Details of the Drug

General Information of Drug (ID: DMLW57T)

• Drug Name: Teniposide
• Synonyms: PTG; Teniposido; Teniposidum; Vehem; Vumon; Demethyl Epipodophyllotoxin Thenylidine Glucoside; VM 26; Teniposido [INN-Spanish]; Teniposidum [INN-Latin]; VM-26; Vee M-26; Veham-Sandoz; Vumon (TN); Teniposide (USAN/INN); Teniposide [USAN:BAN:INN]; VM-26 (TN); Vumon, VM-26, Vehem, NSC 122819, Teniposide; Epipodophyllotoxin, 4'-demethyl-, 9-(4,6-O-2-thenylidene-beta-D-glucopyranoside); 4'-Demethyl-epipodophyllotoxin-beta-D-thenylidene-glucoside; 4'-Demethylepipodophyllotoxin 9-(4,6-O-(R)-2-thenylidene-beta-D-glucopyranoside); 4'-Demethylepipodophyllotoxin 9-(4,6-O-2-thenylidene-beta-D-glucopyranoside); 4'-Demethylepipodophyllotoxin thenylidene glucoside; 4'-Demethylepipodophyllotoxin-beta-D-thenylidine glucoside; 4'-Dimethyl-9-(4,6-O-2-thenyid)-epipodophyllotoxin; 4-Demethylepipodophyllotoxin-.beta.-D-thenylideneglucoside

Indication

Disease Entry	ICD 11	Status	REF
Acute lymphoblastic leukaemia	2A85	Approved	[1], [2]

• Therapeutic Class: Anticancer Agents
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 2:
  Molecular Weight (mw); 656.7
  Topological Polar Surface Area (xlogp); 1.2
  Rotatable Bond Count (rotbonds); 6
  Hydrogen Bond Donor Count (hbonddonor); 3
  Hydrogen Bond Acceptor Count (hbondacc); 14
• ADMET Property:
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 2: low solubility and high permeability [3]
  Clearance: The drug present in the plasma can be removed from the body at the rate of 0.19 mL/min/kg [4]
  Elimination: 9% 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 hours [4]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 10.65988 micromolar/kg/day [5]
  Unbound Fraction: The unbound fraction of drug in plasma is 0.0044% [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 0.41 L/kg [4]
  Water Solubility: The ability of drug to dissolve in water is measured as 0.025 mg/mL [3]
• Chemical Identifiers:
  Formula: C32H32O13S
  IUPAC Name: (5S,5aR,8aR,9R)-5-[[(2R,4aR,6R,7R,8R,8aS)-7,8-dihydroxy-2-thiophen-2-yl-4,4a,6,7,8,8a-hexahydropyrano[3,2-d][1,3]dioxin-6-yl]oxy]-9-(4-hydroxy-3,5-dimethoxyphenyl)-5a,6,8a,9-tetrahydro-5H-[2]benzofuro[6,5-f][1,3]benzodioxol-8-one
  Canonical SMILES: COC1=CC(=CC(=C1O)OC)[C@H]2[C@@H]3[C@H](COC3=O)[C@@H](C4=CC5=C(C=C24)OCO5)O[C@H]6[C@@H]([C@H]([C@H]7[C@H](O6)CO[C@H](O7)C8=CC=CS8)O)O
  InChI: InChI=1S/C32H32O13S/c1-37-19-6-13(7-20(38-2)25(19)33)23-14-8-17-18(42-12-41-17)9-15(14)28(16-10-39-30(36)24(16)23)44-32-27(35)26(34)29-21(43-32)11-40-31(45-29)22-4-3-5-46-22/h3-9,16,21,23-24,26-29,31-35H,10-12H2,1-2H3/t16-,21+,23+,24-,26+,27+,28+,29+,31+,32-/m0/s1
  InChIKey: NRUKOCRGYNPUPR-QBPJDGROSA-N
• Cross-matching ID:
  PubChem CID: 452548
  CAS Number: 29767-20-2
  DrugBank ID: DB00444
  TTD ID: D01DBQ
  VARIDT ID: DR00021
  INTEDE ID: DR1550

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
DNA topoisomerase II (TOP2)	TT0IHXV	TOP2A_HUMAN; TOP2B_HUMAN	Modulator	[6]

Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
Multidrug resistance-associated protein 3 (ABCC3)	DTQ3ZHF	MRP3_HUMAN	Substrate	[7]
Breast cancer resistance protein (ABCG2)	DTI7UX6	ABCG2_HUMAN	Substrate	[8]
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[8]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4)	DE4LYSA	CP3A4_HUMAN	Substrate	[9]
Mephenytoin 4-hydroxylase (CYP2C19)	DEGTFWK	CP2CJ_HUMAN	Substrate	[10]
Cytochrome P450 3A5 (CYP3A5)	DEIBDNY	CP3A5_HUMAN	Substrate	[11]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Teniposide

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Vincristine	DMINOX3	Minor	Decreased metabolism of Teniposide caused by Vincristine mediated inhibition of CYP450 enzyme.	Mature B-cell lymphoma [2A85]	[70]

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

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Arn-509	DMT81LZ	Moderate	Accelerated clearance of Teniposide due to the transporter induction by Arn-509.	Acute myeloid leukaemia [2A60]	[71]
Dronedarone	DMA8FS5	Moderate	Decreased metabolism of Teniposide caused by Dronedarone mediated inhibition of CYP450 enzyme.	Angina pectoris [BA40]	[72]
Roflumilast	DMPGHY8	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Roflumilast.	Asthma [CA23]	[71]
Ofloxacin	DM0VQN3	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Ofloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Ciprofloxacin XR	DM2NLS9	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Ciprofloxacin XR.	Bacterial infection [1A00-1C4Z]	[73]
Trovafloxacin	DM6AN32	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Trovafloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Sparfloxacin	DMB4HCT	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Sparfloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Gemifloxacin	DMHT34O	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Gemifloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Norfloxacin	DMIZ6W2	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Norfloxacin.	Bacterial infection [1A00-1C4Z]	[73]
ABT-492	DMJFD2I	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by ABT-492.	Bacterial infection [1A00-1C4Z]	[73]
Levofloxacin	DMS60RB	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Levofloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Lomefloxacin	DMVRH9C	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Lomefloxacin.	Bacterial infection [1A00-1C4Z]	[73]
Telithromycin	DMZ4P3A	Moderate	Decreased metabolism of Teniposide caused by Telithromycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[74]
Pexidartinib	DMS2J0Z	Moderate	Increased metabolism of Teniposide caused by Pexidartinib mediated induction of CYP450 enzyme.	Bone/articular cartilage neoplasm [2F7B]	[75]
Lapatinib	DM3BH1Y	Moderate	Decreased metabolism of Teniposide caused by Lapatinib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[76]
Tucatinib	DMBESUA	Moderate	Decreased metabolism of Teniposide caused by Tucatinib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[77]
Mifepristone	DMGZQEF	Moderate	Decreased metabolism of Teniposide caused by Mifepristone mediated inhibition of CYP450 enzyme.	Cushing syndrome [5A70]	[78]
MK-8228	DMOB58Q	Moderate	Decreased metabolism of Teniposide caused by MK-8228 mediated inhibition of CYP450 enzyme.	Cytomegaloviral disease [1D82]	[79]
Aprepitant	DM053KT	Moderate	Decreased metabolism of Teniposide caused by Aprepitant mediated inhibition of CYP450 enzyme.	Depression [6A70-6A7Z]	[80]
Primidone	DM0WX6I	Moderate	Increased metabolism of Teniposide caused by Primidone mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[81]
Oxcarbazepine	DM5PU6O	Moderate	Increased metabolism of Teniposide caused by Oxcarbazepine mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[81]
Cenobamate	DMGOVHA	Moderate	Increased metabolism of Teniposide caused by Cenobamate mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[82]
Fosphenytoin	DMOX3LB	Moderate	Increased metabolism of Teniposide caused by Fosphenytoin mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[81]
Phenobarbital	DMXZOCG	Moderate	Increased metabolism of Teniposide caused by Phenobarbital mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[81]
