Details of the Drug

General Information of Drug (ID: DM29GAD)

• Drug Name: Lumefantrine
• Synonyms: Benflumetol; Coartem; Dl-Benflumelol; Lumefantrine (INN); Lumefantrine [INN:BAN]; (+-)-2,7-Dichloro-9-((Z)-p-chlorobenzylidene)-alpha((dibutylamino)methyl)fluorene-4-methanol; (+-)-2,7-Dichloro-9-((Z)-p-chlorobenzylidene)-alpha-((dibutylamino)methyl)fluorene-4-methanol; 2-(dibutylamino)-1-[(9Z)-2,7-dichloro-9-(4-chlorobenzylidene)-9H-fluoren-4-yl]ethanol; 2-(dibutylamino)-1-[(9Z)-2,7-dichloro-9-[(4-chlorophenyl)methylidene]fluoren-4-yl]ethanol; 2-Dibutylamino-1-[2,7-dichloro-9-(4-chloro-benzylidene)-9H-fluoren-4-yl]-ethanol; 2-Dibutylamino-1-{2,7-dichloro-9-[1-(4-chloro-phenyl)-meth-(Z)-ylidene]-9H-fluoren-4-yl}-ethanol

Indication

Disease Entry	ICD 11	Status	REF
Malaria	1F40-1F45	Approved	[1]

• Affected Organisms: Plasmodium
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 2:
  Molecular Weight (mw); 528.9
  Logarithm of the Partition Coefficient (xlogp); 8.7
  Rotatable Bond Count (rotbonds); 10
  Hydrogen Bond Donor Count (hbonddonor); 1
  Hydrogen Bond Acceptor Count (hbondacc); 2
• ADMET Property:
  Half-life: The concentration or amount of drug in body reduced by one-half in 4.5 days [2]
  Metabolism: The drug is metabolized via the liver []
• Chemical Identifiers:
  Formula: C30H32Cl3NO
  IUPAC Name: 2-(dibutylamino)-1-[(9Z)-2,7-dichloro-9-[(4-chlorophenyl)methylidene]fluoren-4-yl]ethanol
  Canonical SMILES: CCCCN(CCCC)CC(C1=CC(=CC\\2=C1C3=C(/C2=C/C4=CC=C(C=C4)Cl)C=C(C=C3)Cl)Cl)O
  InChI: InChI=1S/C30H32Cl3NO/c1-3-5-13-34(14-6-4-2)19-29(35)28-18-23(33)17-27-25(15-20-7-9-21(31)10-8-20)26-16-22(32)11-12-24(26)30(27)28/h7-12,15-18,29,35H,3-6,13-14,19H2,1-2H3/b25-15-
  InChIKey: DYLGFOYVTXJFJP-MYYYXRDXSA-N
• Cross-matching ID:
  PubChem CID: 6437380
  ChEBI ID: CHEBI:156095
  CAS Number: 82186-77-4
  UNII: F38R0JR742
  DrugBank ID: DB06708
  TTD ID: D06MQM
  INTEDE ID: DR0992

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Sodium pump subunit alpha-1 (ATP1A1)	TTWK8D0	AT1A1_HUMAN	Binder	[3]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4) Main DME	DE4LYSA	CP3A4_HUMAN	Substrate	[4]
Cytochrome P450 3A5 (CYP3A5) Main DME	DEIBDNY	CP3A5_HUMAN	Substrate	[]

Molecular Expression Atlas of This Drug

• The Studied Disease: Malaria
• ICD Disease Classification: 1F40-1F45

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Sodium pump subunit alpha-1 (ATP1A1)	DTT	ATP1A1	4.66E-01	1.00E-02	0.06
Sodium pump subunit alpha-1 (ATP1A1)	DTT	ATP1A1	3.31E-01	-0.03	-0.19
Cytochrome P450 3A4 (CYP3A4)	DME	CYP3A4	2.13E-01	4.03E-02	2.50E-01
Cytochrome P450 3A4 (CYP3A4)	DME	CYP3A4	8.21E-02	8.17E-02	4.35E-01

