Isavuconazonium
Identification
- Summary
Isavuconazonium is a triazole antifungal used for the treatment of invasive aspergillosis and mucormycosis.
- Brand Names
- Cresemba
- Generic Name
- Isavuconazonium
- DrugBank Accession Number
- DB06636
- Background
Isavuconazonium is a second-generation triazole antifungal approved on March 6, 2015 by the FDA and July 2015 by the EMA for the treatment of adults with invasive aspergillosis and invasive mucormycosis, marketed by Astellas under the brand Cresemba.4 It is the prodrug form of isavuconazole, the active moiety, and it is available in oral and parenteral formulations. Due to low solubility in water of isavuconazole on its own, the isovuconazonium formulation is favorable as it has high solubility in water and allows for intravenous administration. This formulation also avoids the use of a cyclodextrin vehicle for solubilization required for intravenous administration of other antifungals such as voriconazole and posaconazole, eliminating concerns of nephrotoxicity associated with cyclodextrin. Isovuconazonium has excellent oral bioavailability, predictable pharmacokinetics, and a good safety profile, making it a reasonable alternative to its few other competitors on the market.1,2,3
On December 08, 2023, the FDA approved the expanded use of isovuconazonium in pediatric patients for the same indications.7
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Structure
- Weight
- Average: 717.77
Monoisotopic: 717.241370179 - Chemical Formula
- C35H35F2N8O5S
- Synonyms
- Isavuconazonium
- External IDs
- BAL-8557
- BAL8557
Pharmacology
- Indication
Isavuconazonium is indicated for the treatment of invasive aspergillosis and mucormycosis in adults and pediatric patients 1 year of age and older in capsule form and adults and pediatric patients 6 years of age and older who weigh 16 kilograms (kg) and greater in injection form.6
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Indication Type Indication Combined Product Details Approval Level Age Group Patient Characteristics Dose Form Treatment of Invasive aspergillosis •••••••••••• •••••• ••••••••• •••• •••••• •• •• ••••• •• •• ••••••• Treatment of Invasive aspergillosis •••••••••••• •••••• ••••••••• •••••••••• ••••••• ••• •••••••• Treatment of Invasive mucormycosis •••••••••••• •••••• ••••••••• •••• •••••• •• •• ••••• •• •• ••••••• Treatment of Invasive mucormycosis •••••••••••• ••••• •••••••••• ••••••• ••• •••••••• - Contraindications & Blackbox Warnings
- Prevent Adverse Drug Events TodayTap into our Clinical API for life-saving information on contraindications & blackbox warnings, population restrictions, harmful risks, & more.Avoid life-threatening adverse drug events with our Clinical API
- Pharmacodynamics
In patients treated with isavuconazonium for invasive aspergillosis in a controlled trial, there was no significant association between plasma AUC or plasma isavuconazole concentration and efficacy.6
The effect on QTc interval of multiple doses of isavuconazonium capsules was evaluated. Isavuconazonium was administered as 2 capsules (equivalent to 200 mg isavuconazole) three times daily on days 1 and 2 followed by either 2 capsules or 6 capsules (equivalent to 600 mg isavuconazole) once daily for 13 days in a randomized, placebo- and active-controlled (moxifloxacin 400 mg single-dose), four-treatment-arms, parallel study in 160 healthy subjects.6
Isavuconazole resulted in dose-related shortening of the QTc interval. For the 2-capsule dosing regimen, the least squares mean (LSM) difference from placebo was -13.1 msec at 2 hours postdose [90% CI: -17.1, -9.1 msec]. Increasing the dose to 6 capsules resulted in an LSM difference from the placebo of -24.6 msec at 2 hours postdose [90% CI: -28.7, -20.4]. Isavuconazonium was not evaluated in combination with other drugs that reduce the QTc interval, so the additive effects are not known.6
The mechanism of resistance to isavuconazole, like other azole antifungals, is likely due to multiple mechanisms that include substitutions in the target gene CYP51. Changes in sterol profile and elevated efflux pump activity were observed; however, the clinical relevance of these findings is unclear.6
In vitro and animal studies suggest cross-resistance between isavuconazole and other azoles. The relevance of cross-resistance to clinical outcomes has not been fully characterized; however, patients failing prior azole therapy may require alternative antifungal therapy.6
- Mechanism of action
