Details of the Drug

General Information of Drug (ID: DMKE7L9)

Drug Name

Doxacurium

Synonyms

Nuromax; Chlorure de doxacurium; Chlorure de doxacurium [French]; Cloruro de doxacurio; Cloruro de doxacurio [Spanish]; Doxacurii chloridum; Doxacurii chloridum [Latin]; Doxacurium chloride(no stereochemistry); Nuromax (TN); Doxacurium chloride (USAN/INN); Bis[3-[6,7,8-trimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propyl] butanedioate; Bis[3-[6,7,8-trimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propyl] butanedioate dichloride

Indication

Disease Entry	ICD 11	Status	REF
Spasm	MB47.3	Approved	[1]

Therapeutic Class

Analgesics

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 4

Molecular Weight (mw)

1035.2

Topological Polar Surface Area (xlogp)

7.4

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

Clearance: The drug present in the plasma can be removed from the body at the rate of 2.7 mL/min/kg [2]
Half-life: The concentration or amount of drug in body reduced by one-half in 99 minutes (in normal healthy adults) [2]
Metabolism: The drug is not metabolised [3]
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.0452 micromolar/kg/day [4]
Unbound Fraction: The unbound fraction of drug in plasma is 0.53% [2]
Vd: The volume of distribution (Vd) of drug is 0.11-0.43 L/kg [5]

Chemical Identifiers

Formula: C56H78N2O16+2
IUPAC Name: bis[3-[6,7,8-trimethoxy-2-methyl-1-[(3,4,5-trimethoxyphenyl)methyl]-3,4-dihydro-1H-isoquinolin-2-ium-2-yl]propyl] butanedioate
Canonical SMILES: C[N+]1(CCC2=CC(=C(C(=C2C1CC3=CC(=C(C(=C3)OC)OC)OC)OC)OC)OC)CCCOC(=O)CCC(=O)OCCC[N+]4(CCC5=CC(=C(C(=C5C4CC6=CC(=C(C(=C6)OC)OC)OC)OC)OC)OC)C
InChI: InChI=1S/C56H78N2O16/c1-57(23-19-37-33-45(65-7)53(69-11)55(71-13)49(37)39(57)27-35-29-41(61-3)51(67-9)42(30-35)62-4)21-15-25-73-47(59)17-18-48(60)74-26-16-22-58(2)24-20-38-34-46(66-8)54(70-12)56(72-14)50(38)40(58)28-36-31-43(63-5)52(68-10)44(32-36)64-6/h29-34,39-40H,15-28H2,1-14H3/q+2
InChIKey: GBLRQXKSCRCLBZ-UHFFFAOYSA-N

Cross-matching ID

PubChem CID: 60169
ChEBI ID: CHEBI:4706
CAS Number: 133814-18-3
DrugBank ID: DB01135
TTD ID: D0Y7TO

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Neuronal acetylcholine receptor alpha (NACHRA)	TTS5WZF	NOUNIPROTAC	Antagonist	[6]

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Molecular Interaction Atlas (MIA)

MIA Detail

Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Doxacurium

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Vecuronium	DMP0UK2	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Vecuronium.	Tonus and reflex abnormality [MB47]	[7]
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Coadministration of a Drug Treating the Disease Different from Doxacurium (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Clindamycin	DM15HL8	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Clindamycin.	Acne vulgaris [ED80]	[8]
Paromomycin	DM1AGXN	Major	Additive neuromuscular blocking effects by the combination of Doxacurium and Paromomycin.	Amoebiasis [1A36]	[9]
Kanamycin	DM2DMPO	Major	Additive neuromuscular blocking effects by the combination of Doxacurium and Kanamycin.	Bacterial infection [1A00-1C4Z]	[9]
Fosphenytoin	DMOX3LB	Moderate	Increased metabolism of Doxacurium caused by Fosphenytoin mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[10]
Nadolol	DMW6GVL	Moderate	Additive cardiorespiratory depression effects by the combination of Doxacurium and Nadolol.	Essential hypertension [BA00]	[11]
Metipranolol	DMJMVKI	Moderate	Additive cardiorespiratory depression effects by the combination of Doxacurium and Metipranolol.	Glaucoma [9C61]	[12]
Levobetaxolol	DMSREPX	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Levobetaxolol.	Glaucoma [9C61]	[12]
Levobunolol	DMTNFCQ	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Levobunolol.	Glaucoma [9C61]	[12]
Carvedilol	DMHTEAO	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Carvedilol.	Heart failure [BD10-BD1Z]	[11]
Acebutolol	DM0TI4U	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Acebutolol.	Hypertension [BA00-BA04]	[11]
Penbutolol	DM4ES8F	Moderate	Additive cardiorespiratory depression effects by the combination of Doxacurium and Penbutolol.	Hypertension [BA00-BA04]	[12]
Nebivolol	DM7F1PA	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Nebivolol.	Hypertension [BA00-BA04]	[11]
Dexamethasone	DMMWZET	Moderate	Additive neuromuscular blocking effects by the combination of Doxacurium and Dexamethasone.	Rheumatoid arthritis [FA20]	[13]
Plazomicin	DMKMBES	Major	Additive neuromuscular blocking effects by the combination of Doxacurium and Plazomicin.	Urinary tract infection [GC08]	[14]
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⏷ Show the Full List of 14 DDI Information of This Drug

References

1	Natural products as sources of new drugs over the last 25 years. J Nat Prod. 2007 Mar;70(3):461-77.
2	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
3	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.
4	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
5	An FDA phase I clinical trial of quinacrine sterilization (QS). Int J Gynaecol Obstet. 2003 Oct;83 Suppl 2:S45-9.
6	Interaction of nondepolarizing muscle relaxants with M2 and M3 muscarinic receptors in guinea pig lung and heart. Anesthesiology. 1996 Jan;84(1):155-61.
7	Pandit SK, Ferres CJ, Gibson FM, Mirakhur RK "Time course of action of combinations of vecuronium and pancuronium." Anaesthesia 41 (1986): 151-4. [PMID: 2869710]
8	Alahdal O, Bevan DR "Clindamycin-induced neuromuscular blockade." Can J Anaesth 42 (1995): 614-7. [PMID: 7553999]
9	Burkett L, Bikhazi GB, Thomas KC Jr, Rosenthal DA, Wirta MG, Foldes FF "Mutual potentiation of the neuromuscular effects of antibiotics and relaxants." Anesth Analg 58 (1979): 107-15. [PMID: 571233]
10	Liberman BA, Norman P, Hardy BG "Pancuronium-phenytoin interaction: a case of decreased duration of neuromuscular blockade." Int J Clin Pharmacol Ther Toxicol 26 (1988): 371-4. [PMID: 3220609]
11	Chapple DJ, Clark JS, Hughes R "Interaction between atracurium and drugs used in anaesthesia." Br J Anaesth 55 Suppl 1 (1983): s17-22. [PMID: 6688011]
12	Harrah MD, Way WL, Katzung BG "The interaction of d-tubocurarine with antiarrhythmic drugs." Anesthesiology 33 (1970): 406-10. [PMID: 5512329]
13	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
14	Geha DG, Blitt CD, Moon BJ "Prolonged neuromuscular blockade with pancuronium in the presence of acute renal failure: a case report." Anesth Analg 55 (1976): 343-5. [PMID: 945014]