Zalcitabine

Identification

Summary

Zalcitabineis a dideoxynucleoside used to treat HIV.

Generic Name
Zalcitabine
DrugBank Accession Number
DB00943
Background

A dideoxynucleoside compound in which the 3'-hydroxyl group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of 5' to 3' phosphodiester linkages, which are needed for the elongation of DNA chains, thus resulting in the termination of viral DNA growth. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chain-terminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 211.2178
Monoisotopic: 211.095691297
Chemical Formula
C9H13N3O3
Synonyms
  • 2',3'-Dideoxycytidine
  • 4-amino-1-[(2R,5S)-5-(hydroxymethyl)tetrahydrofuran-2-yl]pyrimidin-2(1H)-one
  • DDC
  • DDCYD
  • Dideoxycytidine
  • Zalcitabine
External IDs
  • RO 24-2027/000
  • RO-24-2027/000
  • RO-24-2027000
  • RO-242027000

Pharmacology

Indication

For the treatment of Human immunovirus (HIV) infections in conjunction with other antivirals.

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Contraindications & Blackbox Warnings
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Pharmacodynamics

Zalcitabine is an analog of 2'-deoxycytidine that is pharmacologically related to but structurally different from other nucleotide reverse transcriptase inhibitors (NRTIs). Zalcitabine inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA.

Mechanism of action

Zalcitabine is a nucleoside reverse transcriptase inhibitor (NRTI) with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Within cells, zalcitabine is converted to its active metabolite, dideoxycytidine 5'-triphosphate (ddCTP), by the sequential action of cellular enzymes. ddCTP interferes with viral RNA-directed DNA polymerase (reverse transcriptase) by competing for utilization of the natural substrate deoxycytidine 5'-triphosphate (dCTP), as well as incorpating into viral DNA. Due to it's lack of a 3'-OH group, the formation of a 5' to 3' phosphodiester linkage that is necessary for DNA chain elongation is inhibited, thus leading to the termination of viral DNA growth.

Target Actions Organism
AReverse transcriptase/RNaseH
inhibitor
Human immunodeficiency virus 1
Absorption

Bioavailability is over 80% following oral administration.

Volume of distribution
  • 0.304 to 0.734 L/kg
Protein binding

Less than 4%

Metabolism

Zalcitabine is not reported to undergo significant hepatic metabolism; it is mainly phosphorylated intracellularly to zalcitabine triphosphate, the active substrate for HIV-reverse transcriptase. The concentration of zalcitabine triphosphate remains low for quantitative detection and measurement in the plasma following administration of therapeutic dosesLabel.

Route of elimination

Renal excretion of unchanged drug appears to be the primary route of elimination, accounting for approximately 80% of an intravenous dose and 60% of an orally administered dose within 24 hours after dosing (n=19). Renal clearance exceeds glomerular filtration rate suggesting renal tubular secretion contributes to the elimination of zalcitabine by the kidneys.

Half-life

2 hours

Clearance
  • 285毫升/分钟[HIV-infected patients receiving 1.5 mg IV infusion for 1 hour]
Adverse Effects
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Toxicity

Acute overdose: Inadvertent pediatric overdoses have occurred with doses up to 1.5 mg/kg zalcitabine. Chronic overdose: in an initial dose-finding study in which zalcitabine was administered at doses 25 times (0.25 mg/kg every 8 hours) the currently recommended dose, one patient discontinued zalcitabine after 1½ weeks of treatment subsequent to the development of a rash and fever.

