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2D Structure
Also known as: 5630-53-5, Liviella, Livial, Org od 14, Tibolona, Tibolonum
Molecular Formula
C21H28O2
Molecular Weight
312.4  g/mol
InChI Key
WZDGZWOAQTVYBX-XOINTXKNSA-N
FDA UNII
FF9X0205V2

Tibolone is a synthetic anabolic steroid with estrogenic, androgenic and progestagenic activities. The 3alpha- and 3beta-hydroxy metabolites of tibilone activate estrogenic receptors (ERs) in bone and vaginal tissue leading to a decrease in bone turnover, and decreased vaginal dryness, respectively; derived from the 3beta-hydroxy metabolite, its delta4-isomer activates androgenic receptors (ARs) in the brain and liver and progestogenic receptors (PRs) in endometrial tissue, affecting sexual function, lipid metabolism, and endometrial function, respectively. In breast and endometrial tissue, tibolone metabolites inhibit sulfatase, preventing the conversion of circulating estrone sulfate and estradiol sulfate to estrone and estradiol, respectively; estrogen-mediated effects in the breast and uterus are thus reduced.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(7R,8R,9S,13S,14S,17R)-17-ethynyl-17-hydroxy-7,13-dimethyl-1,2,4,6,7,8,9,11,12,14,15,16-dodecahydrocyclopenta[a]phenanthren-3-one
2.1.2 InChI
InChI=1S/C21H28O2/c1-4-21(23)10-8-18-19-13(2)11-14-12-15(22)5-6-16(14)17(19)7-9-20(18,21)3/h1,13,17-19,23H,5-12H2,2-3H3/t13-,17-,18+,19-,20+,21+/m1/s1
2.1.3 InChI Key
WZDGZWOAQTVYBX-XOINTXKNSA-N
2.1.4 Canonical SMILES
CC1CC2=C(CCC(=O)C2)C3C1C4CCC(C4(CC3)C)(C#C)O
2.1.5 Isomeric SMILES
C[C@@H]1CC2=C(CCC(=O)C2)[C@@H]3[C@@H]1[C@@H]4CC[C@]([C@]4(CC3)C)(C#C)O
2.2 Other Identifiers
2.2.1 UNII
FF9X0205V2
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Boltin

2. Livial

3. Liviella

4. Org Od 14

5. Org Od14

6. Tibilone

2.3.2 Depositor-Supplied Synonyms

1. 5630-53-5

2. Liviella

3. Livial

4. Org Od 14

5. Tibolona

6. Tibolonum

7. Xyvion

8. Boltin

9. (7r,8r,9s,13s,14s,17r)-17-ethynyl-17-hydroxy-7,13-dimethyl-1,2,4,6,7,8,9,11,12,14,15,16-dodecahydrocyclopenta[a]phenanthren-3-one

10. 17-hydroxy-7alpha-methyl-19-nor-17alpha-pregn-5(10)-en-20-yn-3-one

11. Org-od 14

12. Chebi:32223

13. Ff9x0205v2

14. Nsc-759898

15. (1s,9r,10r,11s,14r,15s)-14-ethynyl-14-hydroxy-9,15-dimethyltetracyclo[8.7.0.0^{2,7}.0^{11,15}]heptadec-2(7)-en-5-one

16. Dsstox_cid_3667

17. (7alpha,17alpha)-17-hydroxy-7-methyl-19-norpregn-5(10)-en-20-yn-3-one

18. Dsstox_rid_77135

19. Dsstox_gsid_23667

20. 17alpha-ethynyl-17beta-hydroxy-7alpha-methylestr-5(10)-en-3-one

21. (17r)-17-hydroxy-7alpha-methyl-19-norpregn-5(10)-en-20-yn-3-one

22. (7alpha,17beta)-17-ethynyl-17-hydroxy-7-methylestr-5(10)en-3-one

23. Cas-5630-53-5

24. Tibolonum [inn-latin]

25. Tibolona [inn-spanish]

26. Tibolone [usan:inn:ban]

27. Tibofem

28. Unii-ff9x0205v2

29. 19-norpregn-5(10)-en-20-yn-3-one, 17-hydroxy-7-methyl-, (7.alpha.,17.alpha.)-