Carbamazepine	DMZOLBI	Moderate	Increased metabolism of Teniposide caused by Carbamazepine mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[81]
Tazemetostat	DMWP1BH	Moderate	Increased metabolism of Teniposide caused by Tazemetostat mediated induction of CYP450 enzyme.	Follicular lymphoma [2A80]	[83]
Boceprevir	DMBSHMF	Moderate	Decreased metabolism of Teniposide caused by Boceprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[84]
Telaprevir	DMMRV29	Moderate	Decreased metabolism of Teniposide caused by Telaprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[85]
Rifapentine	DMCHV4I	Moderate	Increased metabolism of Teniposide caused by Rifapentine mediated induction of CYP450 enzyme.	HIV-infected patients with tuberculosis [1B10-1B14]	[86]
Brentuximab vedotin	DMWLC57	Moderate	Increased risk of peripheral neuropathy by the combination of Teniposide and Brentuximab vedotin.	Hodgkin lymphoma [2B30]	[87]
Delavirdine	DM3NF5G	Minor	Decreased metabolism of Teniposide caused by Delavirdine mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[88]
Efavirenz	DMC0GSJ	Moderate	Increased metabolism of Teniposide caused by Efavirenz mediated induction of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[89]
Etravirine	DMGV8QU	Moderate	Increased metabolism of Teniposide caused by Etravirine mediated induction of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[90]
Zalcitabine	DMH7MUV	Moderate	Increased risk of peripheral neuropathy by the combination of Teniposide and Zalcitabine.	Human immunodeficiency virus disease [1C60-1C62]	[91]
Darunavir	DMN3GCH	Moderate	Decreased metabolism of Teniposide caused by Darunavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[92]
Teriflunomide	DMQ2FKJ	Major	Additive immunosuppressive effects by the combination of Teniposide and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[93]
Conivaptan	DM1V329	Moderate	Decreased metabolism of Teniposide caused by Conivaptan mediated inhibition of CYP450 enzyme.	Hypo-osmolality/hyponatraemia [5C72]	[94]
Berotralstat	DMWA2DZ	Moderate	Decreased metabolism of Teniposide caused by Berotralstat mediated inhibition of CYP450 enzyme.	Innate/adaptive immunodeficiency [4A00]	[95]
Denosumab	DMNI0KO	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Denosumab.	Low bone mass disorder [FB83]	[96]
Brigatinib	DM7W94S	Moderate	Increased metabolism of Teniposide caused by Brigatinib mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[97]
Ceritinib	DMB920Z	Moderate	Decreased metabolism of Teniposide caused by Ceritinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[71]
PF-06463922	DMKM7EW	Moderate	Increased metabolism of Teniposide caused by PF-06463922 mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[98]
Selpercatinib	DMZR15V	Moderate	Decreased metabolism of Teniposide caused by Selpercatinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[99]
IPI-145	DMWA24P	Moderate	Decreased metabolism of Teniposide caused by IPI-145 mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[100]
Dabrafenib	DMX6OE3	Moderate	Increased metabolism of Teniposide caused by Dabrafenib mediated induction of CYP450 enzyme.	Melanoma [2C30]	[71]
Exjade	DMHPRWG	Moderate	Decreased metabolism of Teniposide caused by Exjade mediated inhibition of CYP450 enzyme.	Mineral absorption/transport disorder [5C64]	[101]
Thalidomide	DM70BU5	Major	Additive thrombogenic effects by the combination of Teniposide and Thalidomide.	Multiple myeloma [2A83]	[102]
Tecfidera	DM2OVDT	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Tecfidera.	Multiple sclerosis [8A40]	[103]
Siponimod	DM2R86O	Major	Additive immunosuppressive effects by the combination of Teniposide and Siponimod.	Multiple sclerosis [8A40]	[78]
Fingolimod	DM5JVAN	Major	Additive immunosuppressive effects by the combination of Teniposide and Fingolimod.	Multiple sclerosis [8A40]	[104]
Ocrelizumab	DMEZ2KH	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Ocrelizumab.	Multiple sclerosis [8A40]	[105]
Ozanimod	DMT6AM2	Major	Additive immunosuppressive effects by the combination of Teniposide and Ozanimod.	Multiple sclerosis [8A40]	[71]
Fedratinib	DM4ZBK6	Moderate	Decreased metabolism of Teniposide caused by Fedratinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[71]
