Details of the Drug

General Information of Drug (ID: DM50ILT)

• Drug Name: Fostemsavir
• Synonyms: BMS-216; BMS-248; BMS-378806; BMS-626529; BMS-705; BMS-806; BMS-806 series; BMS-853; HIV-1 attachment inhibitors, BMS; HIV-1 entry inhibitors, BMS; BMS-488043 follow-on compounds, BMS; HIV-1 attachment inhibitors, Bristol-Myers Squibb

Indication

Disease Entry	ICD 11	Status	REF
Human immunodeficiency virus infection	1C62	Approved	[1]

• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 2:
  Molecular Weight (mw); 583.5
  Logarithm of the Partition Coefficient (xlogp); -0.1
  Rotatable Bond Count (rotbonds); 8
  Hydrogen Bond Donor Count (hbonddonor); 2
  Hydrogen Bond Acceptor Count (hbondacc); 11
• ADMET Property:
  Absorption AUC: The area under the plot of plasma concentration (AUC) of drug is 12.9 mcgh/L [2]
  Absorption Cmax: The maximum plasma concentration (Cmax) of drug is 1770 mcg/L [2]
  Absorption Tmax: The time to maximum plasma concentration (Tmax) is 2 h [2]
  Bioavailability: The bioavailability of drug is 26.9% [2]
  Clearance: The clearance of drug is 17.9 L/h [3]
  Elimination: Approximately 51% of a given dose is excreted in the urine, with <2% comprising unchanged parent drug, and 33% is excreted in the feces, of which 1.1% is unchanged parent drug [3]
  Half-life: The concentration or amount of drug in body reduced by one-half in 11 hours [3]
  Metabolism: The drug is metabolized via the alkaline phosphatase present at the brush border membrane of the intestinal lumen [2]
  Vd: The volume of distribution (Vd) of drug is 29.5 L [3]
• Chemical Identifiers:
  Formula: C25H26N7O8P
  IUPAC Name: [3-[2-(4-benzoylpiperazin-1-yl)-2-oxoacetyl]-4-methoxy-7-(3-methyl-1,2,4-triazol-1-yl)pyrrolo[2,3-c]pyridin-1-yl]methyl dihydrogen phosphate
  Canonical SMILES: CC1=NN(C=N1)C2=NC=C(C3=C2N(C=C3C(=O)C(=O)N4CCN(CC4)C(=O)C5=CC=CC=C5)COP(=O)(O)O)OC
  InChI: InChI=1S/C25H26N7O8P/c1-16-27-14-32(28-16)23-21-20(19(39-2)12-26-23)18(13-31(21)15-40-41(36,37)38)22(33)25(35)30-10-8-29(9-11-30)24(34)17-6-4-3-5-7-17/h3-7,12-14H,8-11,15H2,1-2H3,(H2,36,37,38)
  InChIKey: SWMDAPWAQQTBOG-UHFFFAOYSA-N
• Cross-matching ID:
  PubChem CID: 11319217
  CAS Number: 864953-29-7
  DrugBank ID: DB11796
  TTD ID: D00ZCT
  ACDINA ID: D01108

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Human immunodeficiency virus Envelope glycoprotein gp120 (HIV gp120)	TTBYP1X	ENV_HV1H2	Inhibitor	[1]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Fostemsavir

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
MK-1439	DM215WE	Minor	Increased metabolism of Fostemsavir caused by MK-1439 mediated induction of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[4]

