Gabapentin enacarbil

Gabapentin prodrug used to treat restless legs syndrome and shingles complications
  • US DailyMed: Gabapentin_enacarbil
  • US FDA: Horizant
Pregnancy
category
  • AU: B1
Routes of
administrationBy mouthDrug classGabapentinoidATC code
  • None
Legal statusLegal status
  • US: ℞-only
Pharmacokinetic dataExcretionKidneyIdentifiers
  • (1-{[({(1RS)-1-[isobutyryloxy]ethoxy}carbonyl)
    amino]methyl}cyclohexyl)acetic acid
CAS Number
  • 478296-72-9 checkY
PubChem CID
  • 9883933
IUPHAR/BPS
  • 7560
ChemSpider
  • 8059607 ☒N
UNII
  • 75OCL1SPBQ
ChEBI
  • CHEBI:68840 ☒N
Chemical and physical dataFormulaC16H27NO6Molar mass329.393 g·mol−13D model (JSmol)
  • Interactive image
  • CC(C)C(=O)OC(C)OC(=O)NCC1(CCCCC1)CC(=O)O
  • InChI=1S/C16H27NO6/c1-11(2)14(20)22-12(3)23-15(21)17-10-16(9-13(18)19)7-5-4-6-8-16/h11-12H,4-10H2,1-3H3,(H,17,21)(H,18,19) ☒N
  • Key:TZDUHAJSIBHXDL-UHFFFAOYSA-N ☒N
 ☒NcheckY (what is this?)  (verify)

Gabapentin enacarbil (Horizant (ER) (U.S.Tooltip United States), Regnite (in Japan)) is an anticonvulsant and analgesic drug of the gabapentinoid class, and a prodrug to gabapentin.[1] It was designed for increased oral bioavailability over gabapentin,[2][3] and human trials showed it to produce extended release of gabapentin with almost twice the overall bioavailability,[4] especially when taken with a fatty meal.[5] Gabapentin enacarbil has passed human clinical trials for the treatment of restless legs syndrome, and initial results have shown it to be well tolerated and reasonably effective.[6][7][8]

Gabapentin enacarbil was denied approval by the U.S. Food and Drug Administration (FDA) in February 2010, citing concerns about possible increased cancer risk shown by some animal studies. Similar concerns had been raised about gabapentin itself in the past, but were felt to be outweighed by its clinical utility as an anticonvulsant, whereas the treatment of restless legs syndrome was not seen to justify the same kind of risk.[9] On April 6, 2011, Xenoport received FDA approval for Horizant (gabapentin enacarbil) for the treatment of moderate-to-severe restless legs syndrome.[10] On June 7, 2012, the FDA approved Horizant for the treatment of postherpetic neuralgia in adults.[11]