30. Ncgc00164632-01

31. Einecs 227-069-1

32. Tibolone [usan]

33. Org-od14

34. Tibolone [inn]

35. Tibolone [jan]

36. Tibolone [mi]

37. Tibolone [vandf]

38. Tibolone [mart.]

39. Tibolone [who-dd]

40. Schembl41172

41. Org Od 14;org Od14

42. Tibolone (jan/usan/inn)

43. Mls001424234

44. Tibolone [ep Impurity]

45. Gtpl9711

46. Tibolone [ep Monograph]

47. Chembl2103774

48. Dtxsid5023667

49. 17-hydroxy-7.alpha.-methyl-19-nor-17.alpha.-pregn-5(10)-en-20-yn-3-one

50. Hms2052k21

51. Hms2090b10

52. Hms2232b13

53. Hms3649j14

54. Hms3712j15

55. Zinc3812889

56. Tox21_112250

57. Kb-889

58. Akos015963197

59. Tox21_112250_1

60. Ccg-101148

61. Db09070

62. Gs-3562

63. Nc00398

64. Nsc 759898

65. Ncgc00164632-02

66. (7beta,8xi,9beta,13alpha,14beta,17alpha)-17-ethynyl-17-hydroxy-7-methylestr-5(10)-en-3-one

67. Ac-20036

68. Ac-31722

69. Cpd000469219

70. Smr000469219

71. D01639

72. T-3854

73. Ab00698273-05

74. 630t535

75. Q413805

76. Sr-01000763531

77. Sr-01000946727

78. Sr-01000763531-3

79. Sr-01000946727-1

80. 17.alpha.-hydroxy-7.alpha.-methyl-19-norpregn-5(10)-en-20-yn-3-one

81. 19-norpregn-5(10)-en-20-yn-3-one, 17-hydroxy-7-methyl-, (7alpha,17alpha)-

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 312.4 g/mol
Molecular Formula C21H28O2
XLogP32.4
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count2
Rotatable Bond Count1
Exact Mass312.208930132 g/mol
Monoisotopic Mass312.208930132 g/mol
Topological Polar Surface Area37.3 Ų
Heavy Atom Count23
Formal Charge0
Complexity636
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 Indication

For the relief of post-menopausal symptoms and for the prevention of osteoporosis.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Tibolone prevents bone loss and treating post-menopausal symptoms without stimulating the endometrial tissues, which may lead to malignancy. Typical, drugs that treat post-menopausal symptoms such as estrogen, have a proliferative effect on the endometrium, increasing the risk of endometrial carcinoma. The effects on the bone, brain and vaginal tissues can be explained by the estrogenic activity of tibolone. It is important to note that activity is not expressed in the endometrium. Tibolone behaves differently from estrogen plus progesterone combinations on the breast. Therefore, tibolone can be characterized as a selective estrogen activity regulator. Tibolone has been demonstrated to be an effective agent in treating symptoms associated with menopause. A 16 week trial in 1189 women examined the effect of tibolone 2.5 mg once daily on climacteric symptoms. Women treated with tibolone showed improvement from baseline in typical menopausal symptoms including hot flashes, sweating, insomnia, and anxiety.


5.2 MeSH Pharmacological Classification

Anabolic Agents

These compounds stimulate anabolism and inhibit catabolism. They stimulate the development of muscle mass, strength, and power. (See all compounds classified as Anabolic Agents.)


Androgen Antagonists

Compounds which inhibit or antagonize the biosynthesis or actions of androgens. (See all compounds classified as Androgen Antagonists.)


Antihypertensive Agents

Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. (See all compounds classified as Antihypertensive Agents.)


Estrogen Receptor Modulators

Substances that possess antiestrogenic actions but can also produce estrogenic effects as well. They act as complete or partial agonist or as antagonist. They can be either steroidal or nonsteroidal in structure. (See all compounds classified as Estrogen Receptor Modulators.)


Antineoplastic Agents, Hormonal

Antineoplastic agents that are used to treat hormone-sensitive tumors. Hormone-sensitive tumors may be hormone-dependent, hormone-responsive, or both. A hormone-dependent tumor regresses on removal of the hormonal stimulus, by surgery or pharmacological block. Hormone-responsive tumors may regress when pharmacologic amounts of hormones are administered regardless of whether previous signs of hormone sensitivity were observed. The major hormone-responsive cancers include carcinomas of the breast, prostate, and endometrium; lymphomas; and certain leukemias. (From AMA Drug Evaluations Annual 1994, p2079) (See all compounds classified as Antineoplastic Agents, Hormonal.)