Isavuconazonium sulfate is the prodrug of isavuconazole, an azole antifungal. Isavuconazole inhibits the synthesis of ergosterol, a key component of the fungal cell membrane, by inhibiting cytochrome P-450-dependent enzyme lanosterol 14-alpha-demethylase (Erg11p). This enzyme is responsible for the conversion of lanosterol to ergosterol. An accumulation of methylated sterol precursors and a depletion of ergosterol within the fungal cell membrane weaken the membrane structure and function. Mammalian cell demethylation is less sensitive to isavuconazole inhibition.6
Target Actions Organism ULanosterol 14-alpha demethylase Not Available - Absorption
In healthy subjects, the pharmacokinetics of isavuconazole following oral administration of isavuconazonium capsules at isavuconazole equivalent doses up to 600 mg per day (6 capsules) are dose-proportional. Following oral administration of isavuconazonium capsules at an isavuconazole equivalent dose of 200 mg in 66 fasted healthy male subjects, a single dose administration of two 186 mg isavuconazonium capsules and five 74.5 mg isavuconazonium capsules exhibited a mean (SD) Cmax and AUC of 3.3 (0.6) mg/L and 112.2 (30.3) mg·hr/L, respectively, and 3.3 (0.6) mg/L and 118.0 (33.1) mg·hr/L, respectively.6
After oral administration of isavuconazonium in healthy volunteers, the active moiety, isavuconazole, generally reaches maximum plasma concentrations (Cmax) 2 hours to 3 hours after single and multiple dosing. The absolute bioavailability of isavuconazole following oral administration of isavuconazonium is 98%. No significant concentrations of the prodrug or inactive cleavage product were seen in plasma after oral administration.6
Following intravenous administration of isavuconazonium, maximal plasma concentrations of the prodrug and inactive cleavage product were detectable during infusion and declined rapidly following the end of administration. The prodrug was below the level of detection by 1.25 hours after the start of a one-hour infusion. The total exposure of the prodrug based on AUC was less than 1% that of isavuconazole. The inactive cleavage product was quantifiable in some subjects up to 8 hours after the start of infusion. The total exposure of inactive cleavage product based on AUC was approximately 1.3% that of isavuconazole. Isavuconazonium given orally as an intravenous solution administered via nasogastric (NG) tube provides systemic isavuconazole exposure that is similar to the oral capsule.6
Coadministration of isavuconazonium equivalent to isavuconazole 400 mg oral dose with a high-fat meal reduced isavuconazole Cmax by 9% and increased AUC by 9%. isavuconazonium can be taken with or without food.6
- Volume of distribution
Isavuconazole is extensively distributed with a mean steady-state volume of distribution (Vss) of approximately 450 L.6
- Protein binding
Isavuconazole is highly protein bound (greater than 99%), predominantly to albumin.6
- Metabolism
In in vitro studies, isavuconazonium sulfate is rapidly hydrolyzed in blood to isavuconazole by esterases, predominantly by butylcholinesterase. Isavuconazole is a substrate of cytochrome P450 enzymes 3A4 and 3A5.6
Following single doses of [cyano 14C] isavuconazonium and [pyridinylmethyl 14C] isavuconazonium in humans, in addition to the active moiety (isavuconazole) and the inactive cleavage product, several minor metabolites were identified. Except for the active moiety isavuconazole, no individual metabolite was observed with an AUC greater than 10% of drug-related material.6
In vivo studies indicate that CYP3A4, CYP3A5, and subsequently uridine diphosphate-glucuronosyltransferases (UGT) are involved in the metabolism of isavuconazole.6
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- Route of elimination
Following oral administration of radio-labeled isavuconazonium sulfate to healthy volunteers, a mean of 46.1% of the total radioactive dose was recovered in the feces and 45.5% was recovered in the urine.6
Renal excretion of isavuconazole itself was less than 1% of the dose administered.6
The inactive cleavage product is primarily eliminated by metabolism and subsequent renal excretion of the metabolites. Renal elimination of intact cleavage product was less than 1% of the total dose administered. Following intravenous administration of radio-labeled cleavage product, 95% of the total radioactive dose was excreted in the urine.6
- Half-life
Based on a population pharmacokinetics analysis of healthy subjects and patients, the mean plasma half-life of isavuconazole was 130 hours.6
- Clearance