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

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Ivosidenib	DM8S6T7	Major	Increased risk of prolong QT interval by the combination of Fostemsavir and Ivosidenib.	Acute myeloid leukaemia [2A60]	[5]
Gilteritinib	DMTI0ZO	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Gilteritinib.	Acute myeloid leukaemia [2A60]	[6]
Levalbuterol	DM5YBO1	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Levalbuterol.	Asthma [CA23]	[7]
ABT-492	DMJFD2I	Moderate	Decreased clearance of Fostemsavir due to the transporter inhibition by ABT-492.	Bacterial infection [1A00-1C4Z]	[4]
Troleandomycin	DMUZNIG	Moderate	Decreased metabolism of Fostemsavir caused by Troleandomycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[4]
Pexidartinib	DMS2J0Z	Minor	Increased metabolism of Fostemsavir caused by Pexidartinib mediated induction of CYP450 enzyme.	Bone/articular cartilage neoplasm [2F7B]	[8]
Alpelisib	DMEXMYK	Moderate	Decreased clearance of Fostemsavir due to the transporter inhibition by Alpelisib.	Breast cancer [2C60-2C6Y]	[4]
PF-04449913	DMSB068	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and PF-04449913.	Chronic myelomonocytic leukaemia [2A40]	[9]
Revefenacin	DMMP5SI	Moderate	Decreased clearance of Fostemsavir due to the transporter inhibition by Revefenacin.	Chronic obstructive pulmonary disease [CA22]	[10]
Osilodrostat	DMIJC9X	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Osilodrostat.	Cushing syndrome [5A70]	[11]
Eslicarbazepine	DMZREFQ	Minor	Increased metabolism of Fostemsavir caused by Eslicarbazepine mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[4]
Tazemetostat	DMWP1BH	Minor	Increased metabolism of Fostemsavir caused by Tazemetostat mediated induction of CYP450 enzyme.	Follicular lymphoma [2A80]	[8]
Brigatinib	DM7W94S	Minor	Increased metabolism of Fostemsavir caused by Brigatinib mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[4]
PF-06463922	DMKM7EW	Minor	Increased metabolism of Fostemsavir caused by PF-06463922 mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[4]
Selpercatinib	DMZR15V	Major	Increased risk of prolong QT interval by the combination of Fostemsavir and Selpercatinib.	Lung cancer [2C25]	[12]
Rimegepant	DMHOAUG	Moderate	Decreased clearance of Fostemsavir due to the transporter inhibition by Rimegepant.	Migraine [8A80]	[13]
Siponimod	DM2R86O	Major	Increased risk of ventricular arrhythmias by the combination of Fostemsavir and Siponimod.	Multiple sclerosis [8A40]	[14]
Ozanimod	DMT6AM2	Major	Increased risk of ventricular arrhythmias by the combination of Fostemsavir and Ozanimod.	Multiple sclerosis [8A40]	[15]
Entrectinib	DMMPTLH	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Entrectinib.	Non-small cell lung cancer [2C25]	[14]
Rucaparib	DM9PVX8	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Rucaparib.	Ovarian cancer [2C73]	[4]
Triclabendazole	DMPWGBR	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Triclabendazole.	Parasitic worm infestation [1F90]	[4]
Lefamulin	DME6G97	Major	Increased risk of prolong QT interval by the combination of Fostemsavir and Lefamulin.	Pneumonia [CA40]	[5]
Relugolix	DMK7IWL	Moderate	Increased risk of prolong QT interval by the combination of Fostemsavir and Relugolix.	Prostate cancer [2C82]	[11]
Telotristat ethyl	DMDIYFZ	Minor	Increased metabolism of Fostemsavir caused by Telotristat ethyl mediated induction of CYP450 enzyme.	Small intestine developmental anomaly [DA90]	[8]
Lusutrombopag	DMH6IKO	Moderate	Decreased clearance of Fostemsavir due to the transporter inhibition by Lusutrombopag.	Thrombocytopenia [3B64]	[16]
Elagolix	DMB2C0E	Minor	Increased metabolism of Fostemsavir caused by Elagolix mediated induction of CYP450 enzyme.	Uterine fibroid [2E86]	[8]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Ferric hydroxide oxide yellow	E00539	23320441	Colorant
Hydroxypropyl cellulose	E00632	Not Available	Binding agent; Coating agent; Emulsifying agent; Film/Membrane-forming agent; Modified-release agent; Suspending agent; Viscosity-controlling agent
Hypromellose	E00634	Not Available	Coating agent
Magnesium stearate	E00208	11177	lubricant
Polyethylene glycol 4000	E00654	Not Available	Coating agent; Diluent; Ointment base; Plasticizing agent; Solvent; Suppository base; lubricant
Polyvinyl alcohol	E00666	Not Available	Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent
Haematite red	E00236	14833	Colorant
Hydrophobic colloidal silica	E00285	24261	Anticaking agent; Emulsion stabilizing agent; Glidant; Suspending agent; Viscosity-controlling agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Fostemsavir 600mg Extended-Release tablet	600mg	Extended-Release Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2020
• [2] Yu HZ, Han SF, Li P, Zhu CL, Zhang XX, Gan L, Gan Y: An examination of the potential effect of lipids on the first-pass metabolism of the lipophilic drug anethol trithione. J Pharm Sci. 2011 Nov;100(11):5048-58. doi: 10.1002/jps.22702. Epub 2011 Jul 15.
• [3] FDA Approved Drug Products: Rukobia (fostemsavir) extended-release tablets
• [4] Product Information. Rukobia (fostemsavir). ViiV Healthcare, Research Triangle Park, NC.
• [5] Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
• [6] Product Information. Xospata (gilteritinib). Astellas Pharma US, Inc, Deerfield, IL.
• [7] Product Information. Arcapta Neohaler (indacaterol). Novartis Pharmaceuticals, East Hanover, NJ.
• [8] Product Information. Diabinese (chlorpropamide). Pfizer US Pharmaceuticals, New York, NY.
• [9] Product Information. Daurismo (glasdegib). Pfizer U.S. Pharmaceuticals Group, New York, NY.
• [10] Product Information. Nexletol (bempedoic acid). Esperion Therapeutics, Ann Arbor, MI.
• [11] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [12] Product Information. Retevmo (selpercatinib). Lilly, Eli and Company, Indianapolis, IN.
• [13] Product Information. Nurtec ODT (rimegepant). Biohaven Pharmaceuticals, New Haven, CT.
• [14] Cerner Multum, Inc. "Australian Product Information.".
• [15] Product Information. Zeposia (ozanimod). Celgene Corporation, Summit, NJ.
• [16] EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".