General Information of Drug (ID: DM6AUHV)

Drug Name
Fostamatinib
Synonyms 901119-35-5; R788; Tavalisse; UNII-SQ8A3S5101; R-788 Free acid; R 788; R-788; R-935788 Free acid; SQ8A3S5101; R7935788; Fostamatinib [USAN:INN]
Indication
Disease Entry ICD 11 Status REF
Immune thrombocytopenic purpura 3B64.13 Approved [1]
Rheumatoid arthritis FA20 Phase 3 [2], [3]
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 2 Molecular Weight (mw) 580.5
Topological Polar Surface Area (xlogp) 1.6
Rotatable Bond Count (rotbonds) 10
Hydrogen Bond Donor Count (hbonddonor) 4
Hydrogen Bond Acceptor Count (hbondacc) 15
ADMET Property
Absorption Tmax
The time to maximum plasma concentration (Tmax) is 1.5 h [4]
Bioavailability
The bioavailability of drug is 55% [4]
Clearance
The apparent oral clearance of drug is 300 mL/min [4]
Elimination
About 80% of R406 is excreted in the feces, primarily as the O-glucuronide conjugate and the O-desmethyl metabolite produced by gut bacteria [5]
Half-life
The concentration or amount of drug in body reduced by one-half in 406 hours [4]
Metabolism
The drug is metabolized via the alkaline phosphatase to the active metabolite R406 [6]
Vd
The volume of distribution (Vd) of drug is 400 L [4]
Chemical Identifiers
Formula
C23H26FN6O9P
IUPAC Name
[6-[[5-fluoro-2-(3,4,5-trimethoxyanilino)pyrimidin-4-yl]amino]-2,2-dimethyl-3-oxopyrido[3,2-b][1,4]oxazin-4-yl]methyl dihydrogen phosphate
Canonical SMILES
CC1(C(=O)N(C2=C(O1)C=CC(=N2)NC3=NC(=NC=C3F)NC4=CC(=C(C(=C4)OC)OC)OC)COP(=O)(O)O)C
InChI
InChI=1S/C23H26FN6O9P/c1-23(2)21(31)30(11-38-40(32,33)34)20-14(39-23)6-7-17(28-20)27-19-13(24)10-25-22(29-19)26-12-8-15(35-3)18(37-5)16(9-12)36-4/h6-10H,11H2,1-5H3,(H2,32,33,34)(H2,25,26,27,28,29)
InChIKey
GKDRMWXFWHEQQT-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
11671467
CAS Number
901119-35-5
DrugBank ID
DB12010
TTD ID
D0V8HJ
VARIDT ID
DR00300
INTEDE ID
DR0754
ACDINA ID
D01107

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Tyrosine-protein kinase SYK (SYK) TTOU65C KSYK_HUMAN Modulator [7]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
ATP-binding cassette sub-family B member 5 (ABCB5) DTKVEXO ABCB5_HUMAN Substrate [8]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 3A4 (CYP3A4) DE4LYSA CP3A4_HUMAN Substrate [9]
UDP-glucuronosyltransferase 1A9 (UGT1A9) DE85D2P UD19_HUMAN Substrate []
Alkaline phosphatase (ALPL)
Main DME
DEVEFKM PPBT_HUMAN Substrate []
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Immune thrombocytopenic purpura
ICD Disease Classification 3B64.13
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Tyrosine-protein kinase SYK (SYK) DTT SYK 3.05E-05 0.29 0.43
ATP-binding cassette sub-family B member 5 (ABCB5) DTP ABCB5 3.35E-01 -2.42E-02 -1.22E-01
Cytochrome P450 3A4 (CYP3A4) DME CYP3A4 6.90E-01 2.35E-02 7.88E-02
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Fostamatinib
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Lusutrombopag DMH6IKO Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Lusutrombopag. Thrombocytopenia [3B64] [29]
Coadministration of a Drug Treating the Disease Different from Fostamatinib (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Remdesivir DMBFZ6L Moderate Increased risk of hepatotoxicity by the combination of Fostamatinib and Remdesivir. 1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019] [30]
Ivosidenib DM8S6T7 Moderate Increased metabolism of Fostamatinib caused by Ivosidenib mediated induction of CYP450 enzyme. Acute myeloid leukaemia [2A60] [31]
Gilteritinib DMWQ4MZ Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Gilteritinib. Acute myeloid leukaemia [2A60] [32]
Oliceridine DM6MDCF Moderate Decreased metabolism of Fostamatinib caused by Oliceridine mediated inhibition of CYP450 enzyme. Acute pain [MG31] [31]
Troleandomycin DMUZNIG Major Decreased metabolism of Fostamatinib caused by Troleandomycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [31]
Pexidartinib DMS2J0Z Major Increased risk of hepatotoxicity by the combination of Fostamatinib and Pexidartinib. Bone/articular cartilage neoplasm [2F7B] [33]
Eslicarbazepine DMZREFQ Moderate Increased metabolism of Fostamatinib caused by Eslicarbazepine mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [31]
Ripretinib DM958QB Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Ripretinib. Gastrointestinal stromal tumour [2B5B] [30]
PF-06463922 DMKM7EW Moderate Increased metabolism of Fostamatinib caused by PF-06463922 mediated induction of CYP450 enzyme. Lung cancer [2C25] [31]
Ubrogepant DM749I3 Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Ubrogepant. Migraine [8A80] [34]
Lefamulin DME6G97 Moderate Decreased metabolism of Fostamatinib caused by Lefamulin mediated inhibition of CYP450 enzyme. Pneumonia [CA40] [35]
Upadacitinib DM32B5U Moderate Decreased metabolism of Fostamatinib caused by Upadacitinib mediated inhibition of CYP450 enzyme. Rheumatoid arthritis [FA20] [31]
Voxelotor DMCS6M5 Moderate Decreased metabolism of Fostamatinib caused by Voxelotor mediated inhibition of CYP450 enzyme. Sickle-cell disorder [3A51] [31]
Telotristat ethyl DMDIYFZ Moderate Increased metabolism of Fostamatinib caused by Telotristat ethyl mediated induction of CYP450 enzyme. Small intestine developmental anomaly [DA90] [36]
Larotrectinib DM26CQR Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Larotrectinib. Solid tumour/cancer [2A00-2F9Z] [30]
Fluticasone DMGCSVF Moderate Decreased metabolism of Fostamatinib caused by Fluticasone mediated inhibition of CYP450 enzyme. Vasomotor/allergic rhinitis [CA08] [31]
Betrixaban DM2C4RF Moderate Decreased clearance of Fostamatinib due to the transporter inhibition by Betrixaban. Venous thromboembolism [BD72] [31]
⏷ Show the Full List of 17 DDI Information of This Drug