Pathways
Pathway Category
Zalcitabine Action Pathway Drug action
Pharmacogenomic Effects/ADRsBrowse all" title="" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
Not Available

Interactions

Drug InteractionsLearn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction
Acetazolamide The excretion of Zalcitabine can be decreased when combined with Acetazolamide.
Acetylsalicylic acid The excretion of Zalcitabine can be decreased when combined with Acetylsalicylic acid.
Acyclovir The excretion of Zalcitabine can be decreased when combined with Acyclovir.
Adefovir dipivoxil The excretion of Zalcitabine can be decreased when combined with Adefovir dipivoxil.
Adenovirus type 7 vaccine live The therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Zalcitabine.
Aminohippuric酸 The excretion of Zalcitabine can be decreased when combined with Aminohippuric acid.
Aminophenazone The excretion of Zalcitabine can be decreased when combined with Aminophenazone.
阿莫西林 The excretion of Zalcitabine can be decreased when combined with Amoxicillin.
Anthrax vaccine The therapeutic efficacy of Anthrax vaccine can be decreased when used in combination with Zalcitabine.
Antipyrine The excretion of Zalcitabine can be decreased when combined with Antipyrine.
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Food Interactions
  • Avoid multivalent ions. Magnesium and aluminum containing products can reduce the absorption of this medication.
  • Take on an empty stomach. Take at least 1 hour before or 2 hours after meals.

Products

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Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image
Hivid Tablet, film coated 0.75 mg/1 Oral Physicians Total Care, Inc. 1992-06-19 2007-08-21 US flag
Hivid Tablet, film coated 0.75 mg/1 Oral Genentech, Inc. 1992-06-19 2009-06-18 US flag
Hivid Tablet, film coated 0.375 mg/1 Oral Genentech, Inc. 1992-06-19 2009-06-18 US flag
Hivid Tab 0.375mg Tablet .375 mg Oral Hoffmann La Roche 1992-12-31 2003-07-30 Canada flag
Hivid Tab 0.75 mg Tablet .75 mg Oral Hoffmann La Roche 1992-12-31 2006-07-25 Canada flag

Categories

ATC Codes
J05AF03 — Zalcitabine
Drug Categories
Chemical TaxonomyProvided byClassyfire
Description
这种化合物属于类的有机排版ounds known as pyrimidine 2',3'-dideoxyribonucleosides. These are compounds consisting of a pyrimidine linked to a ribose which lacks a hydroxyl group at positions 2 and 3.
Kingdom
Organic compounds
Super Class
Nucleosides, nucleotides, and analogues
Class
Pyrimidine nucleosides
Sub Class
Pyrimidine 2',3'-dideoxyribonucleosides
Direct Parent
Pyrimidine 2',3'-dideoxyribonucleosides
Alternative Parents
Pyrimidones/Aminopyrimidines and derivatives/Imidolactams/Hydropyrimidines/Tetrahydrofurans/Heteroaromatic compounds/Oxacyclic compounds/Azacyclic compounds/Primary amines/Primary alcohols
show 3 more
Substituents
Alcohol/Amine/Aminopyrimidine/Aromatic heteromonocyclic compound/Azacycle/Heteroaromatic compound/Hydrocarbon derivative/Hydropyrimidine/Imidolactam/Organic nitrogen compound
show 13 more
Molecular Framework
芳香heteromonocyclic化合物
External Descriptors
pyrimidine 2',3'-dideoxyribonucleoside (CHEBI:10101)
Affected organisms
  • Human Immunodeficiency Virus

Chemical Identifiers

UNII
6L3XT8CB3I
CAS number
7481-89-2
InChI Key
WREGKURFCTUGRC-POYBYMJQSA-N
InChI
InChI=1S/C9H13N3O3/c10-7-3-4-12(9(14)11-7)8-2-1-6(5-13)15-8/h3-4,6,8,13H,1-2,5H2,(H2,10,11,14)/t6-,8+/m0/s1
IUPAC Name
4-amino-1-[(2R,5S)-5-(hydroxymethyl)oxolan-2-yl]-1,2-dihydropyrimidin-2-one
SMILES
NC1=NC(=O)N(C=C1)[C@H]1CC[C@@H](CO)O1

