Details of the Drug

General Information of Drug (ID: DMTAJQE)

• Drug Name: Amphotericin B
• Synonyms: ABLC; Abelcet; Abelecet; Ambisome; Amphocin; Amphomoronal; Amphotec; Amphotericin; Amphotericinum; Amphotherizin; Amphozone; Fungilin; Fungisome; Fungisone; Fungizone; Halizon; SinuNase; Amfotericina B; Amophotericin B; Amphortericin B; Amphotericin B Cholesterol Dispersion; Amphotericin B Colloidal Dispersion; Amphotericin B liposomal; Amphotericin BETA; Amphotericine B; Amphotericinum B; Amphotherizin [German]; Liposomal Amphotericin B; NCI527017; NS 718; AMPH-B; Abelcet (TN); AmBisome (TN); Amfotericina B [INN-Spanish]; Ampho-Moronal; Amphocil (TN); Amphotec (TN); Amphotericin-B; Amphotericine B [INN-French]; Amphotericinum B [INN-Latin]; Fungilin (TN); Fungisome (TN); Fungizone (TN); LNS-AmB; Mysteclin-F; NKTR-024; Amphotericin B [USAN:INN:JAN]; Amphotericin B, Lipid-based; Amphotericin B, Streptomyces sp.; Amphotericin B (JP15/USP/INN)

Indication

Disease Entry	ICD 11	Status	REF
Fungal infection	1F29-1F2F	Approved	[1]
Mycoses	1F2Z	Investigative	[2]

• Therapeutic Class: Antifungal Agents
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 3:
  Molecular Weight (mw); 924.1
  Topological Polar Surface Area (xlogp); 0
  Rotatable Bond Count (rotbonds); 3
  Hydrogen Bond Donor Count (hbonddonor); 12
  Hydrogen Bond Acceptor Count (hbondacc); 18
• 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 0.17 mL/min/kg [4]
  Elimination: 3.5% 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 40 hours [4]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 4.32852 micromolar/kg/day [5]
  Unbound Fraction: The unbound fraction of drug in plasma is 0.03% [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 0.62 L/kg [4]
  Water Solubility: The ability of drug to dissolve in water is measured as 0.1 mg/mL [3]
• Chemical Identifiers:
  Formula: C47H73NO17
  IUPAC Name: (1R,3S,5R,6R,9R,11R,15S,16R,17R,18S,19E,21E,23E,25E,27E,29E,31E,33R,35S,36R,37S)-33-[(2R,3S,4S,5S,6R)-4-amino-3,5-dihydroxy-6-methyloxan-2-yl]oxy-1,3,5,6,9,11,17,37-octahydroxy-15,16,18-trimethyl-13-oxo-14,39-dioxabicyclo[33.3.1]nonatriaconta-19,21,23,25,27,29,31-heptaene-36-carboxylic acid
  Canonical SMILES: C[C@H]1/C=C/C=C/C=C/C=C/C=C/C=C/C=C/[C@@H](C[C@H]2[C@@H]([C@H](C[C@](O2)(C[C@H](C[C@H]([C@@H](CC[C@H](C[C@H](CC(=O)O[C@H]([C@@H]([C@@H]1O)C)C)O)O)O)O)O)O)O)C(=O)O)O[C@H]3[C@H]([C@H]([C@@H]([C@H](O3)C)O)N)O
  InChI: InChI=1S/C47H73NO17/c1-27-17-15-13-11-9-7-5-6-8-10-12-14-16-18-34(64-46-44(58)41(48)43(57)30(4)63-46)24-38-40(45(59)60)37(54)26-47(61,65-38)25-33(51)22-36(53)35(52)20-19-31(49)21-32(50)23-39(55)62-29(3)28(2)42(27)56/h5-18,27-38,40-44,46,49-54,56-58,61H,19-26,48H2,1-4H3,(H,59,60)/b6-5+,9-7+,10-8+,13-11+,14-12+,17-15+,18-16+/t27-,28-,29-,30+,31+,32+,33-,34-,35+,36+,37-,38-,40+,41-,42+,43+,44-,46-,47+/m0/s1
  InChIKey: APKFDSVGJQXUKY-INPOYWNPSA-N
• Cross-matching ID:
  PubChem CID: 5280965
  CAS Number: 1397-89-3
  DrugBank ID: DB00681
  TTD ID: D02DWM
  VARIDT ID: DR01468

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Fungal Cell membrane ergosterol (Fung CME)	TTQKWA4	NOUNIPROTAC	Modulator	[6]

Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[7]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Amphotericin B

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Pentamidine	DMHZJCG	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Pentamidine.	Fungal infection [1F29-1F2F]	[17]

