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Also known as: 162359-55-9, 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol, 2-amino-2-(4-octylphenethyl)propane-1,3-diol, Fty-720, Fingolimod [inn], 2-amino-2-[2-(4-octylphenyl)ethyl]-1,3-propanediol
Molecular Formula
C19H33NO2
Molecular Weight
307.5  g/mol
InChI Key
KKGQTZUTZRNORY-UHFFFAOYSA-N
FDA UNII
3QN8BYN5QF

CAS 162359-55-9
A sphingosine-derivative and IMMUNOSUPPRESSIVE AGENT that blocks the migration and homing of LYMPHOCYTES to the CENTRAL NERVOUS SYSTEM through its action on SPHINGOSINE 1-PHOSPHATE RECEPTORS. It is used in the treatment of MULTIPLE SCLEROSIS.
Fingolimod is a Sphingosine 1-phosphate Receptor Modulator. The mechanism of action of fingolimod is as a Sphingosine 1-Phosphate Receptor Modulator.
1 2D Structure

CAS 162359-55-9

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol
2.1.2 InChI
InChI=1S/C19H33NO2/c1-2-3-4-5-6-7-8-17-9-11-18(12-10-17)13-14-19(20,15-21)16-22/h9-12,21-22H,2-8,13-16,20H2,1H3
2.1.3 InChI Key
KKGQTZUTZRNORY-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CCCCCCCCC1=CC=C(C=C1)CCC(CO)(CO)N
2.2 Other Identifiers
2.2.1 UNII
3QN8BYN5QF
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 2-amino-2-(2-(4-octylphenyl)ethyl)-1,3-propanediol Hydrochloride

2. Fingolimod Hydrochloride

3. Fty 720

4. Fty-720

5. Fty720

6. Gilenia

7. Gilenya

2.3.2 Depositor-Supplied Synonyms

1. 162359-55-9

2. 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol

3. 2-amino-2-(4-octylphenethyl)propane-1,3-diol

4. Fty-720

5. Fingolimod [inn]

6. 2-amino-2-[2-(4-octylphenyl)ethyl]-1,3-propanediol

7. 2-amino-2-[2-(4-octylphenyl)ethyl]-1,3-propandiol

8. 1,3-propanediol, 2-amino-2-[2-(4-octylphenyl)ethyl]-

9. Gilenya (tn)

10. 3qn8byn5qf

11. 1,3-propanediol, 2-amino-2-(2-(4-octylphenyl)ethyl)-

12. Chembl314854

13. Chebi:63115

14. Fingolimod (inn)

15. 2-amino-2-(2-(4-octylphenyl)ethyl)propane-1,3-diol

16. Fty-720a

17. Unii-3qn8byn5qf

18. 2-amino-2-(2-(4-octylphenyl)ethyl)-1,3-propanediol

19. Fingolimodum

20. Fingolimod Base

21. Fingolimod- Bio-x

22. Fingolimod [mi]

23. Fingolimod [vandf]

24. Fingolimod [mart.]

25. Schembl7445

26. Fingolimod [who-dd]

27. 2-(4-octylphenylethyl)-2-aminopropane-1,3-diol

28. Gtpl2407

29. Fingolimod [orange Book]

30. Dtxsid40167363

31. Hms3743o13

32. Amy22173

33. Bcp05969

34. Zinc1542002

35. Bdbm50158336

36. Nsc755643

37. S5950

38. Stl445699

39. Akos015999594

40. Db05286

41. Db08868

42. Nsc-755643

43. Ncgc00188399-01

44. Ncgc00188399-03

45. Ncgc00188399-04

46. Ncgc00188399-06

47. Ncgc00188399-16

48. Ac-25899

49. As-68987

50. Bf164460

51. Hy-11063

52. Db-064455

53. Ft-0660847

54. 2-(4-octylphenethyl)-2-aminopropane-1,3-diol

55. D70458

56. 2-amino-2-(4-octylphenyl)ethylpropane-1,3-diol

57. Q425137

58. 2-amino-2-hydroxymethyl-4-(4-(octyl)phenyl)butanol

59. Brd-k88025533-003-01-7

60. 2-amino-2-[2-(4-octyl-phenyl)-ethyl]-propane-1,3-diol

2.4 Create Date
2005-08-08
3 Chemical and Physical Properties
Molecular Weight 307.5 g/mol
Molecular Formula C19H33NO2
XLogP34.2
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count3
Rotatable Bond Count12
Exact Mass307.251129295 g/mol
Monoisotopic Mass307.251129295 g/mol
Topological Polar Surface Area66.5 Ų
Heavy Atom Count22
Formal Charge0
Complexity258
Isotope Atom Count0
Defined Atom Stereocenter Count0
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

Fingolimod is indicated for the treatment of patients aged 10 and above with relapsing forms of multiple sclerosis, which may include clinically isolated syndrome, relapsing-remitting disease, as well as active secondary progressive disease. This drug is being studied for administration in patients infected with COVID-19 with a high risk for acute respiratory distress syndrome, or ARDS. As of April 3 2020, this is currently not an approved indication and clinical trials are underway.


