General Information of Drug (ID: DMDEA85)

Drug Name
Trimetrexate
Synonyms
TMQ; Trimetrexato; Trimetrexatum; JB 11; Jb-11; Trimetrexato [INN-Spanish]; Trimetrexatum [INN-Latin]; Trimetrexate (USAN/INN); Trimetrexate [USAN:BAN:INN]; 2,4-Diamino-5-methyl-6-((3,4,5-trimethoxyanilino)methyl)quinazoline; 5-Methyl-6-(((3,4,5-trimethoxyphenyl)amino)methyl)-2,4-quinazolinediamine; 5-methyl-6-({[3,4,5-tris(methyloxy)phenyl]amino}methyl)quinazoline-2,4-diamine; 5-methyl-6-[(3,4,5-trimethoxyanilino)methyl]quinazoline-2,4-diamine; 6-[((3,4,5-Trimethoxyphenyl)amino)methyl]-5-methyl-2,4-quinazolinediamine
Indication
Disease Entry ICD 11 Status REF
Toxoplasmosis 1F57 Approved [1]
Therapeutic Class
Antifungal Agents
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 369.4
Topological Polar Surface Area (xlogp) 2.5
Rotatable Bond Count (rotbonds) 6
Hydrogen Bond Donor Count (hbonddonor) 3
Hydrogen Bond Acceptor Count (hbondacc) 8
ADMET Property
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [2]
Clearance
The drug present in the plasma can be removed from the body at the rate of 0.77 mL/min/kg [3]
Elimination
20% of drug is excreted from urine in the unchanged form [2]
Half-life
The concentration or amount of drug in body reduced by one-half in 11 - 20 hours [3]
Metabolism
The drug is metabolized via the hepatic [4]
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 3.30241 micromolar/kg/day [5]
Unbound Fraction
The unbound fraction of drug in plasma is 0.05% [3]
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 0.77 L/kg [3]
Water Solubility
The ability of drug to dissolve in water is measured as 50 mg/mL [2]
Chemical Identifiers
Formula
C19H23N5O3
IUPAC Name
5-methyl-6-[(3,4,5-trimethoxyanilino)methyl]quinazoline-2,4-diamine
Canonical SMILES
CC1=C(C=CC2=C1C(=NC(=N2)N)N)CNC3=CC(=C(C(=C3)OC)OC)OC
InChI
InChI=1S/C19H23N5O3/c1-10-11(5-6-13-16(10)18(20)24-19(21)23-13)9-22-12-7-14(25-2)17(27-4)15(8-12)26-3/h5-8,22H,9H2,1-4H3,(H4,20,21,23,24)
InChIKey
NOYPYLRCIDNJJB-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
5583
ChEBI ID
CHEBI:9737
CAS Number
52128-35-5
DrugBank ID
DB01157
TTD ID
D0Y7TS
VARIDT ID
DR01434

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Polypeptide deformylase (PDF) TT9SL3Q DEFM_HUMAN Inhibitor [6], [7]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Breast cancer resistance protein (ABCG2) DTI7UX6 ABCG2_HUMAN Substrate [8]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Toxoplasmosis
ICD Disease Classification 1F57
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Polypeptide deformylase (PDF) DTT PDF 8.87E-16 -0.54 -0.86
Breast cancer resistance protein (ABCG2) DTP BCRP 1.20E-13 -1.20E+00 -1.06E+00
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 Disease Different from Trimetrexate (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Remdesivir DMBFZ6L Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Remdesivir. 1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019] [26]
Bedaquiline DM3906J Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Bedaquiline. Antimicrobial drug resistance [MG50-MG52] [27]
Roflumilast DMPGHY8 Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Roflumilast. Asthma [CA23] [28]
Pexidartinib DMS2J0Z Major Increased risk of hepatotoxicity by the combination of Trimetrexate and Pexidartinib. Bone/articular cartilage neoplasm [2F7B] [29]
Cannabidiol DM0659E Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Cannabidiol. Epileptic encephalopathy [8A62] [28]
Brentuximab vedotin DMWLC57 Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Brentuximab vedotin. Hodgkin lymphoma [2B30] [30]
