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2D Structure
Also known as: 379270-37-8, Gs-7340, Gs 7340, Unii-el9943ag5j, Gs-734003, El9943ag5j
Molecular Formula
C21H29N6O5P
Molecular Weight
476.5  g/mol
InChI Key
LDEKQSIMHVQZJK-CAQYMETFSA-N
FDA UNII
EL9943AG5J

Tenofovir Alafenamide is a lipophilic phosphonamidate prodrug of tenofovir, a synthetic antiviral acyclic nucleotide analog of adenosine 5-monophosphate and a nucleoside reverse transcriptase inhibitor (NRTI), with antiviral activity against hepatitis B virus (HBV) and potentially against human immunodeficiency virus (HIV). Upon oral administration, tenofovir alafenamide is taken up by hepatocytes through passive diffusion and through the hepatic uptake transporters organic anion transporting polypeptides 1B1 (OATP1B1) and 1B3 (OATP1B3). Inside the hepatocytes, tenofovir alafenamide is hydrolyzed and converted to tenofovir by carboxylesterase 1 (CES1). Intracellular tenofovir is phosphorylated by cellular kinases to its pharmacologically active form, tenofovir diphosphate. Tenofovir diphosphate is incorporated into viral DNA instead of the natural substrate deoxyadenosine 5-triphosphate, and inhibits HBV reverse transcriptase, resulting in DNA chain-termination and inhibition of HBV replication. In addition, tenofovir diphosphate is incorporated into HIV DNA instead of the natural substrate deoxyadenosine 5-triphosphate, thereby inhibiting HIV-1 reverse transcriptase (RT) and resulting in DNA chain termination and impairment of HIV replication.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
propan-2-yl (2S)-2-[[[(2R)-1-(6-aminopurin-9-yl)propan-2-yl]oxymethyl-phenoxyphosphoryl]amino]propanoate
2.1.2 InChI
InChI=1S/C21H29N6O5P/c1-14(2)31-21(28)16(4)26-33(29,32-17-8-6-5-7-9-17)13-30-15(3)10-27-12-25-18-19(22)23-11-24-20(18)27/h5-9,11-12,14-16H,10,13H2,1-4H3,(H,26,29)(H2,22,23,24)/t15-,16+,33+/m1/s1
2.1.3 InChI Key
LDEKQSIMHVQZJK-CAQYMETFSA-N
2.1.4 Canonical SMILES
CC(C)OC(=O)C(C)NP(=O)(COC(C)CN1C=NC2=C(N=CN=C21)N)OC3=CC=CC=C3
2.1.5 Isomeric SMILES
C[C@H](CN1C=NC2=C(N=CN=C21)N)OC[P@@](=O)(N[C@@H](C)C(=O)OC(C)C)OC3=CC=CC=C3
2.2 Other Identifiers
2.2.1 UNII
EL9943AG5J
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Gs-7340

2. Gs-734003

3. L-alanine, N-((s)-(((1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy)methyl)phenoxyphosphinyl)-, 1-methylethyl Ester

4. Vemlidy

2.3.2 Depositor-Supplied Synonyms

1. 379270-37-8

2. Gs-7340

3. Gs 7340

4. Unii-el9943ag5j

5. Gs-734003

6. El9943ag5j

7. 383365-04-6

8. Vemlidy

9. L-alanine, N-((s)-(((1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy)methyl)phenoxyphosphinyl)-, 1-methylethyl Ester

10. (s)-isopropyl 2-(((s)-((((r)-1-(6-amino-9h-purin-9-yl)propan-2-yl)oxy)methyl)(phenoxy)phosphoryl)amino)propanoate

11. Propan-2-yl (2s)-2-[[[(2r)-1-(6-aminopurin-9-yl)propan-2-yl]oxymethyl-phenoxyphosphoryl]amino]propanoate

12. Gs7340

13. J4414g3buk

14. Tenofovir Alafenamide [usan]

15. Taf

16. Gs-7339

17. Tenofovir Alafenamide [usan:inn]

18. L-alanine, N-[(s)-[[(1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy]methyl]phenoxyphosphinyl]-, 1-methylethyl Ester

