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2D Structure
Also known as: 459789-99-2, 6-ecdca, Int-747, 6-ethylchenodeoxycholic acid, Ocaliva, Obetichloic acid
Molecular Formula
C26H44O4
Molecular Weight
420.6  g/mol
InChI Key
ZXERDUOLZKYMJM-ZWECCWDJSA-N
FDA UNII
0462Z4S4OZ

Obeticholic Acid is an orally bioavailable semi-synthetic bile acid derivative and an agonist of the nuclear bile acid receptor farnesoid X receptor (FXR) that may be used to lower hepatic exposure to bile acids. Upon oral administration, obeticholic acid targets and binds to FXR expressed in the liver and intestine, activating FXR-mediated bile acid, inflammatory, fibrotic, and metabolic pathways. This suppresses the production of bile acid in the hepatocytes and increases bile acid transport out of the hepatocytes, thereby reducing hepatic exposure to bile acids. FXR plays an important role in bile acid homeostasis and is involved in hepatic and intestinal inflammation and liver fibrosis.
Obeticholic acid is a Farnesoid X Receptor Agonist. The mechanism of action of obeticholic acid is as a Farnesoid X Receptor Agonist.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(4R)-4-[(3R,5S,6R,7R,8S,9S,10S,13R,14S,17R)-6-ethyl-3,7-dihydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl]pentanoic acid
2.1.2 InChI
InChI=1S/C26H44O4/c1-5-17-21-14-16(27)10-12-26(21,4)20-11-13-25(3)18(15(2)6-9-22(28)29)7-8-19(25)23(20)24(17)30/h15-21,23-24,27,30H,5-14H2,1-4H3,(H,28,29)/t15-,16-,17-,18-,19+,20+,21+,23+,24-,25-,26-/m1/s1
2.1.3 InChI Key
ZXERDUOLZKYMJM-ZWECCWDJSA-N
2.1.4 Canonical SMILES
CCC1C2CC(CCC2(C3CCC4(C(C3C1O)CCC4C(C)CCC(=O)O)C)C)O
2.1.5 Isomeric SMILES
CC[C@@H]1[C@@H]2C[C@@H](CC[C@@]2([C@H]3CC[C@]4([C@H]([C@@H]3[C@@H]1O)CC[C@@H]4[C@H](C)CCC(=O)O)C)C)O
2.2 Other Identifiers
2.2.1 UNII
0462Z4S4OZ
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 6-ecdca

2. 6-ethyl Chenodeoxycholic Acid

3. 6-ethyl-3,7-dihydroxycholan-24-oic Acid

4. 6-ethylchenodeoxycholic Acid

5. 6alpha-ethyl-3alpha,7alpha-dihydroxy-5beta-cholan-24-oic Acid

6. 6alpha-ethyl-chenodeoxycholic Acid

7. 6ecdca

8. Cholan-24-oic Acid, 6-ethyl-3,7-dihydroxy-, (3alpha,5beta,6alpha,7alpha)-

9. Dsp-1747

10. Dsp1747

11. Int 747

12. Int-747

13. Int747

14. Ocaliva

2.3.2 Depositor-Supplied Synonyms

1. 459789-99-2

2. 6-ecdca

3. Int-747

4. 6-ethylchenodeoxycholic Acid

5. Ocaliva

6. Obetichloic Acid

7. 6alpha-ethyl-chenodeoxycholic Acid

8. Int747

9. Int 747

10. Dsp-1747

11. 6-ethyl-cdca

12. (4r)-4-[(3r,5s,6r,7r,8s,9s,10s,13r,14s,17r)-6-ethyl-3,7-dihydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1h-cyclopenta[a]phenanthren-17-yl]pentanoic Acid

13. 6-ethyl-chenodeoxycholic Acid

14. 6alpha-ethylchenodeoxycholic Acid

15. 0462z4s4oz

16. 6alpha-ethyl-3alpha,7alpha-dihydroxy-5beta-cholan-24-oic Acid

17. 6ecdca

18. (4r)-4-[(1s,2s,5r,7s,8r,9r,10s,11s,14r,15r)-8-ethyl-5,9-dihydroxy-2,15-dimethyltetracyclo[8.7.0.0^{2,7}.0^{11,15}]heptadecan-14-yl]pentanoic Acid