References

General References
  1. Shelton MJ, O'Donnell AM, Morse GD: Zalcitabine. Ann Pharmacother. 1993 Apr;27(4):480-9. [Article]
  2. Devineni D, Gallo JM: Zalcitabine. Clinical pharmacokinetics and efficacy. Clin Pharmacokinet. 1995 May;28(5):351-60. [Article]
Human Metabolome Database
HMDB0015078
KEGG Drug
D00412
KEGG Compound
C07207
PubChem Compound
24066
PubChem Substance
46507879
ChemSpider
22498
BindingDB
50145605
RxNav
3363
ChEBI
10101
ChEMBL
CHEMBL853
ZINC
ZINC000000039906
Therapeutic Targets Database
DNC000527
PharmGKB
PA451950
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Zalcitabine
FDA label
Download (244 KB)
MSDS
Download (36 KB)

Clinical Trials

Clinical TrialsLearn More" title="" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count
4 Completed Treatment Hemophilia A/Human Immunodeficiency Virus (HIV) Infections 1
3 Completed Treatment Human Immunodeficiency Virus (HIV) Infections 7
2 Completed Treatment Human Immunodeficiency Virus (HIV) Infections 15
2 Completed Treatment Human Immunodeficiency Virus (HIV) Infections/Progressive Multifocal Leucoencephalopathy (PML) 1
1 Completed Treatment Hepatitis C Virus (HCV) Infection/Human Immunodeficiency Virus (HIV) Infections 1
1 Completed Treatment Human Immunodeficiency Virus (HIV) Infections 4
1 Completed Treatment Human Immunodeficiency Virus (HIV) Infections/Kaposi's Sarcoma 1
Not Available Completed Treatment Human Immunodeficiency Virus (HIV) Infections 9

Pharmacoeconomics

Manufacturers
  • Hoffmann la roche inc
Packagers
  • Murfreesboro Pharmaceutical Nursing Supply
  • Pharmaceutical Utilization Management Program VA Inc.
  • Physicians Total Care Inc.
Dosage Forms
Form Route Strength
Tablet Oral
Tablet, film coated Oral 0.375 mg/1
Tablet, film coated Oral 0.75 mg/1
Tablet Oral .375 mg
Tablet Oral .75 mg
Tablet Oral 0.75 mg
Tablet Oral 0.375 mg
Tablet, film coated Oral 0.75 mg
Prices
Unit description Cost Unit
Hivid 0.75 mg tablet 2.84USD tablet
Hivid 0.375 mg tablet 2.27USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
Property Value Source
melting point (°C) 217-218 °C PhysProp
water solubility 7.64E+004 mg/L (at 25 °C) PHYSICIANS DESK REFERENCE (2001)
logP -1.30 SANGSTER (1993)
Predicted Properties
Property Value Source
Water Solubility 7.05 mg/mL ALOGPS
logP -1.3 ALOGPS
logP -1.2 Chemaxon
logS -1.5 ALOGPS
pKa (Strongest Acidic) 14.67 Chemaxon
pKa (Strongest Basic) 4.48 Chemaxon
Physiological Charge 0 Chemaxon
Hydrogen Acceptor Count 5 Chemaxon
Hydrogen Donor Count 2 Chemaxon
Polar Surface Area 88.15 Å2 Chemaxon
Rotatable Bond Count 2 Chemaxon
Refractivity 52.24 m3·mol-1 Chemaxon
Polarizability 20.92 Å3 Chemaxon
Number of Rings 2 Chemaxon
Bioavailability 1 Chemaxon
Rule of Five Yes Chemaxon
Ghose Filter No Chemaxon
Veber's Rule No Chemaxon
MDDR-like Rule No Chemaxon
Predicted ADMET Features
Property Value Probability
Human Intestinal Absorption + 0.9972
Blood Brain Barrier + 0.9761
Caco-2 permeable - 0.7931
P-glycoprotein substrate Non-substrate 0.7746
P-glycoprotein inhibitor I Non-inhibitor 0.937
P-glycoprotein inhibitor II Non-inhibitor 0.9171
Renal organic cation transporter Non-inhibitor 0.8163
CYP450 2C9 substrate Non-substrate 0.8286
CYP450 2D6 substrate Non-substrate 0.8493
CYP450 3A4 substrate Non-substrate 0.5762
CYP450 1A2 substrate Non-inhibitor 0.9046
CYP450 2C9 inhibitor Non-inhibitor 0.9071
CYP450 2D6 inhibitor Non-inhibitor 0.9231
CYP450 2C19 inhibitor Non-inhibitor 0.9025
CYP450 3A4 inhibitor Non-inhibitor 0.8893
CYP450 inhibitory promiscuity 低CYP抑制滥交 0.9213
Ames test AMES toxic 0.9107
Carcinogenicity Non-carcinogens 0.8626
Biodegradation Not ready biodegradable 0.8721
Rat acute toxicity 2.0606 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.925
hERG inhibition (predictor II) Non-inhibitor 0.875
ADMET data is predicted usingadmetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Spectrum Spectrum Type Splash Key
Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
LC-MS/MS Spectrum - LC-ESI-QQ , negative LC-MS/MS splash10-03di-0190000000-5d3365f648d5f5675ab9
LC-MS/MS Spectrum - LC-ESI-QQ , negative LC-MS/MS splash10-066r-2900000000-843d28df71eab94652c3
LC-MS/MS Spectrum - LC-ESI-QQ , negative LC-MS/MS splash10-0a4l-7900000000-628c9e8f6a131581a8d4
LC-MS/MS Spectrum - LC-ESI-QQ , negative LC-MS/MS splash10-0006-9200000000-60a00651a71121843a19
LC-MS/MS Spectrum - LC-ESI-QQ , negative LC-MS/MS splash10-0006-9000000000-237a0c1094225974a6e8
LC-MS/MS Spectrum - LC-ESI-QQ , positive LC-MS/MS splash10-03di-0910000000-95a2a7845a54a61d7c15
LC-MS/MS Spectrum - LC-ESI-QQ , positive LC-MS/MS splash10-03di-0900000000-345deba429b644c7b4f5
LC-MS/MS Spectrum - LC-ESI-QQ , positive LC-MS/MS splash10-03di-0900000000-6aaba2f2eeb001628ab2
LC-MS/MS Spectrum - LC-ESI-QQ , positive LC-MS/MS splash10-03di-5900000000-03b881f85c17ccbe5295
LC-MS/MS Spectrum - LC-ESI-QQ , positive LC-MS/MS splash10-01ot-9300000000-2896ce7406bb834c001a
LC-MS/MS Spectrum - LC-ESI-IT , positive LC-MS/MS splash10-03di-0900000000-056961b8bc4067346530