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

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Decreased renal excretion of Amphotericin B caused by Remdesivir mediated nephrotoxicity.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[18]
Uracil mustard	DMHL7OB	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Uracil mustard.	Acute myeloid leukaemia [2A60]	[18]
Framycetin	DMF8DNE	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Framycetin.	Alcoholic liver disease [DB94]	[19]
Inotersen	DMJ93CT	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Inotersen.	Amyloidosis [5D00]	[20]
Dronedarone	DMA8FS5	Major	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Dronedarone.	Angina pectoris [BA40]	[21]
Kanamycin	DM2DMPO	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Kanamycin.	Bacterial infection [1A00-1C4Z]	[19]
Streptomycin	DME1LQN	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Streptomycin.	Bacterial infection [1A00-1C4Z]	[19]
Gentamicin	DMKINJO	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Gentamicin.	Bacterial infection [1A00-1C4Z]	[19]
Rabeprazole	DMMZXIW	Moderate	Increased risk of hypomagnesemia by the combination of Amphotericin B and Rabeprazole.	Bacterial infection [1A00-1C4Z]	[22]
Netilmicin	DMRD1QK	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Netilmicin.	Bacterial infection [1A00-1C4Z]	[19]
Tobramycin	DMUI0CH	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Tobramycin.	Bacterial infection [1A00-1C4Z]	[19]
Etidronic acid	DM1XHYJ	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Etidronic acid.	Bone paget disease [FB85]	[23]
Iodipamide	DMXIQYS	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Iodipamide.	Cholelithiasis [DC11]	[24]
Atracurium	DM42HXN	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Atracurium.	Corneal disease [9A76-9A78]	[25]
Mivacurium	DM473VD	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Mivacurium.	Corneal disease [9A76-9A78]	[25]
Pancuronium	DMB0VY8	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Pancuronium.	Corneal disease [9A76-9A78]	[25]
Tubocurarine	DMBZIVP	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Tubocurarine.	Corneal disease [9A76-9A78]	[25]
Methoxyflurane	DML0RAE	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Methoxyflurane.	Corneal disease [9A76-9A78]	[20]
Dexlansoprazole	DM1DBV5	Moderate	Increased risk of hypomagnesemia by the combination of Amphotericin B and Dexlansoprazole.	Gastro-oesophageal reflux disease [DA22]	[22]
Givosiran	DM5PFIJ	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Givosiran.	Inborn porphyrin/heme metabolism error [5C58]	[18]
Balsalazide	DMO091F	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Balsalazide.	Indeterminate colitis [DD72]	[26]
Ibandronate	DM0QZBN	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Ibandronate.	Low bone mass disorder [FB83]	[27]
Arsenic trioxide	DM61TA4	Major	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Arsenic trioxide.	Mature B-cell lymphoma [2A85]	[28]
Exjade	DMHPRWG	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Exjade.	Mineral absorption/transport disorder [5C64]	[29]
Melphalan	DMOLNHF	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Melphalan.	Multiple myeloma [2A83]	[18]
Levomethadyl Acetate	DM06HG5	Major	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Levomethadyl Acetate.	Opioid use disorder [6C43]	[30]
Esomeprazole	DM7BN0X	Moderate	Increased risk of hypomagnesemia by the combination of Amphotericin B and Esomeprazole.	Peptic ulcer [DA61]	[22]
Estramustine	DMWTAOI	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Estramustine.	Prostate cancer [2C82]	[18]
Everolimus	DM8X2EH	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Everolimus.	Renal cell carcinoma [2C90]	[31]
Temsirolimus	DMS104F	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Temsirolimus.	Renal cell carcinoma [2C90]	[31]
Sulfasalazine	DMICA9H	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Sulfasalazine.	Rheumatoid arthritis [FA20]	[26]
Paliperidone	DM7NPJS	Moderate	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Paliperidone.	Schizophrenia [6A20]	[18]
Trifluoperazine	DMKBYWI	Moderate	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Trifluoperazine.	Schizophrenia [6A20]	[18]
Risperidone	DMN6DXL	Moderate	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Risperidone.	Schizophrenia [6A20]	[18]
Amisulpride	DMSJVAM	Moderate	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Amisulpride.	Schizophrenia [6A20]	[18]
Pimozide	DMW83TP	Major	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Pimozide.	Schizophrenia [6A20]	[32]
Ifosfamide	DMCT3I8	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Ifosfamide.	Solid tumour/cancer [2A00-2F9Z]	[18]
Pipecuronium	DM5F84A	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Pipecuronium.	Tonus and reflex abnormality [MB47]	[25]
Doxacurium	DMKE7L9	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Doxacurium.	Tonus and reflex abnormality [MB47]	[25]
Vecuronium	DMP0UK2	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Vecuronium.	Tonus and reflex abnormality [MB47]	[25]
Rocuronium	DMY9BMK	Moderate	Additive neuromuscular blocking effects by the combination of Amphotericin B and Rocuronium.	Tonus and reflex abnormality [MB47]	[25]
Sirolimus	DMGW1ID	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Sirolimus.	Transplant rejection [NE84]	[31]
Tacrolimus	DMZ7XNQ	Major	Increased risk of nephrotoxicity by the combination of Amphotericin B and Tacrolimus.	Transplant rejection [NE84]	[31]
Olsalazine	DMZW9HA	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Olsalazine.	Ulcerative colitis [DD71]	[26]
Plazomicin	DMKMBES	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Plazomicin.	Urinary tract infection [GC08]	[19]
Amiodarone	DMUTEX3	Major	Increased risk of ventricular arrhythmias by the combination of Amphotericin B and Amiodarone.	Ventricular tachyarrhythmia [BC71]	[33]
Ganciclovir	DM1MBYQ	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Ganciclovir.	Virus infection [1A24-1D9Z]	[18]
Valganciclovir	DMS2IUH	Moderate	Increased risk of nephrotoxicity by the combination of Amphotericin B and Valganciclovir.	Virus infection [1A24-1D9Z]	[18]

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