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

DIG
DIG Name DIG ID PubChem CID Functional Classification
Mannitol E00103 6251 Diluent; Flavoring agent; Lyophilization aid; Plasticizing agent; Tonicity agent
Ferric hydroxide oxide yellow E00539 23320441 Colorant
Magnesium stearate E00208 11177 lubricant
Polyethylene glycol 3350 E00652 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
Povidone E00667 Not Available Binding agent; Coating agent; Disintegrant; Film/membrane-forming agent; Solubilizing agent; Suspending agent
Sodium bicarbonate E00424 516892 Alkalizing agent; Diluent
Talc E00520 16211421 Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide E00322 26042 Coating agent; Colorant; Opacifying agent
Haematite red E00236 14833 Colorant
⏷ Show the Full List of 10 Pharmaceutical Excipients of This Drug
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Fostamatinib 100 mg tablet 100 mg Tablet Oral
Fostamatinib 150 mg tablet 150 mg Tablet Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

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3 ClinicalTrials.gov (NCT01197521) Evaluation of Effectiveness of Two Dosing Regimens of Fostamatinib Compared to Placebo in Patients With Rheumatoid Arthritis (RA) Who Are Taking Methotrexate But Not Responding.. U.S. National Institutes of Health.
4 Pharmacokinetics of fostamatinib, a spleen tyrosine kinase (SYK) inhibitor, in healthy human subjects following single and multiple oral dosing in three phase I studies. Br J Clin Pharmacol. 2013 Jul;76(1):78-88. doi: 10.1111/bcp.12048.
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7 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. (Target id: 2230).
8 DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. (ID: DB12010)
9 Effects of CYP3A4 inhibitors ketoconazole and verapamil and the CYP3A4 inducer rifampicin on the pharmacokinetic parameters of fostamatinib: results from In vitro and phase I clinical studies. Drugs R D. 2016 Mar;16(1):81-92.
10 Expression levels and activation of a PXR variant are directly related to drug resistance in osteosarcoma cell lines. Cancer. 2007 Mar 1;109(5):957-65.
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14 Metabolic interactions between acetaminophen (paracetamol) and two flavonoids, luteolin and quercetin, through in-vitro inhibition studies. J Pharm Pharmacol. 2017 Dec;69(12):1762-1772.
15 Potent mechanism-based inhibition of CYP3A4 by imatinib explains its liability to interact with CYP3A4 substrates. Br J Pharmacol. 2012 Apr;165(8):2787-98.
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24 Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
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27 Advances in kinase inhibition: treating rheumatic diseases and beyond. Curr Opin Rheumatol. 2014 March; 26(2): 237-243.
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29 EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".
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33 Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
34 Product Information. Ubrelvy (ubrogepant). Allergan Inc, Irvine, CA.
35 Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.
36 Product Information. Diabinese (chlorpropamide). Pfizer US Pharmaceuticals, New York, NY.