Targets

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Kind
Protein
Organism
Human immunodeficiency virus 1
Pharmacological action
Yes
Actions
Inhibitor
General Function
Rna-dna hybrid ribonuclease activity
Specific Function
Not Available
Gene Name
pol
Uniprot ID
Q72547
Uniprot Name
Reverse transcriptase/RNaseH
分子量
65223.615 Da
References
  1. Devineni D, Gallo JM: Zalcitabine. Clinical pharmacokinetics and efficacy. Clin Pharmacokinet. 1995 May;28(5):351-60. [Article]
  2. Adkins JC, Peters DH, Faulds D: Zalcitabine. An update of its pharmacodynamic and pharmacokinetic properties and clinical efficacy in the management of HIV infection. Drugs. 1997 Jun;53(6):1054-80. [Article]
  3. De Clercq E:新兴的抗艾滋病药物。专家知道Emerg Drugs. 2005 May;10(2):241-73. [Article]

Enzymes

细节
1.Deoxycytidine kinase
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Protein homodimerization activity
Specific Function
Required for the phosphorylation of the deoxyribonucleosides deoxycytidine (dC), deoxyguanosine (dG) and deoxyadenosine (dA). Has broad substrate specificity, and does not display selectivity based...
Gene Name
DCK
Uniprot ID
P27707
Uniprot Name
Deoxycytidine kinase
分子量
30518.315 Da
References
  1. Rossi L, Serafini S, Schiavano GF, Casabianca A, Vallanti G, Chiarantini L, Magnani M: Metabolism, mitochondrial uptake and toxicity of 2', 3'-dideoxycytidine. Biochem J. 1999 Dec 15;344 Pt 3:915-20. [Article]
  2. Kitos TE, Tyrrell DL: Intracellular metabolism of 2',3'-dideoxynucleosides in duck hepatocyte primary cultures. Biochem Pharmacol. 1995 May 11;49(9):1291-302. [Article]

