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Chemistry

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Also known as: 402957-28-2, Vx-950, Incivek, Telaprevir (vx-950), Incivo, Mp-424
Molecular Formula
C36H53N7O6
Molecular Weight
679.8  g/mol
InChI Key
BBAWEDCPNXPBQM-GDEBMMAJSA-N
FDA UNII
655M5O3W0U

Telaprevir
Telaprevir is an orally available peptidomimetic small molecule with activity against hepatitis C virus (HCV). Telaprivir is a selective protease inhibitor that targets the viral HCV NS3-4A serine protease and disrupts processing of viral proteins and formation of a viral replication complex.
Telaprevir is a Hepatitis C Virus NS3/4A Protease Inhibitor. The mechanism of action of telaprevir is as a HCV NS3/4A Protease Inhibitor, and Cytochrome P450 3A Inhibitor, and P-Glycoprotein Inhibitor, and Organic Anion Transporting Polypeptide 1B1 Inhibitor, and Organic Anion Transporting Polypeptide 2B1 Inhibitor.
1 2D Structure

Telaprevir

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(3S,3aS,6aR)-2-[(2S)-2-[[(2S)-2-cyclohexyl-2-(pyrazine-2-carbonylamino)acetyl]amino]-3,3-dimethylbutanoyl]-N-[(3S)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl]-3,3a,4,5,6,6a-hexahydro-1H-cyclopenta[c]pyrrole-3-carboxamide
2.1.2 InChI
InChI=1S/C36H53N7O6/c1-5-10-25(29(44)34(48)39-23-15-16-23)40-33(47)28-24-14-9-13-22(24)20-43(28)35(49)30(36(2,3)4)42-32(46)27(21-11-7-6-8-12-21)41-31(45)26-19-37-17-18-38-26/h17-19,21-25,27-28,30H,5-16,20H2,1-4H3,(H,39,48)(H,40,47)(H,41,45)(H,42,46)/t22-,24-,25-,27-,28-,30+/m0/s1
2.1.3 InChI Key
BBAWEDCPNXPBQM-GDEBMMAJSA-N
2.1.4 Canonical SMILES
CCCC(C(=O)C(=O)NC1CC1)NC(=O)C2C3CCCC3CN2C(=O)C(C(C)(C)C)NC(=O)C(C4CCCCC4)NC(=O)C5=NC=CN=C5
2.1.5 Isomeric SMILES
CCC[C@@H](C(=O)C(=O)NC1CC1)NC(=O)[C@@H]2[C@H]3CCC[C@H]3CN2C(=O)[C@H](C(C)(C)C)NC(=O)[C@H](C4CCCCC4)NC(=O)C5=NC=CN=C5
2.2 Other Identifiers
2.2.1 UNII
655M5O3W0U
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Incivek

2. Vx 950

3. Vx-950

4. Vx950 Cpd

2.3.2 Depositor-Supplied Synonyms

1. 402957-28-2

2. Vx-950

3. Incivek

4. Telaprevir (vx-950)

5. Incivo

6. Mp-424

7. Vx 950

8. Ly-570310

9. Telavic

10. Mp 424

11. Vrt 111950

12. Vrt-111950

13. Ly 570310

14. Chembl231813

15. (1s,3ar,6as)-2-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-2-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl)octahydrocyclopenta[c]pyrrole-1-carboxamide

16. Chebi:68595

17. 655m5o3w0u

18. (3s,3as,6ar)-2-[(2s)-2-[[(2s)-2-cyclohexyl-2-(pyrazine-2-carbonylamino)acetyl]amino]-3,3-dimethylbutanoyl]-n-[(3s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl]-3,3a,4,5,6,6a-hexahydro-1h-cyclopenta[c]pyrrole-3-carboxamide

19. (1s,3ar,6as)-2-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-6-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl)-octahydrocyclopenta[c]pyrrole-1-carboxamide

