Details of the Drug

General Information of Drug (ID: DMTK4LS)

• Drug Name: Triptorelin
• Synonyms: Gonapeptyl depot (TN)

Indication

Disease Entry	ICD 11	Status	REF
Infertility	GB04	Approved	[1]
Solid tumour/cancer	2A00-2F9Z	Approved	[2]
Prostate cancer	2C82.0	Phase 4	[3]

• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 4:
  Molecular Weight (mw); 1311.4
  Logarithm of the Partition Coefficient (xlogp); -0.3
  Rotatable Bond Count (rotbonds); 33
  Hydrogen Bond Donor Count (hbonddonor); 17
  Hydrogen Bond Acceptor Count (hbondacc); 15
• ADMET Property:
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [4]
  Clearance: The total clearance of drug is 211.9 mL/min []
  Elimination: 41.7% of drug is excreted from urine in the unchanged form [4]
  Half-life: The concentration or amount of drug in body reduced by one-half in 3 hours [5]
  Metabolism: The drug is metabolized via the hepatic []
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.00451 micromolar/kg/day [6]
  Vd: The volume of distribution (Vd) of drug is 30-33 L []
• Chemical Identifiers:
  Formula: C64H82N18O13
  IUPAC Name: (2S)-N-[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2R)-1-[[(2S)-1-[[(2S)-1-[(2S)-2-[(2-amino-2-oxoethyl)carbamoyl]pyrrolidin-1-yl]-5-(diaminomethylideneamino)-1-oxopentan-2-yl]amino]-4-methyl-1-oxopentan-2-yl]amino]-3-(1H-indol-3-yl)-1-oxopropan-2-yl]amino]-3-(4-hydroxyphenyl)-1-oxopropan-2-yl]amino]-3-hydroxy-1-oxopropan-2-yl]amino]-3-(1H-indol-3-yl)-1-oxopropan-2-yl]amino]-3-(1H-imidazol-5-yl)-1-oxopropan-2-yl]-5-oxopyrrolidine-2-carboxamide
  Canonical SMILES: CC(C)C[C@@H](C(=O)N[C@@H](CCCN=C(N)N)C(=O)N1CCC[C@H]1C(=O)NCC(=O)N)NC(=O)[C@@H](CC2=CNC3=CC=CC=C32)NC(=O)[C@H](CC4=CC=C(C=C4)O)NC(=O)[C@H](CO)NC(=O)[C@H](CC5=CNC6=CC=CC=C65)NC(=O)[C@H](CC7=CN=CN7)NC(=O)[C@@H]8CCC(=O)N8
  InChI: InChI=1S/C64H82N18O13/c1-34(2)23-46(56(88)75-45(13-7-21-69-64(66)67)63(95)82-22-8-14-52(82)62(94)72-31-53(65)85)76-58(90)48(25-36-28-70-42-11-5-3-9-40(36)42)78-57(89)47(24-35-15-17-39(84)18-16-35)77-61(93)51(32-83)81-59(91)49(26-37-29-71-43-12-6-4-10-41(37)43)79-60(92)50(27-38-30-68-33-73-38)80-55(87)44-19-20-54(86)74-44/h3-6,9-12,15-18,28-30,33-34,44-52,70-71,83-84H,7-8,13-14,19-27,31-32H2,1-2H3,(H2,65,85)(H,68,73)(H,72,94)(H,74,86)(H,75,88)(H,76,90)(H,77,93)(H,78,89)(H,79,92)(H,80,87)(H,81,91)(H4,66,67,69)/t44-,45-,46-,47-,48+,49-,50-,51-,52-/m0/s1
  InChIKey: VXKHXGOKWPXYNA-PGBVPBMZSA-N
• Cross-matching ID:
  PubChem CID: 25074470
  ChEBI ID: CHEBI:63633
  CAS Number: 57773-63-4
  DrugBank ID: DB06825
  TTD ID: D03QRS
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Gonadotropin-releasing hormone receptor (GNRHR)	TT8R70G	GNRHR_HUMAN	Modulator	[7]

Molecular Expression Atlas of This Drug

• The Studied Disease: Infertility
• ICD Disease Classification: GB04

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Gonadotropin-releasing hormone receptor (GNRHR)	DTT	GNRHR	9.07E-01	0.02	0.09