19. Unii-0462z4s4oz

20. 6-et Cdca

21. Obeticholic Acid [usan]

22. Obeticholic Acid [usan:inn]

23. 1osv

24. Dsp1747

25. Ocaliva (tn)

26. 6-ethyl-3,7-dihydroxycholan-24-oic Acid

27. 6-ecdca; Obeticholic Acid

28. Obeticholic Acid [mi]

29. Schembl715823

30. Obeticholic Acid (int-747)

31. Obeticholic Acid [inn]

32. Obeticholic Acid [jan]

33. Chembl566315

34. Gtpl3435

35. (3alpha,5beta,6alpha,7alpha)-6-ethyl-3,7-dihydroxycholan-24-oic Acid

36. Bdbm21675

37. Chebi:43602

38. Dtxsid20196671

39. Ex-a387

40. 6-alpha-ethylchenodeoxycholic Acid

41. Obeticholic Acid [who-dd]

42. Obeticholic Acid (jan/usan/inn)

43. Amy16595

44. Mfcd16621104

45. Zinc14164617

46. Akos024259126

47. Cholan-24-oic Acid, 6-ethyl-3,7-dihydroxy-, (3alpha,5beta,6alpha,7alpha)-

48. Obeticholic Acid [orange Book]

49. Cs-3813

50. Db05990

51. Gs-6103

52. Ncgc00480885-01

53. Hy-12222

54. D09360

55. P16663

56. A854341

57. Q15708271

58. 3a, 7a -dihydroxy-6a -ethyl-5b-cholan-24-oic Acid

59. 3alpha,7alpha-dihydroxy-6alpha-ethyl-5beta-cholan-24-oic Acid

60. (3alpha,5beta,6alpha,7alpha,8xi)-6-ethyl-3,7-dihydroxycholan-24-oic Acid

61. (3beta,5beta,6alpha,7beta)-6-ethyl-3,7-dihydroxycholan-24-oic Acid

62. (3.alpha.,5.beta.,6.alpha.,7.alpha.)-6-ethyl-3,7-dihydroxycholan-24-oic Acid

63. (r)-4-((3r,5s,6r,7r,8s,9s,10s,13r,14s,17r)-6-ethyl-3,7-dihydroxy-10,13-dimethyl-hexadecahydro-1h-cyclopenta[a]phenanthren-17-yl)pentanoic Acid

64. (r)-4-((3r,7r,8s,9s,10s,13r,14s,17r)-6-ethyl-3,7-dihydroxy-10,13-dimethyl-hexadecahydro-1h-cyclopenta[a]phenanthren-17-yl)pentanoic Acid

65. Cholan-24-oic Acid, 6-ethyl-3,7-dihydroxy-, (3.alpha.,5.beta.,6.alpha.,7.alpha.)-

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 420.6 g/mol
Molecular Formula C26H44O4
XLogP35.7
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count4
Rotatable Bond Count5
Exact Mass420.32395988 g/mol
Monoisotopic Mass420.32395988 g/mol
Topological Polar Surface Area77.8 Ų
Heavy Atom Count30
Formal Charge0
Complexity649
Isotope Atom Count0
Defined Atom Stereocenter Count11
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

Obeticholic acid is indicated for the treatment of primary biliary cholangitis in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA. It is also used as a monotherapy in adults with PBC that are unable to tolerate UDCA. Obeticholic acid is currently being considered for FDA approval to treat fibrosis caused by non-alcoholic liver steatohepatitis (NASH), and is likely to be approved for this indication in 2020.


FDA Label


Ocaliva is indicated for the treatment of primary biliary cholangitis (also known as primary biliary cirrhosis) in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA or as monotherapy in adults unable to tolerate UDCA.


Treatment of non-alcoholic steatohepatitis (NASH)


Treatment of biliary atresia, Treatment of primary biliary cirrhosis


5 Pharmacology and Biochemistry
5.1 Pharmacology

The activation of the FXR by obeticholic acid acts to reduce the synthesis of bile acids, inflammation, and the resulting hepatic fibrosis. This may increase the survival of patients with PBC, but to date, an association between obeticholic acid and survival in PBC has not been established.


5.2 FDA Pharmacological Classification
5.2.1 Active Moiety
OBETICHOLIC ACID
5.2.2 FDA UNII
0462Z4S4OZ
5.2.3 Pharmacological Classes
Farnesoid X Receptor Agonists [MoA]; Farnesoid X Receptor Agonist [EPC]
5.3 ATC Code

A05AA04


A05AA04

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


A - Alimentary tract and metabolism

A05 - Bile and liver therapy

A05A - Bile therapy

A05AA - Bile acids and derivatives

A05AA04 - Obeticholic acid


5.4 Absorption, Distribution and Excretion

Absorption

Obeticholic acid is absorbed in the gastrointestinal tract. The Cmax of obeticholic acid occurs at approximately 1.5 hours after an oral dose and ranges from 28.8-53.7 ng/mL at doses of 5-10mg. The median Tmax for both the conjugates of obeticholic acid is about 10 hours. One product monograph reports a Tmax of 4.5h for both 5 and 10mg doses. The AUC ranged from 236.6-568.1 ng/h/mL with 5mg to 10 mg doses.


Route of Elimination

About 87% of an orally administered dose is accounted for in the feces. Less than 3% of the dose can be recovered in the urine.


Volume of Distribution

The volume of distribution of obeticholic acid is 618 L.


Clearance

Clearance information for obeticholic acid is not readily available in the literature.


5.5 Metabolism/Metabolites

The metabolism of obeticholic acid occurs in the liver. Obeticholic acid is conjugated with glycine or taurine, followed by secretion into bile. The conjugates are then absorbed in the small intestine and then re-enter the liver via enterohepatic circulation. The intestinal microbiota in the ileum converts conjugated obeticholic acid in a deconjugated form that may be either reabsorbed or eliminated. Glycine conjugates account for 13.8% of the metabolites and taurine conjugates account for 12.3%. Another metabolite, 3-glucuronide, may also be formed, but displays little pharmacological activity.


5.6 Biological Half-Life

The biological half-life of obeticholic acid is reported to be 24 hours.


5.7 Mechanism of Action

Primary biliary cirrhosis is an autoimmune process by which the bile ducts and liver are damaged progressively, leading to fibrosis and cirrhosis. Bile acids increase the risk of damage and fibrosis to the damaged bile ducts. Obeticholic acid is a potent agonist of the farnesoid X receptor, which serves to regulate the hepatic metabolism of bile and cholesterol. This drug acts by binding to the farnesoid X receptor (FXR), found in the nucleus of liver and intestinal cells, which in turn increases liver bile flow, suppressing its production and decreasing hepatocyte exposure to excess levels of bile with cholestasis. Cholestasis is a process that normally causes inflammation and cirrhosis of the liver.