In healthy subjects, the clearance of isavuconazole was estimated to be from 2.4 to 4.1 L/h.3 Chinese subjects were found to have on average a 40% lower clearance compared to Western subjects (1.6 L/hr for Chinese subjects as compared to 2.6 L/hr for Western subjects).6
- Adverse Effects
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- Toxicity
Based on findings from animal studies, isavuconazonium may cause fetal harm when administered to a pregnant woman. There are no available human data on the use of isavuconazonium in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. In animal reproduction studies, perinatal mortality was increased in the offspring of pregnant rats dosed orally with isavuconazonium sulfate at approximately 0.5 times the clinical exposure during pregnancy through the weaning period. In animal studies when isavuconazonium chloride was administered by oral gavage to pregnant rats and rabbits during organogenesis at exposures corresponding to less than the human maintenance dose increases in the incidences of multiple skeletal abnormalities, including rudimentary cervical ribs and fused zygomatic arches were observed.6
During clinical studies, total daily isavuconazonium doses higher than the recommended dose regimen were associated with an increased rate of adverse reactions. At supratherapeutic doses (three times the recommended maintenance dose) evaluated in a thorough QT study, there were proportionally more treatment-emergent adverse reactions than in the therapeutic dose group (maintenance dose) for the following: headache, dizziness, paresthesia, somnolence, disturbance in attention, dysgeusia, dry mouth, diarrhea, oral hypoesthesia, vomiting, hot flush, anxiety, restlessness, palpitations, tachycardia, photophobia and arthralgia. Adverse reactions leading to discontinuation of the study drug occurred in 7 of 39 (17.9%) subjects in the supratherapeutic dose group.6
Isavuconazole is not removed by hemodialysis. There is no specific antidote for isavuconazole. Treatment should be supportive with appropriate monitoring.6
In a 2-year rat carcinogenicity study and a 2-year mouse carcinogenicity study, dose-related increases in hepatocellular adenomas and/or carcinomas were observed in male and female B6C3F1/Crl mice and male, but not female Han Wistar rats at doses as low as 0.1 times the exposure seen in humans administered the maintenance dose. Hepatic hemangiomas were increased in female mice at 300 mg/kg, at an exposure similar to the maintenance dose. Hepatoblastoma was increased in male mice at 100 mg/kg, about 0.4 times the systemic exposures based on AUC comparisons. Thyroid follicular cell adenomas were observed in male and female rats at doses as low as 60 mg/kg in male rats (about 0.2 times the human clinical maintenance dose). The relevance of rat thyroid tumors to human carcinogenic risk remains unclear.6
A significant increase in the incidence of skin fibromas was seen in male rats at 300 mg/kg, exposures 0.8 times the human exposure at the human clinical maintenance dose. Uterine adenocarcinomas were observed in female rats at 200 mg/kg, at systemic exposures similar to the human exposure at the human clinical maintenance dose.6
No mutagenic or clastogenic effects were detected in the in vitro bacterial reverse mutation assay and the in vivo bone marrow micronucleus assay in rats.6
Oral administration of isavuconazonium sulfate did not affect fertility in male or female rats treated at doses up to 90 mg/kg/day (approximately 0.3 times the systemic exposure at the human clinical maintenance dose).6
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs Browse all" title="About SNP Mediated Effects/ADRs" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
- Not Available
Interactions
- Drug Interactions Learn More" title="About Drug Interactions" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your software1,2-Benzodiazepine The metabolism of 1,2-Benzodiazepine can be decreased when combined with Isavuconazonium. Abametapir The serum concentration of Isavuconazonium can be increased when it is combined with Abametapir. Abatacept The metabolism of Isavuconazonium can be increased when combined with Abatacept. Abemaciclib The serum concentration of Abemaciclib can be increased when it is combined with Isavuconazonium. Abiraterone The metabolism of Isavuconazonium can be decreased when combined with Abiraterone. - Food Interactions
- Avoid grapefruit products. Grapefruit is a moderate to strong inhibitor of CYP3A4. Strong CYP3A4 inhibitors are contraindicated with isavuconazonium.
