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Also known as: 159811-51-5, Uliprisnil, 6j5j15q2x8, (8s,11r,13s,14s,17r)-17-acetyl-11-[4-(dimethylamino)phenyl]-17-hydroxy-13-methyl-1,2,6,7,8,11,12,14,15,16-decahydrocyclopenta[a]phenanthren-3-one, 11beta-(4-(dimethylamino)phenyl)-17-hydroxy-19-norpregna-4,9-diene-3,20-dione, (8s,11r,13s,14s,17r)-17-acetyl-11-(4-(dimethylamino)phenyl)-17-hydroxy-13-methyl-6,7,8,11,12,13,14,15,16,17-decahydro-1h-cyclopenta[a]phenanthren-3(2h)-one
Molecular Formula
C28H35NO3
Molecular Weight
433.6  g/mol
InChI Key
HKDLNTKNLJPAIY-WKWWZUSTSA-N
FDA UNII
6J5J15Q2X8

CAS 159811-51-5
Ulipristal is a selective progesterone receptor modulator with anti-progesterone activity. Ulipristal binds to the progesterone receptor (PR), thereby inhibiting PR-mediated gene expression, and interfering with progesterone activity in the reproductive system. As a result, this agent may suppress the growth of uterine leiomyomatosis. Furthermore, by inhibiting or delaying ovulation and effecting endometrial tissue, ulipristal can be used as an emergency contraception.
Ulipristal is a Progesterone Agonist/Antagonist. The mechanism of action of ulipristal is as a Selective Progesterone Receptor Modulator.
1 2D Structure

CAS 159811-51-5

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(8S,11R,13S,14S,17R)-17-acetyl-11-[4-(dimethylamino)phenyl]-17-hydroxy-13-methyl-1,2,6,7,8,11,12,14,15,16-decahydrocyclopenta[a]phenanthren-3-one
2.1.2 InChI
InChI=1S/C28H35NO3/c1-17(30)28(32)14-13-25-23-11-7-19-15-21(31)10-12-22(19)26(23)24(16-27(25,28)2)18-5-8-20(9-6-18)29(3)4/h5-6,8-9,15,23-25,32H,7,10-14,16H2,1-4H3/t23-,24+,25-,27-,28-/m0/s1
2.1.3 InChI Key
HKDLNTKNLJPAIY-WKWWZUSTSA-N
2.1.4 Canonical SMILES
CC(=O)C1(CCC2C1(CC(C3=C4CCC(=O)C=C4CCC23)C5=CC=C(C=C5)N(C)C)C)O
2.1.5 Isomeric SMILES
CC(=O)[C@]1(CC[C@@H]2[C@@]1(C[C@@H](C3=C4CCC(=O)C=C4CC[C@@H]23)C5=CC=C(C=C5)N(C)C)C)O
2.2 Other Identifiers
2.2.1 UNII
6J5J15Q2X8
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 17alpha-acetoxy-11beta-(4-n,n-dimethylaminophenyl)-19-norpregna-4,9-diene-3,20-dione

2. Cdb 2914

3. Cdb-2914

4. Hrp 2000

5. Hrp-2000

6. Rti-3021-012

7. Rti-3021-022

8. Va-2914

9. Va2914

2.3.2 Depositor-Supplied Synonyms

1. 159811-51-5

2. Uliprisnil

3. 6j5j15q2x8

4. (8s,11r,13s,14s,17r)-17-acetyl-11-[4-(dimethylamino)phenyl]-17-hydroxy-13-methyl-1,2,6,7,8,11,12,14,15,16-decahydrocyclopenta[a]phenanthren-3-one

5. 11beta-(4-(dimethylamino)phenyl)-17-hydroxy-19-norpregna-4,9-diene-3,20-dione

6. (8s,11r,13s,14s,17r)-17-acetyl-11-(4-(dimethylamino)phenyl)-17-hydroxy-13-methyl-6,7,8,11,12,13,14,15,16,17-decahydro-1h-cyclopenta[a]phenanthren-3(2h)-one

7. Ulipristal [inn]

8. Ellae

9. Ulipristal [usan:inn:ban]

10. Unii-6j5j15q2x8

11. Ulipristal-d3

12. Pgl 4001

13. Ulipristal (usan/inn)

14. Ulipristal [usan]

15. Ulipristal [vandf]

16. Ulipristal [who-dd]

17. Ulipristal Acetate Ulipristal

18. Schembl545159

19. Ulipristal [ema Epar]

20. Chembl2103846

21. Chebi:177631

22. Dtxsid501025842

23. S3081

24. Zinc34089131

25. Akos025401807

26. Db08867

27. Ac-25786

28. Bs-15555

29. Hy-14959

30. Rti-3021-022

31. Ulipristal Acetate Ulipristal [mi]

32. Cs-0003658

33. D09567

34. H12074

35. A906751

36. Q27264992

37. 11.beta.-(4-(dimethylamino)phenyl)-17-hydroxy-19-norpregna-4,9-diene-3,20-dione

38. 17alpha-acetoxy-11beta-(4-n,n-dimethylaminophenyl)-19-norpregna-4,9-diene-3,20-dione

39. 19-norpregna-4,9-diene-3,20-dione, 11-[4-(dimethylamino)phenyl]-17-hydroxy-, (11beta)-

