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Zafirlukast (ICI 204219) is a potent and orally bioavailable antagonist of leukotriene receptor (LTR) used for the maintenance treatment of asthma, often used in conjunction with an inhaled steroid and/or long-acting bronchodilator. It comes in tablet form, and the recommended dosage is twice daily. Telukast (Singulair), another leukotriene receptor antagonist, is administered once daily. Zileuton (Zyflo) is taken four times a day and is also used to treat asthma by inhibiting 5-lipoxygenase. Zafirlukast reduces airway constriction, mucus accumulation in the lungs, and breathing passage inflammation by blocking the action of cysteinyl leukotrienes on CysLT1 receptors.
| Targets |
leukotriene receptor/LTD4
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|---|---|
| ln Vitro |
Zafirlukast possesses an N-methylindole moiety with a 3-alkyl substituent on the indole ring, which makes it similar to 3-methylindole. Zafirlukast readily forms a GSH adduct with a molecular mass of 880 Da upon incubation with horseradish peroxidase (10% conversion in 60 min). CYP3A4 is inactivated in a concentration-, time-, and NADP(H)-dependent manner by zafirlukast. In one report, zafirlukast was shown to inhibit CYP3A enzyme activity in vitro (nonpreincubation inhibition) with a Ki of 2 μM; however, higher values have been published, and our KI for the inactivation process is 13.4 μM. The high plasma protein binding of zafirlukast (>99%) would reduce the concentration of free drug. A highly electrophilic α,β-unsaturated iminium species is produced by two consecutive one-electron oxidations of zafirlukast, which then spontaneously reacts with GSH to produce the observed adduct.[1]
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| ln Vivo |
Zafirlukast is a potent and selective antagonist of the cysteinyl leukotriene receptor that is primarily used in the prevention of bronchial asthma. When administered orally at a dose of 80 mg/kg, zafirlukast significantly lowers tissue levels of myeloperoxidase, reduced glutathione, and catalase while having no effect on these parameters when administered rectal route.[2]
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| Enzyme Assay |
Zafirlukast is a leukotriene antagonist indicated for the treatment of mild to moderate asthma, but the drug has been associated with occasional idiosyncratic hepatotoxicity. Structurally, zafirlukast is similar to 3-methylindole because it contains an N-methylindole moiety that has a 3-alkyl substituent on the indole ring. The results presented here describe the metabolic activation of zafirlukast via a similar mechanism to that described for 3-methylindole. NADP(H)-dependent biotransformation of zafirlukast by hepatic microsomes from rats and humans afforded a reactive metabolite, which was detected as its GSH adduct. Mass spectrometry and NMR data indicated that the GSH adduct was formed by the addition of GSH to the methylene carbon between the indole- and methoxy-substituted phenyl rings of zafirlukast. The formation of this reactive metabolite in human liver microsomes was shown to be exclusively catalyzed by CYP3A enzymes. Evidence for in vivo metabolic activation of zafirlukast was obtained when the same GSH adduct was detected in bile of rats given an iv or oral dose of the drug. On the basis of results with model peroxidases and of the structures of product alcohols from incubations containing H2(18)O, it appeared that zafirlukast underwent dehydrogenation by two sequential one-electron oxidations. In addition, zafirlukast proved to be a mechanism-based inhibitor of CYP3A4 activity in human liver microsomes and in microsomes containing cDNA-expressed CYP3A4. The enzyme inhibitory property of zafirlukast was selective for this enzyme among all of the P450 enzymes that were tested in human liver microsomes. The inactivation was characterized by a K(I) of 13.4 microM and k(inact) of 0.026 min(-1). In summary, zafirlukast dehydrogenation to an electrophilic alpha,beta-unsaturated iminium intermediate may be associated with idiosyncratic hepatotoxicity and/or cause drug-drug interactions through inactivation of CYP3A4[1].