Drug-Drug Interaction (DDI) Information of This Drug

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

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Ivosidenib	DM8S6T7	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Ivosidenib.	Acute myeloid leukaemia [2A60]	[8]
Gilteritinib	DMTI0ZO	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Gilteritinib.	Acute myeloid leukaemia [2A60]	[9]
Oliceridine	DM6MDCF	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Oliceridine.	Acute pain [MG31]	[9]
Ivabradine	DM0L594	Major	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Ivabradine.	Angina pectoris [BA40]	[9]
Bedaquiline	DM3906J	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Bedaquiline.	Antimicrobial drug resistance [MG50-MG52]	[10]
Levalbuterol	DM5YBO1	Moderate	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Levalbuterol.	Asthma [CA23]	[11]
Eribulin	DM1DX4Q	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Eribulin.	Breast cancer [2C60-2C6Y]	[9]
PF-04449913	DMSB068	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and PF-04449913.	Chronic myelomonocytic leukaemia [2A40]	[9]
Olodaterol	DM62B78	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Olodaterol.	Chronic obstructive pulmonary disease [CA22]	[12]
Vilanterol	DMF5EK1	Moderate	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Vilanterol.	Chronic obstructive pulmonary disease [CA22]	[11]
Osilodrostat	DMIJC9X	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Osilodrostat.	Cushing syndrome [5A70]	[9]
Deutetrabenazine	DMUPFLI	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Deutetrabenazine.	Dystonic disorder [8A02]	[9]
Ingrezza	DMVPLNC	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Ingrezza.	Dystonic disorder [8A02]	[9]
Fostemsavir	DM50ILT	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Fostemsavir.	Human immunodeficiency virus disease [1C60-1C62]	[9]
Rilpivirine	DMJ0QOW	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Rilpivirine.	Human immunodeficiency virus disease [1C60-1C62]	[9]
Polyethylene glycol	DM4I1JP	Moderate	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Polyethylene glycol.	Irritable bowel syndrome [DD91]	[9]
Crizotinib	DM4F29C	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Crizotinib.	Lung cancer [2C25]	[13]
Ceritinib	DMB920Z	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Ceritinib.	Lung cancer [2C25]	[14]
Osimertinib	DMRJLAT	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Osimertinib.	Lung cancer [2C25]	[15]
Selpercatinib	DMZR15V	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Selpercatinib.	Lung cancer [2C25]	[9]
Vemurafenib	DM62UG5	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Vemurafenib.	Melanoma [2C30]	[14]
LGX818	DMNQXV8	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and LGX818.	Melanoma [2C30]	[9]
Siponimod	DM2R86O	Major	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Siponimod.	Multiple sclerosis [8A40]	[16]
Fingolimod	DM5JVAN	Major	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Fingolimod.	Multiple sclerosis [8A40]	[14]
Ozanimod	DMT6AM2	Major	Increased risk of ventricular arrhythmias by the combination of Triptorelin and Ozanimod.	Multiple sclerosis [8A40]	[17]
Rucaparib	DM9PVX8	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Rucaparib.	Ovarian cancer [2C73]	[9]
Triclabendazole	DMPWGBR	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Triclabendazole.	Parasitic worm infestation [1F90]	[9]
Macimorelin	DMQYJIR	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Macimorelin.	Pituitary gland disorder [5A60-5A61]	[18]
Lefamulin	DME6G97	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Lefamulin.	Pneumonia [CA40]	[19]
Pitolisant	DM8RFNJ	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Pitolisant.	Somnolence [MG42]	[9]
Lenvatinib	DMB1IU4	Moderate	Increased risk of prolong QT interval by the combination of Triptorelin and Lenvatinib.	Thyroid cancer [2D10]	[9]
Cabozantinib	DMIYDT4	Major	Increased risk of prolong QT interval by the combination of Triptorelin and Cabozantinib.	Thyroid cancer [2D10]	[9]

References

• [1] Triptorelin FDA Label
• [2] 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. (Ligand id: 1177).
• [3] ClinicalTrials.gov (NCT00633347) Use of Antagonist Versus Agonist GnRH in Oocyte Recipient Endometrium Preparation. U.S. National Institutes of Health.
• [4] BDDCS applied to over 900 drugs
• [5] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [6] 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
• [7] Regulation of GnRH I receptor gene expression by the GnRH agonist triptorelin, estradiol, and progesterone in the gonadotroph-derived cell line alphaT3-1. Endocrine. 2006 Aug;30(1):139-44.
• [8] Product Information. Tibsovo (ivosidenib). Agios Pharmaceuticals, Cambridge, MA.
• [9] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [10] Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
• [11] Product Information. Arcapta Neohaler (indacaterol). Novartis Pharmaceuticals, East Hanover, NJ.
• [12] Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32. [PMID: 7042176]
• [13] Product Information. Xalkori (crizotinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.
• [14] Canadian Pharmacists Association.
• [15] Product Information. Tagrisso (osimertinib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.
• [16] Cerner Multum, Inc. "Australian Product Information.".
• [17] Product Information. Zeposia (ozanimod). Celgene Corporation, Summit, NJ.
• [18] Product Information. Macrilen (macimorelin). Aeterna Zentaris, Charleston, SC.
• [19] Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.