- Avoid St. John's Wort. This herb induces the CYP3A4 metabolism of isavuconazonium and may reduce its serum concentration. Co-administration of isavuconazonium with St. John's Wort is contraindicated.
- Take with or without food. The bioavailability of isavuconazonium is not significantly impacted by food.
Products
- Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.
- Product Ingredients
Ingredient UNII CAS InChI Key Isavuconazonium sulfate 31Q44514JV 946075-13-4 LWXUIUUOMSMZKJ-KLFWAVJMSA-M - Active Moieties
Name Kind UNII CAS InChI Key Isavuconazole prodrug 60UTO373KE 241479-67-4 DDFOUSQFMYRUQK-RCDICMHDSA-N - Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Cresemba Powder, for solution 200 mg / vial Intravenous Avir Pharma Inc 2019-05-31 Not applicable Canada Cresemba Capsule 100 mg/1 Oral Astellas Pharma US, Inc. 2015-11-04 Not applicable US Cresemba Capsule 100 mg Oral Avir Pharma Inc 2019-05-02 Not applicable Canada Cresemba Capsule 186 mg/1 Oral Astellas Pharma US, Inc. 2015-03-06 2017-01-31 US Cresemba Capsule 40 mg/1 Oral Astellas Pharma US, Inc. 2022-11-22 Not applicable US
Categories
- Drug Categories
- Anti-Infective Agents
- Antifungal Agents
- Azole Antifungals
- BCRP/ABCG2 Inhibitors
- Cholinesterase substrates
- Cytochrome P-450 CYP2B6 Inducers
- Cytochrome P-450 CYP2B6 Inducers (strength unknown)
- Cytochrome P-450 CYP2C19 Inhibitors
- Cytochrome P-450 CYP2C19 inhibitors (strength unknown)
- Cytochrome P-450 CYP2C8 Inducers
- Cytochrome P-450 CYP2C8 Inducers (strength unknown)
- Cytochrome P-450 CYP2C8 Inhibitors
- Cytochrome P-450 CYP2C8 Inhibitors (strength unknown)
- Cytochrome P-450 CYP2C9 Inducers
- Cytochrome P-450 CYP2C9 Inducers (strength unknown)
- Cytochrome P-450 CYP2C9 Inhibitors
- Cytochrome P-450 CYP2C9 Inhibitors (strength unknown)
- Cytochrome P-450 CYP2D6 Inhibitors
- Cytochrome P-450 CYP2D6 Inhibitors (strength unknown)
- Cytochrome P-450 CYP3A Inducers
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 CYP3A Substrates
- Cytochrome P-450 CYP3A4 Inducers
- Cytochrome P-450 CYP3A4 Inducers (strength unknown)
- Cytochrome P-450 CYP3A4 Inhibitors
- Cytochrome P-450 CYP3A4 Inhibitors (moderate)
- Cytochrome P-450 CYP3A4 Substrates
- Cytochrome P-450 CYP3A5 Substrates
- Cytochrome P-450 Enzyme Inducers
- Cytochrome P-450 Enzyme Inhibitors
- Cytochrome P-450 Substrates
- Isavuconazole and Prodrugs
- OCT2 Inhibitors
- P-glycoprotein inhibitors
- Chemical TaxonomyProvided by Classyfire
- Description
- This compound belongs to the class of organic compounds known as alpha amino acid esters. These are ester derivatives of alpha amino acids.