20. S-telaprevir

21. (1s,3ar,6as)-(2s)-2-cyclohexyl-n-(pyrazinylcarbonyl)glycyl-3-methyl-l-valyl-n-((1s)-1-((cyclopropylamino)oxoacetyl)butyl)octahydrocyclopenta(c)pyrrole-1-carboxamide

22. Cyclopenta(c)pyrrole-1-carboxamide, (2s)-2-cyclohexyl-n-(pyrazinylcarbonyl)glycyl-3-methyl-l-valyl-n-((1s)-1-((cyclopropylamino)oxoacetyl)butyl)octahydro-, (1s,3ar,6as)-

23. Vx950 Cpd

24. Telaprevir [usan:inn]

25. Unii-655m5o3w0u

26. Hsdb 8125

27. Incivek(tm)

28. Telaprevir-[d4]

29. 569364-34-7

30. Incivek (tn)

31. Incivo (tn)

32. Telaprevir,vx-950

33. Telaprevir [mi]

34. Telaprevir [inn]

35. Telaprevir [jan]

36. (1s,3ar,6as)-2-[(2s)-2-[[(2s)-2-cyclohexyl-2-(pyrazine-2-carbonylamino)acetyl]amino]-3,3-dimethylbutanoyl]-n-[(3s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl]-3,3a,4,5,6,6a-hexahydro-1h-cyclopenta[c]pyrrole-1-carboxamide

37. Telaprevir [usan]

38. Vx-950 (telaprevir)

39. Telaprevir [vandf]

40. Telaprevir [mart.]

41. Telaprevir [who-dd]

42. Schembl183996

43. Telaprevir (jan/usan/inn)

44. Gtpl7871

45. Telaprevir [orange Book]

46. Dtxsid40193304

47. Ex-a006

48. Aids213006

49. Aids-213006

50. Zinc3992480

51. Bdbm50326056

52. Fd7166

53. Mfcd11616089

54. S1538

55. Vrt111950

56. Akos005145815

57. Ccg-270366

58. Cs-0285

59. Db05521

60. Ncgc00346545-03

61. (3s,3as,6ar)-2-[(2s)-2-[[(2s)-2-cyclohexyl-2-(pyrazine-2-carbonylamino)acetyl]amino]-3,3-dimethyl-butanoyl]-n-[(1s)-1-[2-(cyclopropylamino)-2-oxo-acetyl]butyl]-3,3a,4,5,6,6a-hexahydro-1h-cyclopenta[c]pyrrole-3-carboxamide

62. As-16995

63. Hy-10235

64. Wo-00218369

65. D09012

66. 957t282

67. Q408557

68. Q-101417

69. (1s,3ar,6as)-(2s)-2-cyclohexyl-n-(2-pyrazinylcarbonyl)glycyl-3-methyl-l-valyl-n-[(1s)-1-[2-(cyclopropylamino)-2-oxoacetyl]butyl]octahydrocyclopenta[c]pyrrole-1-carboxamide

70. (1s,3ar,6as)-2-((2s)-2-(((2s)-cyclohexyl((pyrazinylcarbonyl)amino)acetyl)amino)-3,3-dimethylbutanoyl)-n-((1s)-1-((cyclopropylamino)oxoacetyl)butyl) Octahydrocyclopenta(c)pyrrole-1-carboxamide

71. (1s,3ar,6as)-2-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-2-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cyclopropylamino)-1,2-dioxo-hexan-3-yl)octahydrocyclopenta[c]pyrrole-1-carboxamide

72. (1s,3ar,6as)-2-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-2-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cydopropylamino)-1,2-dioxo-hexan-3-yl)octahydrocyclopenta[c]pyrrole-1-carboxamide

73. (1s,3ar,6as)-2-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-3-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl)-octahydrocyclopenta[c]pyrrole-1-carboxamide

74. (1s,3ar,6as)-2-[(2s)-2-({(2s)-2-cyclohexyl-2-[(pyrazin-2-ylcarbonyl)amino]acetyl}amino)-3,3-dimethylbutanoyl]-n-[(3s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl]octahydrocyclopenta[c]pyrrole-1-carboxamide