References

  1. ^ Landmark CJ, Johannessen SI (2008). "Modifications of antiepileptic drugs for improved tolerability and efficacy". Perspectives in Medicinal Chemistry. 2: 21–39. doi:10.1177/1177391X0800200001. PMC 2746576. PMID 19787095.
  2. ^ Cundy KC, Branch R, Chernov-Rogan T, Dias T, Estrada T, Hold K, Koller K, Liu X, Mann A, Panuwat M, Raillard SP, Upadhyay S, Wu QQ, Xiang JN, Yan H, Zerangue N, Zhou CX, Barrett RW, Gallop MA (October 2004). "XP13512 [(+/-)-1-([(alpha-isobutanoyloxyethoxy)carbonyl] aminomethyl)-1-cyclohexane acetic acid], a novel gabapentin prodrug: I. Design, synthesis, enzymatic conversion to gabapentin, and transport by intestinal solute transporters". The Journal of Pharmacology and Experimental Therapeutics. 311 (1): 315–23. doi:10.1124/jpet.104.067934. PMID 15146028. S2CID 1535942.
  3. ^ Cundy KC, Annamalai T, Bu L, De Vera J, Estrela J, Luo W, Shirsat P, Torneros A, Yao F, Zou J, Barrett RW, Gallop MA (October 2004). "XP13512 [(+/-)-1-([(alpha-isobutanoyloxyethoxy)carbonyl] aminomethyl)-1-cyclohexane acetic acid], a novel gabapentin prodrug: II. Improved oral bioavailability, dose proportionality, and colonic absorption compared with gabapentin in rats and monkeys". The Journal of Pharmacology and Experimental Therapeutics. 311 (1): 324–33. doi:10.1124/jpet.104.067959. PMID 15146029. S2CID 25152318.
  4. ^ Cundy KC, Sastry S, Luo W, Zou J, Moors TL, Canafax DM (December 2008). "Clinical pharmacokinetics of XP13512, a novel transported prodrug of gabapentin". Journal of Clinical Pharmacology. 48 (12): 1378–88. doi:10.1177/0091270008322909. PMID 18827074. S2CID 23598218.
  5. ^ Lal R, Sukbuntherng J, Luo W, Huff FJ, Zou J, Cundy KC (February 2010). "The effect of food with varying fat content on the clinical pharmacokinetics of gabapentin after oral administration of gabapentin enacarbil". International Journal of Clinical Pharmacology and Therapeutics. 48 (2): 120–8. doi:10.5414/cpp48120. PMID 20137764.
  6. ^ Merlino G, Serafini A, Lorenzut S, Sommaro M, Gigli GL, Valente M (January 2010). "Gabapentin enacarbil in restless legs syndrome". Drugs of Today. 46 (1): 3–11. doi:10.1358/dot.2010.46.1.1424766. PMID 20200691.
  7. ^ Bogan RK, Bornemann MA, Kushida CA, Trân PV, Barrett RW (June 2010). "Long-term maintenance treatment of restless legs syndrome with gabapentin enacarbil: a randomized controlled study". Mayo Clinic Proceedings. 85 (6): 512–21. doi:10.4065/mcp.2009.0700. PMC 2878254. PMID 20511481.
  8. ^ Imamura S, Kushida C (August 2010). "Gabapentin enacarbil (XP13512/GSK1838262) as an alternative treatment to dopaminergic agents for restless legs syndrome". Expert Opinion on Pharmacotherapy. 11 (11): 1925–32. doi:10.1517/14656566.2010.494598. PMID 20629607. S2CID 27594934.
  9. ^ GlaxoSmithKline/XenoPort: FDA setback halts gabapentin reformulations[permanent dead link]
  10. ^ "XenoPort, Inc. > Investors > RSS Content". Archived from the original on 2012-07-13.
  11. ^ Jeffrey, Susan. "FDA Approves Gabapentin Enacarbil for Postherpetic Neuralgia". Medscape.

External links

  • "Gabapentin enacarbil". Drug Information Portal. U.S. National Library of Medicine.
GABAergics
GABAAR PAMs
GABA-T inhibitors
Others
Channel
modulators
Sodium blockers
Calcium blockers
Potassium openers
Others
CA inhibitors
Others
  • v
  • t
  • e
5-HT1ARTooltip 5-HT1A receptor agonists
GABAARTooltip GABAA receptor PAMsTooltip positive allosteric modulators
Hypnotics
Gabapentinoids
(α2δ VDCC blockers)
Antidepressants
Antipsychotics
Sympatholytics
(Antiadrenergics)
Others
  • v
  • t
  • e
Monoaminergics
Ion channel blockers
Others
  • v
  • t
  • e
Drugs which induce euphoria
See also: Recreational drug use
  • v
  • t
  • e
Major recreational drugs
Depressants
Opioids
Stimulants
Entactogens
Hallucinogens
Psychedelics
Dissociatives
Deliriants
Cannabinoids
Oneirogens
Club drugs
Cannabis culture
Coffee culture
Drinking culture
Psychedelia
Smoking culture
Other
Legality of drug use
International
State level
Drug policy
by country
Drug legality
Other
Other
Drug
production
and trade
Drug
production
Drug trade
Issues with
drug use
Harm reduction
Countries by
drug use
  • v
  • t
  • e
Calcium
VDCCsTooltip Voltage-dependent calcium channels
Blockers
Activators
Potassium
VGKCsTooltip Voltage-gated potassium channels
Blockers
Activators
IRKsTooltip Inwardly rectifying potassium channel
Blockers
Activators
  • GIRKTooltip G protein-coupled inwardly rectifying potassium channel-specific: ML-297 (VU0456810)
KCaTooltip Calcium-activated potassium channel
Blockers
  • BKCa-specific: Ethanol (alcohol)
  • GAL-021
Activators
K2PsTooltip Tandem pore domain potassium channel
Blockers
Activators
Sodium
VGSCsTooltip Voltage-gated sodium channels
Blockers
Activators
ENaCTooltip Epithelial sodium channel
Blockers
Activators
  • Solnatide
ASICsTooltip Acid-sensing ion channel
Blockers
Chloride
CaCCsTooltip Calcium-activated chloride channel
Blockers
Activators
CFTRTooltip Cystic fibrosis transmembrane conductance regulator
Blockers
Activators
Unsorted
Blockers
Others
TRPsTooltip Transient receptor potential channels
  • See here instead.
LGICsTooltip Ligand gated ion channels
  • See here instead.
See also: Receptor/signaling modulators • Transient receptor potential channel modulators
Portal:
  • icon Medicine