- Kingdom
- Organic compounds
- Super Class
- Organic acids and derivatives
- Class
- Carboxylic acids and derivatives
- Sub Class
- Amino acids, peptides, and analogues
- Direct Parent
- Alpha amino acid esters
- Alternative Parents
- Phenylpropanes / Benzonitriles / Fluorobenzenes / 2,4-disubstituted thiazoles / Imidolactams / Pyridines and derivatives / Aryl fluorides / Triazoles / Heteroaromatic compounds / Carbamate esters show 14 more
- Substituents
- 1,2,4-triazole / 2,4-disubstituted 1,3-thiazole / Alcohol / Alpha-amino acid ester / Amine / Aromatic alcohol / Aromatic heteromonocyclic compound / Aryl fluoride / Aryl halide / Azacycle show 32 more
- Molecular Framework
- Aromatic heteromonocyclic compounds
- External Descriptors
- organic cation (CHEBI:85978)
- Affected organisms
- Candida albicans and other yeasts
- Aspergillis, Candida and other fungi
Chemical Identifiers
- UNII
- VH2L779W8Q
- CAS number
- 742049-41-8
- InChI Key
- RSWOJTICKMKTER-QXLBVTBOSA-N
- InChI
- InChI=1S/C35H35F2N8O5S/c1-22(33-42-30(18-51-33)25-9-7-24(15-38)8-10-25)35(48,28-14-27(36)11-12-29(28)37)19-45-21-44(20-41-45)23(2)50-34(47)43(4)32-26(6-5-13-40-32)17-49-31(46)16-39-3/h5-14,18,20-23,39,48H,16-17,19H2,1-4H3/q+1/t22-,23?,35+/m0/s1
- IUPAC Name
- 1-[(2R,3R)-3-[4-(4-cyanophenyl)-1,3-thiazol-2-yl]-2-(2,5-difluorophenyl)-2-hydroxybutyl]-4-[1-({methyl[3-({[2-(methylamino)acetyl]oxy}methyl)pyridin-2-yl]carbamoyl}oxy)ethyl]-1H-1,2,4-triazol-4-ium
- SMILES
- [H]C(C)(OC(=O)N(C)C1=C(COC(=O)CNC)C=CC=N1)[N+]1=CN(C[C@](O)(C2=C(F)C=CC(F)=C2)[C@@]([H])(C)C2=NC(=CS2)C2=CC=C(C=C2)C#N)N=C1
References
- General References
- Rybak JM, Marx KR, Nishimoto AT, Rogers PD: Isavuconazole: Pharmacology, Pharmacodynamics, and Current Clinical Experience with a New Triazole Antifungal Agent. Pharmacotherapy. 2015 Nov;35(11):1037-51. doi: 10.1002/phar.1652. Epub 2015 Nov 2. [Article]
- Miceli MH, Kauffman CA: Isavuconazole: A New Broad-Spectrum Triazole Antifungal Agent. Clin Infect Dis. 2015 Nov 15;61(10):1558-65. doi: 10.1093/cid/civ571. Epub 2015 Jul 15. [Article]
- Desai A, Kovanda L, Kowalski D, Lu Q, Townsend R, Bonate PL: Population Pharmacokinetics of Isavuconazole from Phase 1 and Phase 3 (SECURE) Trials in Adults and Target Attainment in Patients with Invasive Infections Due to Aspergillus and Other Filamentous Fungi. Antimicrob Agents Chemother. 2016 Aug 22;60(9):5483-91. doi: 10.1128/AAC.02819-15. Print 2016 Sep. [Article]
- Wilson DT, Dimondi VP, Johnson SW, Jones TM, Drew RH: Role of isavuconazole in the treatment of invasive fungal infections. Ther Clin Risk Manag. 2016 Aug 3;12:1197-206. doi: 10.2147/TCRM.S90335. eCollection 2016. [Article]
- FDA Approved Drug Products: Cresemba (isavuconazonium sulfate) [Link]
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- FDA Approves Expanded Use of CRESEMBA® (isavuconazonium sulfate) in Children with Invasive Aspergillosis and Invasive Mucormycosis [Link]
- External Links
- KEGG Drug
- D10643
- PubChem Compound
- 6918606
- PubChem Substance
- 310264875
- ChemSpider
- 5293801
- 1608322
- ChEBI
- 85978
- ChEMBL
- CHEMBL1183349
- Wikipedia
- Isavuconazonium
- FDA label
- Download (851 KB)
Clinical Trials
- Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count 4 Recruiting Treatment Invasive Fungal Infections 1 3 Completed Treatment Aspergillosis / Invasive Fungal Infections 2 3 Completed Treatment Candidemia / Fungal Infections / Invasive Candidiasis 1 3 Terminated Prevention Coronavirus Disease 2019 (COVID‑19) / Invasive Aspergillosis / Severe Acute Respiratory Syndrome Coronavirus 2 1 2 Completed Prevention Acute Myeloid Leukemia / Myelodysplastic Syndrome / Neutropenia 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Capsule Oral 100 mg/1 Capsule Oral 100 mg Capsule Oral 186 mg/1 Capsule Oral 186.3 Mg Capsule Oral 40 mg/1 Injection, powder, for solution Intravenous 200 MG Injection, powder, lyophilized, for solution Intravenous 40 mg/1mL Powder, for solution Intravenous 200 mg / vial Capsule, coated Oral 186.3 mg Injection, powder, lyophilized, for solution Intravenous 200 mg - Prices
- Not Available
- Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region US7459561 No 2008-12-02 2020-10-31 US US6812238 Yes 2004-11-02 2026-05-01 US US10206879 Yes 2019-02-19 2028-03-14 US US10603280 Yes 2020-03-31 2028-03-14 US US10812238 No 2020-10-20 2025-10-31 US
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
Property Value Source Water Solubility 0.00516 mg/mL ALOGPS logP 1.73 ALOGPS logP 0.52 Chemaxon logS -5.2 ALOGPS pKa (Strongest Acidic) 12.57 Chemaxon pKa (Strongest Basic) 6.45 Chemaxon Physiological Charge 1 Chemaxon Hydrogen Acceptor Count 9 Chemaxon Hydrogen Donor Count 2 Chemaxon Polar Surface Area 159.37 Å2 Chemaxon Rotatable Bond Count 15 Chemaxon Refractivity 193.86 m3·mol-1 Chemaxon Polarizability 71.63 Å3 Chemaxon Number of Rings 5 Chemaxon Bioavailability 0 Chemaxon Rule of Five No Chemaxon Ghose Filter No Chemaxon Veber's Rule No Chemaxon MDDR-like Rule Yes Chemaxon - Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- Not Available
- Chromatographic Properties
Collision Cross Sections (CCS)
Adduct CCS Value (Å2) Source type Source [M-H]- 248.12622 predictedDeepCCS 1.0 (2019) [M+H]+ 249.95111 predictedDeepCCS 1.0 (2019) [M+Na]+ 255.55693 predictedDeepCCS 1.0 (2019)
Targets
![](https://go.drugbank.com/assets/locked/DrugTargets2-682eb846d210ae4bf33ca03febccfb57bb1c61318e699b729e5df4dfab2c5b67.png)
- Kind
- Protein
- Organism
- Not Available
- Pharmacological action
- Unknown
- General Function
- Sterol 14-demethylase activity
- Specific Function
- Catalyzes C14-demethylation of lanosterol which is critical for ergosterol biosynthesis. It transforms lanosterol into 4,4'-dimethyl cholesta-8,14,24-triene-3-beta-ol (By similarity).
- Gene Name
- ERG11
- Uniprot ID
- P50859
- Uniprot Name
- Lanosterol 14-alpha demethylase
- Molecular Weight
- 61304.95 Da
Enzymes
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inducer
- General Function
- Steroid hydroxylase activity
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
- Gene Name
- CYP2B6
- Uniprot ID
- P20813
- Uniprot Name
- Cytochrome P450 2B6
- Molecular Weight
- 56277.81 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Inhibitor
- General Function
- Steroid hydroxylase activity
- Specific Function
- Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
- Gene Name
- CYP2D6
- Uniprot ID
- P10635
- Uniprot Name
- Cytochrome P450 2D6
- Molecular Weight
- 55768.94 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- InhibitorInducer
- General Function
- Steroid hydroxylase activity
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
- Gene Name
- CYP2C8
- Uniprot ID
- P10632
- Uniprot Name
- Cytochrome P450 2C8
- Molecular Weight
- 55824.275 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- InhibitorInducer
- General Function
- Steroid hydroxylase activity
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
- Gene Name
- CYP2C9
- Uniprot ID
- P11712
- Uniprot Name
- Cytochrome P450 2C9
- Molecular Weight
- 55627.365 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Inhibitor
- General Function
- Steroid hydroxylase activity
- Specific Function
- Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and im...