75. (1s,3ar,6as)-n-((s)-2-((s)-2-cyclohexyl-2-(pyrazine-2-carboxamido)acetamido)-3,3-dimethylbutanoyl)-n-((s)-1-(cyclopropylamino)-1,2-dioxohexan-3-yl)octahydrocyclopenta[c]pyrrole-1-carboxamide

76. (3s)-3-{[(1s,3ar,6as)-2-[(2s)-2-[(2s)-2-cyclohexyl-2-(pyrazin-2-ylformamido)acetamido]-3,3-dimethylbutanoyl]-octahydrocyclopenta[c]pyrrol-1-yl]formamido}-n-cyclopropyl-2-oxohexanamide

77. 2-(2-{2-cyclohexyl-2-[(pyrazine-2-carbonyl)-amino]-acetylamino}-3,3-dimethyl-butyryl)-octahydro-cyclopenta[c]pyrrole-1-carboxylic Acid (1-cyclopropylaminooxalyl-butyl)-amide

2.4 Create Date
2005-08-01
3 Chemical and Physical Properties
Molecular Weight 679.8 g/mol
Molecular Formula C36H53N7O6
XLogP34.2
Hydrogen Bond Donor Count4
Hydrogen Bond Acceptor Count8
Rotatable Bond Count14
Exact Mass679.40573244 g/mol
Monoisotopic Mass679.40573244 g/mol
Topological Polar Surface Area180 Ų
Heavy Atom Count49
Formal Charge0
Complexity1240
Isotope Atom Count0
Defined Atom Stereocenter Count6
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameIncivek
PubMed HealthTelaprevir (By mouth)
Drug ClassesAntiviral
Drug LabelINCIVEK (telaprevir) is an inhibitor of the HCV NS3/4A protease.The IUPAC name for telaprevir is (1S,3aR,6aS)-2-[(2S)-2-({(2S)-2-cyclohexyl-2-[(pyrazin-2-ylcarbonyl)amino]acetyl}amino)-3,3-dimethylbutanoyl]-N-[(3S)-1-(cyclopropylamino)-1,2-dioxohexan...
Active IngredientTelaprevir
Dosage FormTablet
RouteOral
Strength375mg
Market StatusPrescription
CompanyVertex Pharms

2 of 2  
Drug NameIncivek
PubMed HealthTelaprevir (By mouth)
Drug ClassesAntiviral
Drug LabelINCIVEK (telaprevir) is an inhibitor of the HCV NS3/4A protease.The IUPAC name for telaprevir is (1S,3aR,6aS)-2-[(2S)-2-({(2S)-2-cyclohexyl-2-[(pyrazin-2-ylcarbonyl)amino]acetyl}amino)-3,3-dimethylbutanoyl]-N-[(3S)-1-(cyclopropylamino)-1,2-dioxohexan...
Active IngredientTelaprevir
Dosage FormTablet
RouteOral
Strength375mg
Market StatusPrescription
CompanyVertex Pharms

4.2 Therapeutic Uses

Oligopeptides

National Library of Medicine's Medical Subject Headings online file (MeSH, 2009)


INCIVEK (telaprevir), in combination with peginterferon alfa and ribavirin, is indicated for the treatment of genotype 1 chronic hepatitis C in adult patients with compensated liver disease, including cirrhosis, who are treatment-naive or who have previously been treated with interferon-based treatment, including prior null responders, partial responders, and relapsers. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


4.3 Drug Warning

Fatal and non-fatal serious skin reactions, including Stevens Johnson Syndrome (SJS), Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), and Toxic Epidermal Necrolysis (TEN), have been reported in patients treated with INCIVEK combination treatment. Fatal cases have been reported in patients with progressive rash and systemic symptoms who continued to receive INCIVEK combination treatment after a serious skin reaction was identified. For serious skin reactions, including rash with systemic symptoms or a progressive severe rash, INCIVEK, peginterferon alfa, and ribavirin must be discontinued immediately. Discontinuing other medications known to be associated with serious skin reactions should be considered. Patients should be promptly referred for urgent medical care.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