5.3 ATC Code

G03CX01

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


G - Genito urinary system and sex hormones

G03 - Sex hormones and modulators of the genital system

G03C - Estrogens

G03CX - Other estrogens

G03CX01 - Tibolone


5.4 Absorption, Distribution and Excretion

Absorption

Tibolone is extensively and rapidly absorbed after oral administration. The parent drug undergoes extensive metabolism, with. Greater than 80% of a radioactive dose excreted from the body as metabolites, which suggests very low plasma concentrations of tibolone. Plasma concentrations of the metabolites appear within 30 minutes and peak within 11.5 hours.2,7 The plasma concentrations of the hydroxymetabolites are higher than those of the 4-isomer. Food does not appear to have an effect on the absorption of this drug.


Route of Elimination

Excreted in the urine and feces in the form of sulfated metabolites,. The predominant route of elimination of tibolone is via the feces, although some excretion occurs via the urine.


Clearance

Elimination of tibolone is not dependent renal function.


5.5 Metabolism/Metabolites

Tibolone is metabolized mainly in the liver. The cytochrome P450 isoenzyme system is involved in minor hydroxylation of tibolone. Tibolone is rapidly converted into three major metabolites: 3 alpha- and 3 beta-hydroxy-tibolone, which have oestrogenic effects, and the Delta(4)-isomer, which has both progestogenic and androgenic effects. The 3-hydroxy metabolites are present in the circulation, predominantly in their inactive sulfated form.


5.6 Biological Half-Life

The elimination half-life is approximately 45 h.


5.7 Mechanism of Action

This drug's effects are owed to the activity of its metabolites in various tissues. Upon ingestion, tibolone is quickly converted into three major metabolites: _3 alpha- and 3 beta-hydroxy-tibolone_, which have oestrogenic effects, and the _Delta(4)-isomer_, which has progestogenic and androgenic effects. The specific tissue-selective effects of tibolone occur due to the metabolism, regulation of enzymes and receptor activation that varies in different tissues of the body. The bone-conserving effects occur due to estradiol receptor activation, while the progesterone and androgen receptors are not involved in this process. Breast tissue of monkeys is not found to be stimulated after tibolone administration, as occurs with estrogen plus progesterone used in combination. This is explained by the fact that tibolone and its metabolites inhibit _sulphatase and 17 beta-hydroxysteroid dehydrogenase_ (HSD) type I and _stimulate sulphotransferase and 17 beta-HSD type II_. The combined effects of this process prevent the conversion to active estrogens. In the uterus, the progestogenic activity of the _Delta(4)-metabolite_ and the effect on estrogen-inactivating enzymes prevent estrogenic stimulation. The mammary gland is not stimulated in currently used animal models. Tibolone has been shown to regulate estrogenic activity in several tissue types by influencing the availability of estrogenic compounds for the estradiol receptor in a selective manner. Additionally, tibolone modulates cellular homeostasis in the breast by preventing breast tissue proliferation and stimulating cell apoptosis. Tibolone does not stimulate the endometrium because of the action of its highly stable progestogenic metabolite (Delta(4)-isomer) in combination with an effect on the sulfatase (inhibition)-sulfotransferase (stimulation) system. The estrogenic metabolites of tibolone have direct, favorable effects on the cardiovascular system and, in animal models, this drug has shown no adverse consequences. The tissue-selective effects of tibolone are the result of metabolism, enzyme regulation and receptor activation that vary in different tissues. The bone-preserving effects of tibolone are the result of estradiol receptor activation, while other steroid receptors, mainly the progesterone and androgen receptors, are not involved in this process. In a study of monkeys, breast tissue was not stimulated, which occurs with estrogen and progesterone, because tibolone and its metabolites inhibit _sulfatase and 17 beta-hydroxysteroid _dehydrogenase (HSD) type I and stimulate _sulfotransferase and 17 beta-HSD type II_. The simultaneous effects of this process halt conversion to active estrogens. Additionally, tibolone affects cellular homeostasis in the breast by preventing proliferation and stimulating apoptosis. Tibolone does not stimulate the endometrium due to the action of the highly stable progestogenic metabolite (Delta(4)-isomer) in combination with an effect on the sulphatase (inhibition)-sulphotransferase (stimulation) pathway. The levels of tibolone metabolites and the alteration of hormonal activities vary according to the tissue type. In endometrial tissue the _4-isomer_ functions as a progestagen, however, in the brain and liver, it shows androgenic effects. In breast tissue, the primary actions of tibolone are strong inhibition of sulfatase activity and weak inhibition of 17-hydroxysteroid dehydrogenase activity, which leads to blocking the conversion estrone sulfate to E2.