- Gene Name
- CYP2C19
- Uniprot ID
- P33261
- Uniprot Name
- Cytochrome P450 2C19
- Molecular Weight
- 55930.545 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- SubstrateInhibitorInducer
- Curator comments
- Isavuconazonium is a prodrug to Isavuconazole which is the actual CYP3A4 substrate, but it will therefore still participate in CYP3A4 drug interactions when taken.
- General Function
- Vitamin d3 25-hydroxylase activity
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
- Gene Name
- CYP3A4
- Uniprot ID
- P08684
- Uniprot Name
- Cytochrome P450 3A4
- Molecular Weight
- 57342.67 Da
References
- Rybak JM, Marx KR, Nishimoto AT, Rogers PD: Isavuconazole: Pharmacology, Pharmacodynamics, and Current Clinical Experience with a New Triazole Antifungal Agent. Pharmacotherapy. 2015 Nov;35(11):1037-51. doi: 10.1002/phar.1652. Epub 2015 Nov 2. [Article]
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Substrate
- General Function
- Oxygen binding
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
- Gene Name
- CYP3A5
- Uniprot ID
- P20815
- Uniprot Name
- Cytochrome P450 3A5
- Molecular Weight
- 57108.065 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Substrate
- Curator comments
- This is butylcholinesterase
- General Function
- Identical protein binding
- Specific Function
- Esterase with broad substrate specificity. Contributes to the inactivation of the neurotransmitter acetylcholine. Can degrade neurotoxic organophosphate esters.
- Gene Name
- BCHE
- Uniprot ID
- P06276
- Uniprot Name
- Cholinesterase
- Molecular Weight
- 68417.575 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
Carriers
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Binder
- General Function
- Toxic substance binding
- Specific Function
- Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
- Gene Name
- ALB
- Uniprot ID
- P02768
- Uniprot Name
- Serum albumin
- Molecular Weight
- 69365.94 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
Transporters
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Inhibitor
- General Function
- Xenobiotic-transporting atpase activity
- Specific Function
- Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
- Gene Name
- ABCB1
- Uniprot ID
- P08183
- Uniprot Name
- Multidrug resistance protein 1
- Molecular Weight
- 141477.255 Da
References
- Miceli MH, Kauffman CA: Isavuconazole: A New Broad-Spectrum Triazole Antifungal Agent. Clin Infect Dis. 2015 Nov 15;61(10):1558-65. doi: 10.1093/cid/civ571. Epub 2015 Jul 15. [Article]
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Xenobiotic-transporting atpase activity
- Specific Function
- High-capacity urate exporter functioning in both renal and extrarenal urate excretion. Plays a role in porphyrin homeostasis as it is able to mediates the export of protoporhyrin IX (PPIX) both fro...
- Gene Name
- ABCG2
- Uniprot ID
- Q9UNQ0
- Uniprot Name
- ATP-binding cassette sub-family G member 2
- Molecular Weight
- 72313.47 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- No
- Actions
- Inhibitor
- General Function
- Quaternary ammonium group transmembrane transporter activity
- Specific Function
- Mediates tubular uptake of organic compounds from circulation. Mediates the influx of agmatine, dopamine, noradrenaline (norepinephrine), serotonin, choline, famotidine, ranitidine, histamin, creat...
- Gene Name
- SLC22A2
- Uniprot ID
- O15244
- Uniprot Name
- Solute carrier family 22 member 2
- Molecular Weight
- 62579.99 Da
References
- FDA Approved Drug Products: CRESEMBA® (isavuconazonium sulfate) capsules/injection, for oral/intravenous use [Link]
Drug created at March 19, 2008 16:42 / Updated at February 20, 2024 23:54