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| Cell Assay |
1. We investigated the inhibitory effects of the cysteinyl leukotriene (CysLT1) receptor antagonists, pranlukast and zafirlukast, on 35SO4 labelled mucus output, in vitro, in guinea-pig trachea, induced by leukotriene D4 (LTD4) or by antigen challenge of sensitized animals. Agonists and antagonists were administered mucosally, except in selected comparative experiments where drugs were administered both mucosally and serosally to assess the influence of the epithelium on evoked-secretion. 2. LTD4 increased 35SO4 output in a concentration-related manner with a maximal increase of 23 fold above controls at 100 microM and an approximate EC50 of 2 microM. Combined mucosal and serosal addition of LTD4 did not significantly affect the secretory response compared with mucosal addition alone. Neither LTC4 nor LTE4 (10 microM each) affected 35SO4 output. Pranlukast or zafirlukast significantly inhibited 10 microM LTD4-evoked 35SO4 output in a concentration-dependent fashion, with maximal inhibitions of 83% at 10 microM pranlukast and 78% at 10 microM zafirlukast, and IC50 values of 0.3 microM for pranlukast and 0.6 microM for zafirlukast. Combined mucosal and serosal administration of the antagonists (5 microM each) gave degrees of inhibition of mucosal-serosal 10 microM LTD4-evoked 35SO4 output similar to those of the drugs given mucosally. Pranlukast (0.5 microM) caused a parallel rightward shift of the LTD4 concentration-response curve with a pKB of 7. Pranlukast did not inhibit ATP-induced 35SO4 output. 3. Ovalbumin (10-500 microg ml(-1) challenge of tracheae from guinea-pigs actively sensitized with ovalbumin caused a concentration-related increase in 35SO4 output with a maximal increase of 20 fold above vehicle controls at 200 microg ml(-1). The combination of the antihistamines pyrilamine and cimetidine (0.1 mM each) did not inhibit ovalbumin-induced 35SO4 output in sensitized guinea-pigs. Neither mucosal (10 microM or 100 microM) nor mucosal-serosal (100 microM) histamine had any significant effect on 35SO4 output. 4. Pranlukast or zafirlukast (5 microM each) significantly suppressed ovalbumin-induced secretion in tracheae from sensitized guinea-pigs by 70% and 65%, respectively. 5 We conclude that LTD4 or ovalbumin challenge of sensitized animals provokes mucus secretion from guinea-pig trachea in vitro and this effect is inhibited by the CysLT1 receptor antagonists pranlukast and zafirlukast. These antagonists may be beneficial in the treatment of allergic airway diseases in which mucus hypersecretion is a clinical symptom, for example asthma and allergic rhinitis[3].
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| Animal Protocol |
Mice: It uses A/J female mice that are 5–6 weeks old. The first of two intraperitoneal injections (i.p.) of vinyl carbamate (16 mg/kg each, spaced seven days apart) is given to the mice when they are seven to eight weeks old. In their diet, the mice are given leukotriene inhibitors two weeks following their second dosage of vinyl carbamate. The meal should contain the prescribed mg/kg concentrations of zafirlukast (270 or 540 mg/kg), zileuton (600 or 1200 mg/kg), and MK-886 (30 mg/kg). After being exposed to leukotriene inhibitors for the first six weeks, mice are weighed every week. They are weighed every two to four weeks until they are sacrificed after that. Before being embedded in paraffin for histology, the lungs are removed, fixed for one night in formalin, moved to 70% alcohol, and checked for tumors.
The present work was conducted to assess the possible protective effects of zafirlukast against the toxic damage induced by acetic acid in rat colon. Zafirlukast is a potent and selective cysteinyl leukotriene receptor antagonist which is used mainly in the prophylaxis of bronchial asthma. Two doses of zafirlukast were used (40 and 80 mg/kg) dissolved in gum acacia and given either orally or rectally (0.5 ml/kg). Several parameters including, macroscopic score, histopathological and biochemical such as malondialdehyde (MDA), myeloperoxidase (MPO), catalase and reduced glutathione (GSH) levels were measured using standard assay procedures. The study showed that pretreatment with zafirlukast in a dose of 80 mg/kg orally produced a significant decrease in tissue malondialdehyde, myeloperoxidase, and an increase in both reduced glutathione and catalase levels, while there was no significant changes with the rectal route. The 40 mg/kg dose had no significant protective effects when given either orally or rectally. The available data indicate that the inhibition of leukotriene synthesis or action may have a role in inflammatory bowel disease (IBD) as they are considered as important mediators in this condition.[3] |
| ADME/Pharmacokinetics |
Absorption, Distribution and Excretion
Absorption is rapid after oral administration, but decreases after high-fat or high-protein meals. The most common metabolites are hydroxylated metabolites, which are excreted in feces. 70 L Apparent oral clearance = 20 L/h 11.4 L/h [7-11 years] 9.2 L/h [5-6 years] Metabolism/Metabolites Hepatic Metabolism Zafaridazolium's known human metabolites include cyclopentyl N-[1-(hydroxymethyl)-3-({2-methoxy-4-[(2-methylbenzenesulfonyl)carbamoyl]phenyl}methyl)indol-5-yl]carbamate and 3-hydroxycyclopentyl N-[3-({2-methoxy-4-[(2-methylbenzenesulfonyl)carbamoyl]phenyl}methyl)-1-methylindol-5-yl]carbamate. Biological half-life 10 hours |