19. Unii-j4414g3buk

20. Schembl3107149

21. Chembl2107825

22. Gs-7340 Tenofovir Alafenamide

23. Chebi:90926

24. Dtxsid50958941

25. Ex-a610

26. Gs-7340; Tenofovir Alafenamide

27. Tenofovir Alafenamide (usan/inn)

28. Tenofovir Alafenamide [mi]

29. Tenofovir Alafenamide [inn]

30. Isopropyl (2s)-2-[[[(1r)-2-(6-aminopurin-9-yl)-1-methyl-ethoxy]methyl-phenoxy-phosphoryl]amino]propanoate

31. L-alanine, N-((r)-(((1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy)methyl)phenoxyphosphinyl)-, 1-methylethyl Ester

32. N-((r)-(((1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy)methyl)phenoxyphosphinyl)-l-alanine 1-methylethyl Ester

33. Mfcd23843796

34. Akos016009341

35. Tenofovir Alafenamide [who-dd]

36. Zinc100055899

37. Ccg-269506

38. Cs-3366

39. Db09299

40. Ncgc00390564-03

41. Ncgc00390564-04

42. Ac-29893

43. As-55942

44. Hy-15232

45. B8021

46. S7856

47. Tenofovir Alafenamide (prodrug Of Tenofovir)

48. D10428

49. Q22075912

50. Sp-tenofovir-phosphonamidate, Phenyl, L-alanine Isopropyl Ester

51. (s)-isopropyl 2-((s)-(((r)-1-(6-amino-9h-purin-9-yl)propan-2-yloxy)methyl)(phenoxy)phosphorylamino)propanoate

52. 1-methylethyl N-((s)-(((1r)-2-(6-amino-9h-purin-9-yl)-1-methylethoxy)methyl)phenoxyphosphinyl)-l-alaninate

53. 9-[(r)-2-[[(s)-[[(s)-1-(isopropoxycarbonyl)ethyl]amino]phenoxyphosphinyl]methoxy]propyl]adenine

54. L-alanine, Sp-n-[[[[(1r)-2-(6-amino-9h-purin-9-yl)-1-methylethyl]oxy]methyl]phenoxyphosphinyl]-, Isopropyl Ester

55. Propan-2-yl (2s)-2-{[(s)-({[(2r)-1-(6-amino-9h-purin-9-yl)propan-2-yl]oxy}methyl)(phenoxy)phosphoryl]amino}propanoate

56. Propan-2-yl N-[(s)-({[(2r)-1-(6-amino-9h-purin-9-yl)propan-2-yl]oxy}methyl)(phenoxy)phosphoryl]-l-alaninate

2.4 Create Date
2006-10-24
3 Chemical and Physical Properties
Molecular Weight 476.5 g/mol
Molecular Formula C21H29N6O5P
XLogP31.9
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count10
Rotatable Bond Count12
Exact Mass476.19370504 g/mol
Monoisotopic Mass476.19370504 g/mol
Topological Polar Surface Area144 Ų
Heavy Atom Count33
Formal Charge0
Complexity680
Isotope Atom Count0
Defined Atom Stereocenter Count3
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Indication

Tenofovir alafenamide is indicated for the treatment of chronic hepatitis B in adult patients with compensated liver disease. In combination with [emtricitabine] and other antiretrovirals, it is indicated for the treatment of HIV-1 infection in adolescent and adult patients with a weight higher than 35 kg. This combination is also indicated to prevent HIV-1 infections in high risk adolescent and adult patients, excluding patients at risk from receptive vaginal sex. When combined with antiretrovirals other than protease inhibitors that require a CYP3A inhibitor, it can be used to treat pediatric patients weighing 25-35 kg. In the combination product with emtricitabine and [bictegravir], tenofovir alafenamide is considered as a complete regimen for the treatment of HIV-1 infection in treatment-naive patients or in patients virologically suppressed for at least 3 months with no history of treatment failure. Additionally, the combination product including [elvitegravir], [cobicistat], emtricitabine and tenofovir alafenamide and the combination product including emtricitabine, [rilpivirine] and tenofovir alafenamide can be used in the treatment of HIV-1 infection in patients older than 12 years with no previous antiretroviral therapy history or who are virologically suppressed for at least 6 months with no history of treatment failure. The combination product including [darunavir], cobicistat, emtricitabine, and tenofovir alafenamide is indicated for the treatment of HIV-1 infection in adults without prior antiretroviral therapy or in patients virologically suppressed for 6 months and no reported resistance to darunavir or tenofovir.