Rash developed in 56% of patients receiving telaprevir during controlled clinical trials. Severe rash (e.g., generalized rash or rash with vesicles or bullae or ulcerations other than SJS) was reported in 4% of patients receiving telaprevir in conjunction with peginterferon alfa and ribavirin compared with less than 1% of patients receiving peginterferon alfa and ribavirin without telaprevir. Rash frequently was observed during the first 4 weeks of telaprevir treatment, but can occur at any time. Rash generally improves when telaprevir therapy is completed or discontinued; complete resolution may take weeks.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 853


If a serious skin reaction occurs, telaprevir, peginterferon alfa, and ribavirin should be immediately discontinued and the patient promptly referred for urgent medical care. Patients with mild to moderate rash should be monitored for progression of rash or development of systemic symptoms. If rash progresses and becomes severe or if systemic symptoms develop, telaprevir should be discontinued; peginterferon alfa and ribavirin may be continued.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 853


Telaprevir dosage should not be reduced and telaprevir should not be restarted if it was discontinued because of rash. If improvement is not observed within 7 days of discontinuing telaprevir, sequential or simultaneous interruption or discontinuance of peginterferon alfa and/or ribavirin should be considered. If medically indicated, earlier interruption or discontinuance of peginterferon alfa and ribavirin should be considered.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 853


For more Drug Warnings (Complete) data for Telaprevir (18 total), please visit the HSDB record page.


4.4 Drug Indication

Telaprevir, when used in combination with [DB00811], [DB00008], and [DB00022] is indicated for use in the treatment of chronic HCV genotype 1 infection in adults.


FDA Label


Incivo, in combination with peginterferon alfa and ribavirin, is indicated for the treatment of genotype-1 chronic hepatitis C in adult patients with compensated liver disease (including cirrhosis):

- who are treatment nave;

- who have previously been treated with interferon alfa (pegylated or non-pegylated) alone or in combination with ribavirin, including relapsers, partial responders and null responders.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Telaprevir is classified as a direct-acting antiviral (DAA) and prevents viral replication in HCV genotype 1.


5.2 FDA Pharmacological Classification
5.2.1 Active Moiety
TELAPREVIR
5.2.2 FDA UNII
655M5O3W0U
5.2.3 Pharmacological Classes
Mechanisms of Action [MoA] - Organic Anion Transporting Polypeptide 2B1 Inhibitors
5.3 ATC Code

J05AE


J - Antiinfectives for systemic use

J05 - Antivirals for systemic use

J05A - Direct acting antivirals

J05AP - Antivirals for treatment of hcv infections

J05AP02 - Telaprevir


5.4 Absorption, Distribution and Excretion

Absorption

Telaprevir reaches peak plasma concentration 4-5hours after administration. Absolute bioavailability has not been determined. When taken with a normal fat meal (21g of fat), exposure increases by 235% compared to fasting conditions. With low (3.6g of fat) and high fat (56g of fat) meals, exposure increased 117% and 330% respectively.


Route of Elimination

Telaprevir is mainly eliminated in the feces (82%) with a smaller amount eliminated via expiration (9%) and very little in the urine (1%). 31.9% and 18.8% of drug in the feces was present as the parent compound and R-diastereomer of the parent compound respectively.


Volume of Distribution

The estimated apparent volume of distribution for Telapravir is 252 litres with an inter-individual variability of 72%.


Clearance

Telaprevir has an estimated aparent total body clearance of 32.4 liters per hour with an interindividual variability of 27.2%.


