Lotilaner

Identification

Summary

Lotilaner is an antiparasitic agent used to treat Demodex blepharitis.

Brand Names
Xdemvy
Generic Name
Lotilaner
DrugBank Accession Number
DB17992
Background

Lotilaner is an ectoparasiticide that is a member of the isoxazoline family of compounds.4 Lotilaner has largely been used for veterinary uses as an antiparasitic agent to treat flea and tick infestations in animals.3,6 Lotilaner consists of two enantiomers: the S-enantiomer is active in vivo, while the R-enantiomer is reported to exhibit low biological activity. The active ingredient found in drug products of lotilaner is the S-enantiomer.2

On July 25, 2023, lotilaner was approved by the FDA for the treatment of Demodex blepharitis, making it the first and only approved therapeutic for this condition.5

Type
Small Molecule
Groups
Approved, Vet approved
Structure
Weight
Average: 596.75
Monoisotopic: 594.9725646
Chemical Formula
C20H14Cl3F6N3O3S
Synonyms
  • 2-thiophenecarboxamide, 5-((5s)-4,5-dihydro-5-(3,4,5-trichlorophenyl)-5-(trifluoromethyl)-3-isoxazolyl)-3-methyl-n-(2-oxo-2-((2,2,2-trifluoroethyl)amino)ethyl)-
  • 3-methyi-n-(2-oxo-2-((2,2,2-trifluoroethyl)amino)ethyl)-5-((55)-5-(3,4,5-trichlorophenyl)-5-(trifluoromethyl)-4,5-dihydro-1,2-oxazol-3-yl)thiophene-2-carboxamide
  • Credelio
  • Lotilaner (ema epar: veterinary)
External IDs
  • TP 03
  • TP-03
  • TP03

Pharmacology

Indication

Lotilaner is indicated for the treatment of Demodex blepharitis.4

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Treatment ofDemodex blepharitis••••••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Lotilaner is a parasiticide that works against Demodex mites that cause Demodex blepharitis.4 It is also active against insects, ticks, and lice.2,3 Its activity is arthropod-specific, as it does not bind to the same therapeutic target in mammals.2

Mechanism of action

Lotilaner is a non-competitive antagonist of the gamma-aminobutyric acid (GABA)-gated chloride channel (GABACl) selective for mites. Inhibition of GABACl causes a paralytic action in the target organism, leading to death. Lotilaner is not an inhibitor of mammalian GABA-mediated chloride channels when tested at up to 30 µM (18 µg/mL) in vitro, which is approximately 1100 times the recommended human ophthalmic dose.4

The target site in GABACl is hypothesized to be localized in a pore between the T9’ to S15’ region, an interstitial subunit region. A study suggested that lotilaner may migrate within the pore of the GABACl to its final location to stabilize the channel in a closed state; however, this hypothesis requires further investigation.2

TargetActionsOrganism
UGaba-gated chloride channel, putative
antagonist
Pediculus humanus subsp. corporis
Absorption

Tmax is about two hours after a single ocular administration on Day 1 and one hour after the last drug administration on Day 42. In healthy subjects, the peak concentration (Cmax) in whole blood increased after 42 days of repeated ocular administration, from 0.596 to 17.8 ng/mL. The total exposure (AUC0-12) also increased from 5.75 to 149 hr x ng/mL.4

In patients with Demodex blepharitis who received lotilaner twice daily for 42 days, the mean systemic exposure at the end of treatment was 12.0 ng/mL, with a range of 0.4-46.1 ng/mL.4

Volume of distribution

No information is available.

Protein binding

Lotilaner plasma protein binding is high (> 99.9%) in human plasma. The partitioning of lotilaner to human blood cells is approximately 10% (range 0-20%).4

Metabolism

In cats, mininal metabolism of lotilaner was observed.1 Lotilaner is not metabolized by CYP enzymes.4

Route of elimination

No information is available.

Half-life

The effective half-life in healthy subjects, which is based on the accumulation ratio over the dosing interval of 12 hours, is 264 hours (11 days).4

Clearance

No information is available.

Adverse Effects
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Toxicity

There is no information available regarding the overdosage and acute toxicity of lotilaner.

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

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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.
Not Available
Food Interactions
No interactions found.