Mipomersen DMGSRN1 Major Increased risk of hepatotoxicity by the combination of Trimetrexate and Mipomersen. Hyper-lipoproteinaemia [5C80] [31]
Teriflunomide DMQ2FKJ Major Increased risk of hepatotoxicity by the combination of Trimetrexate and Teriflunomide. Hyper-lipoproteinaemia [5C80] [32]
BMS-201038 DMQTAGO Major Increased risk of hepatotoxicity by the combination of Trimetrexate and BMS-201038. Hyper-lipoproteinaemia [5C80] [33]
Denosumab DMNI0KO Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Denosumab. Low bone mass disorder [FB83] [34]
Calaspargase pegol DMQZBXI Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Calaspargase pegol. Malignant haematopoietic neoplasm [2B33] [35]
Idelalisib DM602WT Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Idelalisib. Mature B-cell leukaemia [2A82] [36]
Tecfidera DM2OVDT Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Tecfidera. Multiple sclerosis [8A40] [37]
Siponimod DM2R86O Major Additive immunosuppressive effects by the combination of Trimetrexate and Siponimod. Multiple sclerosis [8A40] [26]
Fingolimod DM5JVAN Major Additive immunosuppressive effects by the combination of Trimetrexate and Fingolimod. Multiple sclerosis [8A40] [38]
Ocrelizumab DMEZ2KH Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Ocrelizumab. Multiple sclerosis [8A40] [39]
Ozanimod DMT6AM2 Major Additive immunosuppressive effects by the combination of Trimetrexate and Ozanimod. Multiple sclerosis [8A40] [28]
Omacetaxine mepesuccinate DMPU2WX Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Omacetaxine mepesuccinate. Myeloproliferative neoplasm [2A20] [40]
Canakinumab DM8HLO5 Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Canakinumab. Rheumatoid arthritis [FA20] [41]
Rilonacept DMGLUQS Moderate Additive immunosuppressive effects by the combination of Trimetrexate and Rilonacept. Rheumatoid arthritis [FA20] [41]
Golimumab DMHZV7X Major Additive immunosuppressive effects by the combination of Trimetrexate and Golimumab. Rheumatoid arthritis [FA20] [42]
Anthrax vaccine DM9GSWY Moderate Antagonize the effect of Trimetrexate when combined with Anthrax vaccine. Sepsis [1G40-1G41] [43]
Trabectedin DMG3Y89 Moderate Increased risk of hepatotoxicity by the combination of Trimetrexate and Trabectedin. Solid tumour/cancer [2A00-2F9Z] [28]
Valganciclovir DMS2IUH Moderate Additive myelosuppressive effects by the combination of Trimetrexate and Valganciclovir. Virus infection [1A24-1D9Z] [26]
⏷ Show the Full List of 24 DDI Information of This Drug

References

1 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
2 BDDCS applied to over 900 drugs
3 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4 FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014 Sep 1;20(17):4436-41.
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 Expression and characterization of recombinant human-derived Pneumocystis carinii dihydrofolate reductase. Antimicrob Agents Chemother. 2000 Nov;44(11):3092-6.
7 Synthesis and biological activities of tricyclic conformationally restricted tetrahydropyrido annulated furo[2,3-d]pyrimidines as inhibitors of dihydrofolate reductases. J Med Chem. 1998 Apr 23;41(9):1409-16.
8 Mutant Gly482 and Thr482 ABCG2 mediate high-level resistance to lipophilic antifolates. Cancer Chemother Pharmacol. 2006 Dec;58(6):826-34.
9 Doxorubicin transport by RALBP1 and ABCG2 in lung and breast cancer. Int J Oncol. 2007 Mar;30(3):717-25.
10 Wild-type breast cancer resistance protein (BCRP/ABCG2) is a methotrexate polyglutamate transporter. Cancer Res. 2003 Sep 1;63(17):5538-43.