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
分子量
69365.94 Da
References
  1. Bocedi A, Notaril S, Narciso P, Bolli A, Fasano M, Ascenzi P: Binding of anti-HIV drugs to human serum albumin. IUBMB Life. 2004 Oct;56(10):609-14. [Article]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Involved in the renal elimination of endogenous and exogenous organic anions. Functions as organic anion exchanger when the uptake of one molecule of organic anion is coupled with an efflux of one ...
Gene Name
SLC22A6
Uniprot ID
Q4U2R8
Uniprot Name
溶质载体family 22 member 6
分子量
61815.78 Da
References
  1. Wada S, Tsuda M, Sekine T, Cha SH, Kimura M, Kanai Y, Endou H: Rat multispecific organic anion transporter 1 (rOAT1) transports zidovudine, acyclovir, and other antiviral nucleoside analogs. J Pharmacol Exp Ther. 2000 Sep;294(3):844-9. [Article]
  2. VanWert AL, Gionfriddo MR, Sweet DH: Organic anion transporters: discovery, pharmacology, regulation and roles in pathophysiology. Biopharm Drug Dispos. 2010 Jan;31(1):1-71. doi: 10.1002/bdd.693. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates sodium-independent multispecific organic anion transport. Transport of prostaglandin E2, prostaglandin F2, tetracycline, bumetanide, estrone sulfate, glutarate, dehydroepiandrosterone sulf...
Gene Name
SLC22A7
Uniprot ID
Q9Y694
Uniprot Name
溶质载体family 22 member 7
分子量
60025.025 Da
References
  1. Morita N, Kusuhara H, Sekine T, Endou H, Sugiyama Y: Functional characterization of rat organic anion transporter 2 in LLC-PK1 cells. J Pharmacol Exp Ther. 2001 Sep;298(3):1179-84. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Nucleoside transmembrane transporter activity
Specific Function
Mediates both influx and efflux of nucleosides across the membrane (equilibrative transporter). It is sensitive (ES) to low concentrations of the inhibitor nitrobenzylmercaptopurine riboside (NBMPR...
Gene Name
SLC29A1
Uniprot ID
Q99808
Uniprot Name
Equilibrative nucleoside transporter 1
分子量
50218.805 Da
References
  1. Yao SY, Ng AM, Sundaram M, Cass CE, Baldwin SA, Young JD: Transport of antiviral 3'-deoxy-nucleoside drugs by recombinant human and rat equilibrative, nitrobenzylthioinosine (NBMPR)-insensitive (ENT2) nucleoside transporter proteins produced in Xenopus oocytes. Mol Membr Biol. 2001 Apr-Jun;18(2):161-7. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Nucleoside transmembrane transporter activity
Specific Function
Mediates equilibrative transport of purine, pyrimidine nucleosides and the purine base hypoxanthine. Very less sensitive than SLC29A1 to inhibition by nitrobenzylthioinosine (NBMPR), dipyridamole, ...
Gene Name
SLC29A2
Uniprot ID
Q14542
Uniprot Name
Equilibrative nucleoside transporter 2
分子量
50112.335 Da
References
  1. Yao SY, Ng AM, Sundaram M, Cass CE, Baldwin SA, Young JD: Transport of antiviral 3'-deoxy-nucleoside drugs by recombinant human and rat equilibrative, nitrobenzylthioinosine (NBMPR)-insensitive (ENT2) nucleoside transporter proteins produced in Xenopus oocytes. Mol Membr Biol. 2001 Apr-Jun;18(2):161-7. [Article]

Drug created at June 13, 2005 13:24 / Updated at June 28, 2022 02:27