User:Mr. Ibrahem/Allopregnanolone

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Mr. Ibrahem/Allopregnanolone
Skeletal formula of allopregnanolone
Ball-and-stick model of the allopregnanolone molecule
Clinical data
Trade namesZulresso
Other namesBrexanolone; Allo; AlloP; SAGE-547; SGE-102; 5α-Pregnan-3α-ol-20-one; 5α-Pregnane-3α-ol-20-one;[1][2][3][4][5] 3α-Hydroxy-5α-pregnan-20-one; 3α,5α-Tetrahydroprogesterone; 3α,5α-THP
AHFS/Drugs.comMonograph
MedlinePlusa619037
License data
Routes of
administration		Intravenous infusion[6]
Drug classNeurosteroid
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: <5%[8]
Protein binding>99%[6][8]
MetabolismNon-CYP450 (keto-reduction via aldo-keto reductases (AKR), glucuronidation via glucuronosyltransferases (UGT), sulfation via sulfotransferases (SULT))[6][8]
Elimination half-life9 hours[6][8]
ExcretionFeces: 47%[6][8]
Urine: 42%[6][8]
Identifiers
  • 1-[(3R,5S,8R,9S,10S,13S,14S,17S)-3-hydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl]ethanone
Chemical and physical data
FormulaC21H34O2
Molar mass318.501 g·mol−1
3D model (JSmol)
  • CC(=O)[C@H]1CC[C@@H]2[C@@]1(CC[C@H]3[C@H]2CC[C@@H]4[C@@]3(CC[C@H](C4)O)C)C
  • InChI=1S/C21H34O2/c1-13(22)17-6-7-18-16-5-4-14-12-15(23)8-10-20(14,2)19(16)9-11-21(17,18)3/h14-19,23H,4-12H2,1-3H3/t14-,15+,16-,17+,18-,19-,20-,21+/m0/s1
  • Key:AURFZBICLPNKBZ-SYBPFIFISA-N

Allopregnanolone is a naturally occurring hormone which is also used as a medication.[9][6] As a medication, it is known as brexanolone, sold under the brand name Zulresso, and used to treat postpartum depression.[6] It is given by injection into a vein over a 60-hour period under medical supervision.[6]

Common side effects include sleepiness, dry mouth, hot flashes, and loss of consciousness.[6] Other side effects may include suicidal thoughts.[6] Use in pregnancy may harm the baby.[6] It is a neurosteroid and acts as a positive allosteric modulator of the GABAA receptor.[6]

Brexanolone was approved for medical use in the United States in 2019.[6] It is not approved in either Europe or the United Kingdom as of 2022.[10] In the United States a course of medication costs 34,000 USD as of 2019.[11] The long administration time, price, and need for hospitalization, have raised concerns about accessibility.[11]

References[edit]

  1. ^ Krieger NR, Mok WM, Herschkowitz S (September 1990). "5α-Pregnane-3α-ol-20-one Identified as an Active Molecular Species of Steroid Anesthetic in Brain". Anesthesiology. 73. doi:10.1097/00000542-199009001-00702.
  2. ^ Yagen B, Gallili GE, Mateles RI (August 1978). "Progesterone biotransformation by plant cell suspension cultures". Applied and Environmental Microbiology. 36 (2): 213–6. Bibcode:1978ApEnM..36..213Y. doi:10.1128/AEM.36.2.213-216.1978. PMC 291203. PMID 697360.
  3. ^ Meyer HH, Jewgenow K, Hodges JK (February 1997). "Binding activity of 5alpha-reduced gestagens to the progestin receptor from African elephant (Loxodonta africana)". General and Comparative Endocrinology. 105 (2): 164–7. doi:10.1006/gcen.1996.6813. PMID 9038248.
  4. ^ Frye C, Seliga A (May 2002). "Olanzapine and progesterone have dose-dependent and additive effects to enhance lordosis and progestin concentrations of rats". Physiology & Behavior. 76 (1): 151–8. doi:10.1016/s0031-9384(02)00689-3. PMID 12175598. S2CID 38249308.
  5. ^ Mahendroo M, Wilson JD, Richardson JA, Auchus RJ (July 2004). "Steroid 5alpha-reductase 1 promotes 5alpha-androstane-3alpha,17beta-diol synthesis in immature mouse testes by two pathways". Molecular and Cellular Endocrinology. 222 (1–2): 113–20. doi:10.1016/j.mce.2004.04.009. PMID 15249131. S2CID 54297812.
  6. ^ a b c d e f g h i j k l m n o p q "Zulresso- brexanolone injection, solution". DailyMed. 18 November 2019. Archived from the original on 2 July 2019. Retrieved 23 November 2019.
  7. ^ "DEA Schedules Postpartum Depression Treatment Zulresso". Monthly Prescribing Reference. 17 June 2019. Archived from the original on 3 September 2019. Retrieved 24 November 2019.
  8. ^ a b c d e f Scott LJ (May 2019). "Brexanolone: First Global Approval". Drugs. 79 (7): 779–783. doi:10.1007/s40265-019-01121-0. PMID 31006078. S2CID 123095177.
  9. ^ Reddy DS (2010). Neurosteroids: endogenous role in the human brain and therapeutic potentials. Progress in Brain Research. Vol. 186. pp. 113–37. doi:10.1016/B978-0-444-53630-3.00008-7. ISBN 9780444536303. PMC 3139029. PMID 21094889. {{cite book}}: |journal= ignored (help)
  10. ^ "Brexanolone". SPS - Specialist Pharmacy Service. 21 January 2016. Archived from the original on 1 November 2019. Retrieved 11 January 2022.
  11. ^ a b Chatterjee R (21 March 2019). "New Postpartum Depression Drug Could Be Hard To Access For Moms Most In Need". NPR. Archived from the original on 21 March 2019. Retrieved 22 March 2019.
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