1990): 837-42. [PMID: 2373666]
9	Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
10	Product Information. Arranon (nelarabine). GlaxoSmithKline, Research Triangle Park, NC.
11	Product Information. Prolia (denosumab). Amgen USA, Thousand Oaks, CA.
12	Bennett CL, Nebeker JR, Samore MH, et al "The Research on Adverse Drug Events and Reports (RADAR) project." JAMA 293 (2005): 2131-40. [PMID: 15870417]
13	Product Information. Vumerity (diroximel fumarate). Alkermes, Inc, Cambridge, MA.
14	Cerner Multum, Inc. "Australian Product Information.".
15	Product Information. Gilenya (fingolimod). Novartis Pharmaceuticals, East Hanover, NJ.
16	Product Information. Ocrevus (ocrelizumab). Genentech, South San Francisco, CA.
17	Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
18	Product Information. Arcalyst (rilonacept). Regeneron Pharmaceuticals Inc, Tarrytown, NY.
19	Product Information. Cimzia (certolizumab). UCB Pharma Inc, Smyrna, GA.
20	CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18. [PMID: 20300058]