Nilotinib	DM7HXWT	Moderate	Decreased clearance of Teniposide due to the transporter inhibition by Nilotinib.	Myeloproliferative neoplasm [2A20]	[106]
Dasatinib	DMJV2EK	Moderate	Decreased metabolism of Teniposide caused by Dasatinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[107]
Omacetaxine mepesuccinate	DMPU2WX	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Omacetaxine mepesuccinate.	Myeloproliferative neoplasm [2A20]	[108]
Modafinil	DMYILBE	Minor	Increased metabolism of Teniposide caused by Modafinil mediated induction of CYP450 enzyme.	Narcolepsy [7A20]	[109]
Entrectinib	DMMPTLH	Moderate	Decreased metabolism of Teniposide caused by Entrectinib mediated inhibition of CYP450 enzyme.	Non-small cell lung cancer [2C25]	[71]
Rucaparib	DM9PVX8	Moderate	Decreased metabolism of Teniposide caused by Rucaparib mediated inhibition of CYP450 enzyme.	Ovarian cancer [2C73]	[110]
Abametapir	DM2RX0I	Moderate	Decreased metabolism of Teniposide caused by Abametapir mediated inhibition of CYP450 enzyme.	Pediculosis [1G00]	[111]
Lefamulin	DME6G97	Moderate	Decreased metabolism of Teniposide caused by Lefamulin mediated inhibition of CYP450 enzyme.	Pneumonia [CA40]	[112]
Lonafarnib	DMGM2Z6	Moderate	Decreased metabolism of Teniposide caused by Lonafarnib mediated inhibition of CYP450 enzyme.	Premature ageing appearance [LD2B]	[113]
Enzalutamide	DMGL19D	Moderate	Increased metabolism of Teniposide caused by Enzalutamide mediated induction of CYP450 enzyme.	Prostate cancer [2C82]	[114]
Bosentan	DMIOGBU	Moderate	Increased metabolism of Teniposide caused by Bosentan mediated induction of CYP450 enzyme.	Pulmonary hypertension [BB01]	[115]
Gatifloxacin	DMSL679	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[73]
Canakinumab	DM8HLO5	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Canakinumab.	Rheumatoid arthritis [FA20]	[116]
Rilonacept	DMGLUQS	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Rilonacept.	Rheumatoid arthritis [FA20]	[116]
Golimumab	DMHZV7X	Major	Additive immunosuppressive effects by the combination of Teniposide and Golimumab.	Rheumatoid arthritis [FA20]	[117]
Leflunomide	DMR8ONJ	Major	Additive immunosuppressive effects by the combination of Teniposide and Leflunomide.	Rheumatoid arthritis [FA20]	[93]
Anthrax vaccine	DM9GSWY	Moderate	Antagonize the effect of Teniposide when combined with Anthrax vaccine.	Sepsis [1G40-1G41]	[118]
Voxelotor	DMCS6M5	Moderate	Decreased metabolism of Teniposide caused by Voxelotor mediated inhibition of CYP450 enzyme.	Sickle-cell disorder [3A51]	[119]
Telotristat ethyl	DMDIYFZ	Moderate	Increased metabolism of Teniposide caused by Telotristat ethyl mediated induction of CYP450 enzyme.	Small intestine developmental anomaly [DA90]	[71]
Larotrectinib	DM26CQR	Moderate	Decreased metabolism of Teniposide caused by Larotrectinib mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[78]
Armodafinil	DMGB035	Minor	Increased metabolism of Teniposide caused by Armodafinil mediated induction of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[109]
LEE011	DMMX75K	Moderate	Decreased metabolism of Teniposide caused by LEE011 mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[120]
Fostamatinib	DM6AUHV	Moderate	Decreased clearance of Teniposide due to the transporter inhibition by Fostamatinib.	Thrombocytopenia [3B64]	[121]
Azathioprine	DMMZSXQ	Moderate	Additive immunosuppressive effects by the combination of Teniposide and Azathioprine.	Transplant rejection [NE84]	[78]
Cinoxacin	DM4EWNS	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Cinoxacin.	Urinary tract infection [GC08]	[73]
Nalidixic acid	DMRM0JV	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Nalidixic acid.	Urinary tract infection [GC08]	[73]
Enoxacin	DMYTE6L	Minor	Decreased absorption of Teniposide due to intestinal mucosa variation caused by Enoxacin.	Urinary tract infection [GC08]	[73]
Ganciclovir	DM1MBYQ	Moderate	Additive myelosuppressive effects by the combination of Teniposide and Ganciclovir.	Virus infection [1A24-1D9Z]	[78]
Valganciclovir	DMS2IUH	Moderate	Additive myelosuppressive effects by the combination of Teniposide and Valganciclovir.	Virus infection [1A24-1D9Z]	[78]

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