Products

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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
XdemvySolution / drops2.5 mg/1mLOphthalmicTarsus Pharmaceuticals, Inc.2023-08-14Not applicableUS flag

Categories

Drug Categories
Classification
Not classified
Affected organisms
  • Microbes (bacteria, parasites)

Chemical Identifiers

UNII
HEH4938D7K
CAS number
1369852-71-0
InChI Key
HDKWFBCPLKNOCK-SFHVURJKSA-N
InChI
InChI=1S/C20H14Cl3F6N3O3S/c1-8-2-13(36-16(8)17(34)30-6-14(33)31-7-19(24,25)26)12-5-18(35-32-12,20(27,28)29)9-3-10(21)15(23)11(22)4-9/h2-4H,5-7H2,1H3,(H,30,34)(H,31,33)/t18-/m1/s1
IUPAC Name
2-({3-methyl-5-[(5S)-5-(3,4,5-trichlorophenyl)-5-(trifluoromethyl)-4,5-dihydro-1,2-oxazol-3-yl]thiophen-2-yl}formamido)-N-(2,2,2-trifluoroethyl)acetamide
SMILES
CC1=C(SC(=C1)C1=NO[C@@](C1)(C1=CC(Cl)=C(Cl)C(Cl)=C1)C(F)(F)F)C(=O)NCC(=O)NCC(F)(F)F

References

General References
  1. Toutain CE, Seewald W, Jung M: Pharmacokinetics of lotilaner following a single oral or intravenous administration in cats. Parasit Vectors. 2018 Jul 13;11(1):412. doi: 10.1186/s13071-018-2966-6. [Article]
  2. Rufener L, Danelli V, Bertrand D, Sager H: The novel isoxazoline ectoparasiticide lotilaner (Credelio): a non-competitive antagonist specific to invertebrates gamma-aminobutyric acid-gated chloride channels (GABACls). Parasit Vectors. 2017 Nov 1;10(1):530. doi: 10.1186/s13071-017-2470-4. [Article]
  3. Lamassiaude N, Toubate B, Neveu C, Charnet P, Dupuy C, Debierre-Grockiego F, Dimier-Poisson I, Charvet CL: The molecular targets of ivermectin and lotilaner in the human louse Pediculus humanus humanus: New prospects for the treatment of pediculosis. PLoS Pathog. 2021 Feb 18;17(2):e1008863. doi: 10.1371/journal.ppat.1008863. eCollection 2021 Feb. [Article]
  4. FDA Approved Drug Products: XDEMVY (lotilaner) 0.25%, Ophthalmic Solution (July 2023) [Link]
  5. Business Wire: FDA Approves XDEMVY™ (lotilaner ophthalmic solution) 0.25% for the treatment of Demodex blepharitis [Link]
  6. EMA Medicines Overview: Credelio [Link]
ChemSpider
32699771
RxNav
1998841
ChEMBL
CHEMBL3707310
ZINC
ZINC000141368345
Wikipedia
Lotilaner

Clinical Trials

Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
PhaseStatusPurposeConditionsCount
4Not Yet RecruitingTreatmentDemodex Blepharitis1
3Active Not RecruitingTreatmentBlepharitis1
3CompletedTreatmentBlepharitis1
2CompletedTreatmentBlepharitis / Demodex Infestation / Meibomian Gland Dysfunction (Disorder)1
2CompletedTreatmentPapulopustular Rosacea (PPR)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Solution / dropsOphthalmic2.5 mg/1mL
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US11690827No2018-12-142038-12-14US flag
US11690826No2018-12-142038-12-14US flag
US11197847No2021-12-142038-12-14US flag
US10835517No2020-11-172038-12-14US flag
US8383659No2013-02-262030-01-17US flag
US11752137No2018-12-142038-12-14US flag

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
logP5.81Chemaxon
pKa (Strongest Acidic)11.15Chemaxon
pKa (Strongest Basic)0.94Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count4Chemaxon
Hydrogen Donor Count2Chemaxon
Polar Surface Area79.79 Å2Chemaxon
Rotatable Bond Count8Chemaxon
Refractivity120.89 m3·mol-1Chemaxon
Polarizability49.71 Å3Chemaxon
Number of Rings3Chemaxon
Bioavailability0Chemaxon
Rule of FiveNoChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleYesChemaxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available
Chromatographic Properties
Collision Cross Sections (CCS)
Not Available

Targets

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Kind
Protein
Organism
Pediculus humanus subsp. corporis
Pharmacological action
Unknown
Actions
Antagonist
Curator comments
Note: The above was chosen as a representative target protein in a representative arthropod, and does not encompass all proteins affected by this agent.
General Function
Not Available
Specific Function
Chloride channel activity
Gene Name
8239847
Uniprot ID
E0W492
Uniprot Name
Gaba-gated chloride channel, putative
Molecular Weight
48851.68 Da
References
  1. Lamassiaude N, Toubate B, Neveu C, Charnet P, Dupuy C, Debierre-Grockiego F, Dimier-Poisson I, Charvet CL: The molecular targets of ivermectin and lotilaner in the human louse Pediculus humanus humanus: New prospects for the treatment of pediculosis. PLoS Pathog. 2021 Feb 18;17(2):e1008863. doi: 10.1371/journal.ppat.1008863. eCollection 2021 Feb. [Article]
  2. FDA Approved Drug Products: XDEMVY (lotilaner) 0.25%, Ophthalmic Solution (July 2023) [Link]

Drug created at July 25, 2023 16:03 / Updated at July 28, 2023 21:40