FDA Label


Vemlidy is indicated for the treatment of chronic hepatitis B in adults and adolescents (aged 12 years and older with body weight at least 35 kg).


5 Pharmacology and Biochemistry
5.1 Pharmacology

Tenofovir alafenamide has been shown to be a potent inhibitor of hepatitis B viral replication. Tenofovir alafenamide presents a better renal tolerance when compared with the counterpart [tenofovir disoproxil]. This improved safety profile seems to be related to a lower plasma concentration of tenofovir. In clinical trials, tenofovir alafenamide was shown to present 5-fold more potent antiviral activity against HIV-1 when compared to tenofovir disoproxil.


5.2 FDA Pharmacological Classification
5.2.1 Pharmacological Classes
Human Immunodeficiency Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]; Nucleoside Reverse Transcriptase Inhibitors [MoA]; Nucleosides [CS]; Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor [EPC]
5.3 ATC Code

J05AF


J - Antiinfectives for systemic use

J05 - Antivirals for systemic use

J05A - Direct acting antivirals

J05AF - Nucleoside and nucleotide reverse transcriptase inhibitors

J05AF13 - Tenofovir alafenamide


5.4 Absorption, Distribution and Excretion

Absorption

As compared to the parent molecule, [tenofovir], tenofovir alafenamide presents a lipophilic group that masks the negative charge of the parent moiety which improves its oral bioavailability. Tenofovir alafenamide is highly stable in plasma and, after administration of this prodrug, there is a low concentration of tenofovir in plasma. After oral administration, tenofovir alafenamide is rapidly absorbed by the gut. When a single dose is administered, a peak concentration of 16 ng/ml of the parent compound, corresponding to about 73% of the dose, is observed after 2 hours with an AUC of 270 ng\*h/mL. Once inside the body, tenofovir alafenamide enters hepatocytes by passive diffusion regulated by the organic anion transporters 1B1 and 1B3 for its activation. Administration of tenofovir alafenamide concomitantly with a high-fat meal results in an increase of about 65% in its internal exposure.


Route of Elimination

Tenofovir alafenamide has been registered to present a bile elimination that corresponds to 47% of the administered dose and a renal elimination the represents about 36%. From the recovered dose in urine, about 75% is represented as unchanged [tenofovir] followed by uric acid and a small dose of tenofovir alafenamide. On the other hand, in feces, 99% of the recovered dose corresponds to tenofovir.


Volume of Distribution

In clinical trials, the reported volume of distribution of tenofovir alafenamide was higher than 100 L.


Clearance

The reported clearance rate of tenofovir alafenamide is 117 L/h. In patients with severe renal impairment, this value can be decreased by 50%, reporting a rate of 61.7 L/h.


5.5 Metabolism/Metabolites

To be activated, tenofovir alafenamide is required to be hydrolyzed to the parent compound [tenofovir] by the activity of cathepsin A or carboxylesterase 1. Tenofovir alafenamide presents significant plasma stability and hence, its activation is performed inside the target cells. After activation, tenofovir is further processed and after 1-2 days, it is detected in plasma almost completely transformed to uric acid.


5.6 Biological Half-Life

The reported half-life for tenofovir alafenamide is of 0.51 hours.


5.7 Mechanism of Action

Tenofovir alafenamide presents 91% lower plasma concentration with an intracellular presence of about 20-fold higher when compared to [tenofovir disoproxil]. This is due to its prolonged systemic exposure and its higher intracellular accumulation of the active metabolite tenofovir diphosphate. Tenofovir alafenamide accumulates more in peripheral blood mononuclear cells compared to red blood cells. Once activated, tenofovir acts with different mechanisms including the inhibition of viral polymerase, causing chain termination and the inhibition of viral synthesis. To know more about the specific mechanism of action of the active form, please visit the drug entry of [tenofovir].