11 The effect of low pH on breast cancer resistance protein (ABCG2)-mediated transport of methotrexate, 7-hydroxymethotrexate, methotrexate diglutamate, folic acid, mitoxantrone, topotecan, and resveratrol in in vitro drug transport models. Mol Pharmacol. 2007 Jan;71(1):240-9.
12 Role of BCRP as a biomarker for predicting resistance to 5-fluorouracil in breast cancer. Cancer Chemother Pharmacol. 2009 May;63(6):1103-10.
13 Inhibiting the function of ABCB1 and ABCG2 by the EGFR tyrosine kinase inhibitor AG1478. Biochem Pharmacol. 2009 Mar 1;77(5):781-93.
14 Sterol transport by the human breast cancer resistance protein (ABCG2) expressed in Lactococcus lactis. J Biol Chem. 2003 Jun 6;278(23):20645-51.
15 The phytoestrogen genistein enhances multidrug resistance in breast cancer cell lines by translational regulation of ABC transporters. Cancer Lett. 2016 Jun 28;376(1):165-72.
16 Curcumin inhibits the activity of ABCG2/BCRP1, a multidrug resistance-linked ABC drug transporter in mice. Pharm Res. 2009 Feb;26(2):480-7.
17 Imatinib mesylate (STI571) is a substrate for the breast cancer resistance protein (BCRP)/ABCG2 drug pump. Blood. 2004 Nov 1;104(9):2940-2.
18 Transformation with human dihydrofolate reductase renders malaria parasites insensitive to WR99210 but does not affect the intrinsic activity of proguanil. Proc Natl Acad Sci U S A. 1997 Sep 30;94(20):10931-6.
19 The fight against drug-resistant malaria: novel plasmodial targets and antimalarial drugs. Curr Med Chem. 2008;15(2):161-71.
20 Hughes B: 2009 FDA drug approvals. Nat Rev Drug Discov. 2010 Feb;9(2):89-92.
21 Novel Saccharomyces cerevisiae screen identifies WR99210 analogues that inhibit Mycobacterium tuberculosis dihydrofolate reductase. Antimicrob Agents Chemother. 2002 Nov;46(11):3362-9.
22 Three-dimensional structure of M. tuberculosis dihydrofolate reductase reveals opportunities for the design of novel tuberculosis drugs. J Mol Biol. 2000 Jan 14;295(2):307-23.
23 Mutant Gly482 and Thr482 ABCG2 mediate high-level resistance to lipophilic antifolates. Cancer Chemother Pharmacol. 2006 Dec;58(6):826-34.
24 Loss of folylpoly-gamma-glutamate synthetase activity is a dominant mechanism of resistance to polyglutamylation-dependent novel antifolates in multiple human leukemia sublines. Int J Cancer. 2003 Feb 20;103(5):587-99.
25 How many drug targets are there Nat Rev Drug Discov. 2006 Dec;5(12):993-6.
26 Cerner Multum, Inc. "Australian Product Information.".
27 Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
28 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
29 Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
30 Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.
31 Product Information. Kynamro (mipomersen). Genzyme Corporation, Cambridge, MA.
32 Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
33 Product Information. Juxtapid (lomitapide). Aegerion Pharmaceuticals Inc, Cambridge, MA.
34 Product Information. Prolia (denosumab). Amgen USA, Thousand Oaks, CA.
35 Al-Nawakil C, Willems L, Mauprivez C, et.al "Successful treatment of l-asparaginase-induced severe acute hepatotoxicity using mitochondrial cofactors." Leuk Lymphoma 55 (2014): 1670-4. [PMID: 24090500]
36 Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
37 Product Information. Vumerity (diroximel fumarate). Alkermes, Inc, Cambridge, MA.
38 Product Information. Gilenya (fingolimod). Novartis Pharmaceuticals, East Hanover, NJ.
39 Product Information. Ocrevus (ocrelizumab). Genentech, South San Francisco, CA.
40 Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
41 Product Information. Arcalyst (rilonacept). Regeneron Pharmaceuticals Inc, Tarrytown, NY.
42 Product Information. Cimzia (certolizumab). UCB Pharma Inc, Smyrna, GA.
43 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]