40. (8s,11r,13s,14s,17r)-17-acetyl-11-(4-dimethylamino-phenyl)-17-hydroxy-13-methyl-1,2,6,7,8,11,12,13,14,15,16,17-dodecahydro-cyclopenta[a]phenanthren-3-one

2.4 Create Date
2007-02-08
3 Chemical and Physical Properties
Molecular Weight 433.6 g/mol
Molecular Formula C28H35NO3
XLogP32.9
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count4
Rotatable Bond Count3
Exact Mass433.26169398 g/mol
Monoisotopic Mass433.26169398 g/mol
Topological Polar Surface Area57.6 Ų
Heavy Atom Count32
Formal Charge0
Complexity877
Isotope Atom Count0
Defined Atom Stereocenter Count5
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

As the product Ella (available in Canada and the US), ulipristal is indicated for use as emergency contraception after unprotected intercourse or possible contraceptive failure when administered within 120 hours (5 days) after unprotected intercourse or a known or suspected contraceptive failure. As the product Fibristal (available in Canada), ulipristal is indicated for treatment of the signs and symptoms of uterine fibroids in adult women.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Ulipristal is a selective, reversible progestin receptor modulator and its tissue targets include the uterus, cervix, ovaries, and hypothalamus. Ulipristal may act as an agonist or antagonist in the presence or absence of progesterone based on the tissue target. If given mid-follicular phase, development of the follicle growth is delayed and estradiol concentrations decrease. If given at the time when luteinizing hormone peaks, follicular rapture is delayed by several days. If given early-luteal phase, a decrease in endometrial thickness can be observed.


5.2 FDA Pharmacological Classification
5.2.1 Active Moiety
ULIPRISTAL
5.2.2 FDA UNII
6J5J15Q2X8
5.2.3 Pharmacological Classes
Mechanisms of Action [MoA] - Selective Progesterone Receptor Modulators
5.3 ATC Code

G - Genito urinary system and sex hormones

G03 - Sex hormones and modulators of the genital system

G03A - Hormonal contraceptives for systemic use

G03AD - Emergency contraceptives

G03AD02 - Ulipristal


G - Genito urinary system and sex hormones

G03 - Sex hormones and modulators of the genital system

G03X - Other sex hormones and modulators of the genital system

G03XB - Progesterone receptor modulators

G03XB02 - Ulipristal


5.4 Absorption, Distribution and Excretion

Absorption

Tmax, healthy subjects, single oral dose = 60-90 minutes; Cmax, healthy subjects, single oral dose = 176 89 ng/mL; AUC(0-), healthy subjects, single oral dose = 556 260 ngh/mL;


Clearance

Mean oral clearance, single oral dose, healthy subject (CL/F) = 76.8 64.0L/h


5.5 Metabolism/Metabolites

Ulipristal is metabolized by CYP3A4 and to a lesser extent by CYP1A2 into mono-demethylated (active) and di-methylated (inactive) metabolites.


5.6 Biological Half-Life

Mean elimination half-life, single oral dose, healthy subject = 32.4 6.3 hours


5.7 Mechanism of Action

The exact mechanism of action of ulipristal has been heavily debated. On one hand, the majority of official prescribing information labels, monographs, and prior research studies for ulipristal indicated as an emergency contraceptive suggest that its primary mechanism of action revolves around inhibiting or delaying ovulation by suppressing surges in LH that result in the postponement of follicular rupture. Conversely, some of the latest investigations pertaining to ulipristal's mechanism of action as an emergency contraceptive propose that it principally elicits its action by preventing embryo implantation, as opposed to preventing ovulation. Although previous investigations have shown that ulipristal essentially has the ability to prevent ovulation equivalent to placebo (ie. null effect or ability) when administered during LH peaks one to two days before ovulation, the agent still demonstrates a stable and consistently high contraceptive effect of approximately >=80% when used at this time. Subsequently, current studies attempt to investigate how ulipristal could elicit emergency contraception via ovulation prevention under circumstances where ovulation had already clearly been observed. Endometrial biopsy samples studied from such circumstances in such investigations subsequently show that the administered ulipristal causes endometrial tissue to become inhospitable and unsuitable for embryo implantation where a variety of genes characteristic of receptive, pro-gestational endometrium are downregulated. Nevertheless, most if not all proposed mechanisms commonly agree that ulipristal ultimately demonstrates its pharmacological effects by binding to human progesterone receptors and prevents natural, endogenous progesterone from occupying such receptors. Regardless, however, considering current and on-going research into ulipristal's ability to prevent embryo implantation, the notion that the medication can elicit post-fertilization effects potentially raises alerts and/or ethical debates over the use of ulipristal owing to potential abortifacient activity, which is considered to be on par or equipotent to that of mifepristone. Attention should be drawn to the fact that some prescribing information, however, such as the US FDA label for ulipristal indicated for emergency contraception, has included new supplementary commentary since 2018 that directly warns about ulipristal not being indicated for termination of existing pregnancies and suggesting that ulipristal use may confer alterations to the endometrium that may affect implantation and contribute to efficacy. In the treatment of fibroids, ulipristal has been shown to exert direct actions on fibroids reducing their size through inhibition of cell proliferation and induction of apoptosis.


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