Gilenya is indicated as single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of adult patients and paediatric patients aged 10 years and older:

- Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy (for exceptions and information about washout periods see sections 4. 4 and 5. 1).

or

- Patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI.


Indicated as single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of adult patients and paediatric patients aged 10 years and older:

Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy

or

Patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI.


Indicated as single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of adult and paediatric patients aged 10 years and older:

Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy (for exceptions and information about washout periods see sections 4. 4 and 5. 1)

or

Patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI.


5 Pharmacology and Biochemistry
5.1 Pharmacology

In multiple sclerosis, fingolimod binds to sphingosine receptors, reducing its associated neuroinflammation.In COVID-19, it may reduce lung inflammation and improve the clinical outcomes of patients with this disease. Cardiovascular effects Fingolimod causes a transient reduction in heart rate and AV conduction during treatment initiation. It has the potential to prolong the QT interval.


5.2 MeSH Pharmacological Classification

Immunosuppressive Agents

Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. (See all compounds classified as Immunosuppressive Agents.)


Sphingosine 1 Phosphate Receptor Modulators

Agents that affect the function of G-protein coupled SPHINGOSINE 1-PHOSPHATE RECEPTORS. Their binding to the receptors blocks lymphocyte migration and are often used as IMMUNOSUPPRESSANTS. (See all compounds classified as Sphingosine 1 Phosphate Receptor Modulators.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
FINGOLIMOD
5.3.2 FDA UNII
3QN8BYN5QF
5.3.3 Pharmacological Classes
Sphingosine 1-phosphate Receptor Modulator [EPC]; Sphingosine 1-Phosphate Receptor Modulators [MoA]
5.4 ATC Code

L04AA27


L04AA27


L04AA27


L04AA27

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


L - Antineoplastic and immunomodulating agents

L04 - Immunosuppressants

L04A - Immunosuppressants

L04AA - Selective immunosuppressants

L04AA27 - Fingolimod


5.5 Absorption, Distribution and Excretion

Absorption

Fingolimod is slowly but efficiently absorbed in the gastrointestinal tract. AUC varies greatly, depending on the patient, and pharmacokinetic studies demonstrate a range of AUC values for fingolimod. The Tmax of fingolimod ranges between 12-16 hours and its bioavailability is 90-93%. Steady-state concentrations of fingolimod are achieved within 1-2 months after initiation when it is administered in a single daily dose.


Route of Elimination

About 81% of an oral dose of fingolimod is excreted in the urine in the form of inactive metabolites. Intact fingolimod and its active metabolite account for less than 2.5% of the dose, and can be found excreted in the feces.


Volume of Distribution

The volume of distribution of fingolimod is about 1200260 L. It is approximately 86% distributed in the red blood cells (RBC).


Clearance

Fingolimod blood clearance is 6.32.3 L/h, according to prescribing information. Another resource mentions it ranges from 6-8 L/h.


5.6 Metabolism/Metabolites

Sphingosine kinase metabolizes fingolimod to an active metabolite, fingolimod phosphate. Fingolimod metabolism occurs via 3 major metabolic pathways: firstly, phosphorylation of the (S)-enantiomer of fingolimod-phosphate (pharmacologically active), secondly, oxidation by cytochrome P450 4F2 (CYP4F2), and thirdly, fatty acid-like metabolism to various inactive metabolites. The formation of inactive non-polar ceramide analogs of fingolimod also occurs during its metabolism.


5.7 Biological Half-Life

The half-life of fingolimod and its active metabolite ranges from 6-9 days.


5.8 Mechanism of Action

Sphingosine1phosphate (S1P) is an important phospholipid that binds to various Gproteincoupled receptor subtypes, which can be identified as S1P15R. S1P and the receptors it binds to perform regular functions in the immune, cardiovascular, pulmonary, and nervous system. S1P can be expressed ubiquitously, playing an important role in regulating inflammation. S1P1R, S1P2R, and S1P3R receptors can be found in the cardiovascular, immune, and central nervous systems. S1P4R is found on lymphocytic and hematopoietic cells, while S1P5R expression is found only on the spleen (on natural killer cells) or in the central nervous system. The active form of the drug, fingolimod phosphate, is a sphingosine 1-phosphate receptor modulator that exerts its mechanism of action in MS by binding to various sphingosine 1-phosphate receptors (1, 3, 4, and 5). It suppresses the exit of lymphocytes from lymph nodes, leading to a lower level of lymphocytes circulating in peripheral circulation. This reduces the inflammation that is associated with MS. The mechanism of action of fingolimod is not fully understood, but may be related to reduced lymphocyte circulation into the central nervous system. Immune modulating treatment such as fingolimod is not typically employed for SARS-CoV-2 pneumonia. Despite this, with the tissue findings of pulmonary edema and hyaline membrane formation, the timely use of immune modulators such as fingolimod can be considered to prevent acute respiratory distress syndrome (ARDS) associated with COVID-19.


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