Drug-Drug Interaction (DDI) Information of This Drug

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

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Ivosidenib	DM8S6T7	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Ivosidenib.	Acute myeloid leukaemia [2A60]	[5]
Gilteritinib	DMTI0ZO	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Gilteritinib.	Acute myeloid leukaemia [2A60]	[5]
Oliceridine	DM6MDCF	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Oliceridine.	Acute pain [MG31]	[5]
Ivabradine	DM0L594	Major	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Ivabradine.	Angina pectoris [BA40]	[6]
Bedaquiline	DM3906J	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Bedaquiline.	Antimicrobial drug resistance [MG50-MG52]	[5]
Levalbuterol	DM5YBO1	Moderate	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Levalbuterol.	Asthma [CA23]	[7]
Eribulin	DM1DX4Q	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Eribulin.	Breast cancer [2C60-2C6Y]	[5]
PF-04449913	DMSB068	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and PF-04449913.	Chronic myelomonocytic leukaemia [2A40]	[5]
Olodaterol	DM62B78	Moderate	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Olodaterol.	Chronic obstructive pulmonary disease [CA22]	[7]
Osilodrostat	DMIJC9X	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Osilodrostat.	Cushing syndrome [5A70]	[5]
Deutetrabenazine	DMUPFLI	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Deutetrabenazine.	Dystonic disorder [8A02]	[5]
Fostemsavir	DM50ILT	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Fostemsavir.	Human immunodeficiency virus disease [1C60-1C62]	[5]
Rilpivirine	DMJ0QOW	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Rilpivirine.	Human immunodeficiency virus disease [1C60-1C62]	[5]
Polyethylene glycol	DM4I1JP	Major	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Polyethylene glycol.	Irritable bowel syndrome [DD91]	[8]
Crizotinib	DM4F29C	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Crizotinib.	Lung cancer [2C25]	[5]
Osimertinib	DMRJLAT	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Osimertinib.	Lung cancer [2C25]	[5]
Selpercatinib	DMZR15V	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Selpercatinib.	Lung cancer [2C25]	[5]
Vemurafenib	DM62UG5	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Vemurafenib.	Melanoma [2C30]	[5]
Siponimod	DM2R86O	Major	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Siponimod.	Multiple sclerosis [8A40]	[5]
Fingolimod	DM5JVAN	Major	Increased risk of ventricular arrhythmias by the combination of Lumefantrine and Fingolimod.	Multiple sclerosis [8A40]	[9]
Ozanimod	DMT6AM2	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Ozanimod.	Multiple sclerosis [8A40]	[5]
Entrectinib	DMMPTLH	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Entrectinib.	Non-small cell lung cancer [2C25]	[5]
Rucaparib	DM9PVX8	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Rucaparib.	Ovarian cancer [2C73]	[5]
Triclabendazole	DMPWGBR	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Triclabendazole.	Parasitic worm infestation [1F90]	[5]
Macimorelin	DMQYJIR	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Macimorelin.	Pituitary gland disorder [5A60-5A61]	[10]
Lefamulin	DME6G97	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Lefamulin.	Pneumonia [CA40]	[11]
LEE011	DMMX75K	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and LEE011.	Solid tumour/cancer [2A00-2F9Z]	[5]
Triptorelin	DMTK4LS	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Triptorelin.	Solid tumour/cancer [2A00-2F9Z]	[5]
Pitolisant	DM8RFNJ	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Pitolisant.	Somnolence [MG42]	[5]
Lenvatinib	DMB1IU4	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Lenvatinib.	Thyroid cancer [2D10]	[5]
Cabozantinib	DMIYDT4	Major	Increased risk of prolong QT interval by the combination of Lumefantrine and Cabozantinib.	Thyroid cancer [2D10]	[5]

References

• [1] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [2] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [3] The fight against drug-resistant malaria: novel plasmodial targets and antimalarial drugs. Curr Med Chem. 2008;15(2):161-71.
• [4] Development of a paediatric physiologically based pharmacokinetic model to assess the impact of drug-drug interactions in tuberculosis co-infected malaria subjects: A case study with artemether-lumefantrine and the CYP3A4-inducer rifampicin. Eur J Pharm Sci. 2017 Aug 30;106:20-33.
• [5] Cerner Multum, Inc. "Australian Product Information.".
• [6] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [7] Product Information. Arcapta Neohaler (indacaterol). Novartis Pharmaceuticals, East Hanover, NJ.
• [8] Hill AG, Parry BR "Hypokalaemia following bowel cleansing with sodium phosphate." N Z Med J 109 (1996): 347. [PMID: 8862361]
• [9] Canadian Pharmacists Association.
• [10] Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
• [11] Product Information. Fareston (toremifene). Schering Laboratories, Kenilworth, NJ.