| Toxicity/Toxicokinetics |
Hepatotoxicity
Prospective studies have shown that the incidence of ALT elevation in patients treated with zafirfukast is 1.5%, most of which are mild, asymptomatic, and resolve spontaneously, even with continued treatment. A similar proportion of transient ALT elevations are also common in the placebo group. Clinically significant liver disease caused by zafirfukast is rare, but there are numerous well-documented case reports, some of which are severe, leading to liver failure, requiring liver transplantation, or death. Symptoms of liver injury usually appear within 2 to 6 months after the start of treatment, but there are also cases reported with longer incubation periods (8–13 months). Symptoms include fatigue, nausea, and right upper quadrant pain, followed by dark urine, jaundice, and itching. The pattern of elevated liver enzymes is usually hepatocellular, similar to acute viral hepatitis. Eosinophilia is common, but immune hypersensitivity features are usually not prominent, and autoantibodies are uncommon (eosinophilia may be due to underlying allergic asthma). Fatal cases have been reported. Re-exposure may lead to a faster and more severe recurrence of injury; re-exposure should be avoided. Zafirlukast may also cause systemic vasculitis and eosinophilia (Thau-Schönlein syndrome), and may be accompanied by liver involvement and mild enzyme elevation. Probability Score: C (likely a cause of clinically significant liver damage). Pregnancy and Lactation Effects ◉ Overview of Use During Lactation There is currently no publicly available information regarding the use of Zafirlukast during lactation; however, manufacturer data suggests that the dose of the drug in breast milk is low. Zafirlukast has been used in infants up to 12 months of age. International guidelines consider leukotriene receptor antagonists to be safe for use during lactation. ◉ Effects on Breastfed Infants No published information found as of the revision date. ◉ Effects on Lactation and Breast Milk No published information found as of the revision date. Protein Binding 99% |
| References | |
| Additional Infomation |
Zafirlukast belongs to the indole, carbamate, and N-sulfonylcarboxamide classes. It is an anti-asthmatic drug and a leukotriene receptor antagonist. Zafirlukast is an oral leukotriene receptor antagonist (LTRA) used for maintenance therapy of asthma, usually in combination with inhaled corticosteroids and/or long-acting bronchodilators. It is available in tablet form and is usually taken twice daily. Another leukotriene receptor antagonist is montelukast (Singulair), usually taken once daily. Zafirlukast blocks the binding of cysteine leukotrienes to CysLT1 receptors, thereby reducing airway constriction, pulmonary mucus buildup, and respiratory inflammation. Zafirlukast is a leukotriene receptor antagonist. Its mechanism of action is as a leukotriene receptor antagonist and a cytochrome P450 2C9 inhibitor. Zafirlukast is an oral leukotriene receptor antagonist widely used for the prevention and chronic treatment of asthma. Zafirlukast is associated with rare but occasionally severe cases of acute liver injury. Zafirlukast is a toluene compound and a leukotriene receptor antagonist (LTRA) with anti-asthmatic and potential preventative effects against capsular contracture. After administration, Zafirlukast selectively and competitively binds to and blocks the cysteyl leukotriene 1 receptor (CYSLTR1), thereby preventing the binding of potent pro-inflammatory mediators leukotriene C4, D4, and E4. This prevents leukotriene-mediated effects, including enhanced eosinophil and neutrophil migration, increased leukocyte adhesion, increased monocyte and neutrophil aggregation, airway edema, inflammation, increased capillary permeability, and bronchoconstriction. Furthermore, Zafirlukast can reduce post-implantation collagen deposition, fibrosis, and capsular thickening, thereby preventing scar tissue formation. Drug Indications: For the prevention and chronic treatment of asthma.
FDA Label Mechanism of Action Zarukast is a selective competitive receptor antagonist of leukotrienes D4 and E4 (LTD4 and LTE4), which are components of slow-reacting anaphylactic substances (SRSA). Cysteinyl leukotrienes production and receptor occupancy are closely associated with the pathophysiology of asthma, including airway edema, smooth muscle contraction, and altered cellular activity related to inflammatory processes, all of which contribute to the signs and symptoms of asthma. Pharmacodynamics Zarukast is a synthetic selective peptide leukotriene receptor antagonist (LTRA) for the prevention and chronic treatment of asthma. One study found that asthmatic patients were 25-100 times more sensitive to the bronchoconstrictive activity of inhaled LTD4 than non-asthmatic patients. In vitro Studies have shown that zarukast antagonizes the contractile activity of three leukotrienes (LTC4, LTD4, and LTE4) in the smooth muscle of the airways in laboratory animals and humans. Zafirlukast can prevent the increase in skin vascular permeability induced by intradermal injection of LTD4 and inhibit the influx of eosinophils induced by inhalation of LTD4 into the lungs of animals. |