The pharmacokinetic properties of telaprevir have been evaluated in healthy adult subjects and in subjects with chronic hepatitis C. Following multiple doses of telaprevir (750 mg every 8 hr) in combination with peginterferon alfa and ribavirin in treatment-naive subjects with genotype 1 chronic hepatitis C, mean (SD) Cmax was 3510 (1280) ng/mL, Cmin was 2030 (930) ng/mL, and AUC8h was 22,300 (8650) ng.hr/mL.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


Telaprevir is orally available, most likely absorbed in the small intestine, with no evidence for absorption in the colon. Maximum plasma concentrations after a single dose of telaprevir are generally achieved after 4 to 5 hours.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


Telaprevir is a substrate for and inhibitor of P-glycoprotein transport.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 855


The systemic exposure (AUC) to telaprevir was increased by 237% when telaprevir was administered with a standard fat meal (containing 533 kcal and 21 g fat) compared to when telaprevir was administered under fasting conditions. In addition, the type of meal significantly affects exposure to telaprevir. Relative to fasting, when telaprevir was administered with a low-fat meal (249 kcal, 3.6 g fat) and a high-fat meal (928 kcal, 56 g fat), the systemic exposure (AUC) to telaprevir was increased by approximately 117% and 330%, respectively.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


For more Absorption, Distribution and Excretion (Complete) data for Telaprevir (13 total), please visit the HSDB record page.


5.5 Metabolism/Metabolites

Telaprevir is extensively metabolized via hydrolysis, oxidation, and reduction. The major metabolites of Telaprevir are pyrazinoic acid, a metabolite that underwent reduction at the -ketoamide bond, and the R-diastereomer of telaprevir which is 30-fold less active than the parent compound were found to be the predominant metabolites. The primary enzyme involved in the metabolism of Telaprevir is CYP3A4. Some metabolism is performed by aldo-keto reductases and other reductases.


Telaprevir is extensively metabolized in the liver, involving hydrolysis, oxidation, and reduction. Multiple metabolites were detected in feces, plasma, and urine. After repeated oral administration, the R-diastereomer of telaprevir (30-fold less active), pyrazinoic acid, and a metabolite that underwent reduction at the alpha-ketoamide bond of telaprevir (not active) were found to be the predominant metabolites of telaprevir.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


5.6 Biological Half-Life

Telaprevir has a half-life of elimination of 4.0-4.7 hours after a single dose and an effective half life of 9-11 hours at steady state.


The mean elimination half-life after single-dose oral administration of telaprevir 750 mg typically ranged from about 4.0 to 4.7 hours. At steady state, the effective half-life is about 9 to 11 hours.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


5.7 Mechanism of Action

Telaprevir is a NS3/4a protease inhibitor used to inhibit viral HCV replication. NS3/4a protease is an integral part of viral replication and mediates the cleavage the virally encoded polyprotein to mature proteins (NS4A, NS4B, NS5A and NS5B). Telaprevir inhibits NS3/4A with an IC50 of 10nM.


Telaprevir is a peptidomimetic, selective hepatitis C virus (HCV) nonstructural 3/4A (NS3/4A) protease inhibitor. The drug is a direct-acting antiviral (DAA) agent with activity against HCV. Telaprevir contains an alpha-ketoamide functional group that covalently and reversibly binds the active serine site of HCV NS3/4 protease. By blocking proteolytic cleavage of NS4A, NS4B, NS5A, and NS5B from the HCV-encoded polyprotein, the drug inhibits HCV replication. Telaprevir has in vitro activity against HCV genotypes 1a, 1b, and 2, but is less active against genotypes 3a and 4a.

American Society of Health-System Pharmacists 2012; Drug Information 2012. Bethesda, MD. 2012, p. 855


Telaprevir is an inhibitor of the HCV NS3/4A serine protease, necessary for the proteolytic cleavage of the HCV encoded polyprotein into mature forms of the NS4A, NS4B, NS5A and NS5B proteins and essential for viral replication. In a biochemical assay, telaprevir inhibited the proteolytic activity of the recombinant HCV NS3 protease domain with an IC50 value of 10 nM.

US Natl Inst Health; DailyMed. Current Medication Information for INCIVEK (telaprevir) tablet, film coated (December 2012). Available from, as of March 12, 2013: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ed0e4f33-cf21-4fe3-918d-1d5b3a23eee4


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