| Molecular Formula |
C31H33N3O6S
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|---|---|
| Molecular Weight |
575.6752
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| Exact Mass |
575.208
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| Elemental Analysis |
C, 64.68; H, 5.78; N, 7.30; O, 16.67; S, 5.57
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| CAS # |
107753-78-6
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| Related CAS # |
Zafirlukast-d7; 1217174-18-9; Zafirlukast-13C,d3; Zafirlukast-13C,d6
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| PubChem CID |
5717
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| Appearance |
Off-white to pink solid powder
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| Density |
1.3±0.1 g/cm3
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| Melting Point |
139°C
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| Index of Refraction |
1.641
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| LogP |
6.15
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| Hydrogen Bond Donor Count |
2
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| Hydrogen Bond Acceptor Count |
6
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| Rotatable Bond Count |
9
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| Heavy Atom Count |
41
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| Complexity |
1010
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| Defined Atom Stereocenter Count |
0
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| SMILES |
S(C1=C([H])C([H])=C([H])C([H])=C1C([H])([H])[H])(N([H])C(C1C([H])=C([H])C(=C(C=1[H])OC([H])([H])[H])C([H])([H])C1=C([H])N(C([H])([H])[H])C2C([H])=C([H])C(=C([H])C1=2)N([H])C(=O)OC1([H])C([H])([H])C([H])([H])C([H])([H])C1([H])[H])=O)(=O)=O
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| InChi Key |
YEEZWCHGZNKEEK-UHFFFAOYSA-N
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| InChi Code |
InChI=1S/C31H33N3O6S/c1-20-8-4-7-11-29(20)41(37,38)33-30(35)22-13-12-21(28(17-22)39-3)16-23-19-34(2)27-15-14-24(18-26(23)27)32-31(36)40-25-9-5-6-10-25/h4,7-8,11-15,17-19,25H,5-6,9-10,16H2,1-3H3,(H,32,36)(H,33,35)
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| Chemical Name |
cyclopentyl N-[3-[[2-methoxy-4-[(2-methylphenyl)sulfonylcarbamoyl]phenyl]methyl]-1-methylindol-5-yl]carbamate
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| Synonyms |
ICI-204219; ICI204219; ICI 204219; ICI-204,219; ICI 204,219; ICI204,219; Zafirlukast; brand names Accolate, Accoleit, and Vanticon; Olmoran; Cyclopentyl (3-(2-methoxy-4-((o-tolylsulfonyl)carbamoyl)benzyl)-1-methyl-1H-indol-5-yl)carbamate;
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| HS Tariff Code |
2934.99.9001
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| Storage |
Powder -20°C 3 years 4°C 2 years In solvent -80°C 6 months -20°C 1 month Note: Please store this product in a sealed and protected environment, avoid exposure to moisture. |
| Shipping Condition |
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
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| Solubility (In Vitro) |
DMSO: ~100 mg/mL (~173.7 mM)
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| Solubility (In Vivo) |
Solubility in Formulation 1: ≥ 2.08 mg/mL (3.61 mM) (saturation unknown) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 20.8 mg/mL clear DMSO stock solution to 400 μL PEG300 and mix evenly; then add 50 μL Tween-80 to the above solution and mix evenly; then add 450 μL normal saline to adjust the volume to 1 mL. Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution. Solubility in Formulation 2: ≥ 2.08 mg/mL (3.61 mM) (saturation unknown) in 10% DMSO + 90% Corn Oil (add these co-solvents sequentially from left to right, and one by one), clear solution. For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 20.8 mg/mL clear DMSO stock solution to 900 μL of corn oil and mix evenly. View More
Solubility in Formulation 3: 5%DMSO + 40%PEG300 + 5%Tween 80 + 50%ddH2O: 5.0mg/ml (8.69mM) |
| Preparing Stock Solutions | 1 mg | 5 mg | 10 mg | |
| 1 mM | 1.7371 mL | 8.6854 mL | 17.3708 mL | |
| 5 mM | 0.3474 mL | 1.7371 mL | 3.4742 mL | |
| 10 mM | 0.1737 mL | 0.8685 mL | 1.7371 mL |
*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.
Calculation results
Working concentration: mg/mL;
Method for preparing DMSO stock solution: mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.
Method for preparing in vivo formulation::Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.
(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
(2) Be sure to add the solvent(s) in order.
| NCT Number | Recruitment | interventions | Conditions | Sponsor/Collaborators | Start Date | Phases |
| NCT04339140 | Recruiting | Drug: Zafirlukast | Ovarian Cancer | Beth Israel Deaconess Medical Center |
June 24, 2020 | Phase 2 |
| NCT06069063 | Not yet recruiting | Drug: Zafirlukast | Allergy to Cats | Allergy & Asthma Medical Group & Research Center |
January 5, 2024 | Phase 2 |
| NCT01283061 | Completed | Drug: Zafirlukast | Healthy | Dr. Reddy's Laboratories Limited | December 2007 | Phase 1 |
| NCT02950480 | Terminated | Drug: zafirlukast Other: Standard of Care (no intervention) |
Breast Cancer | University of California, San Francisco |
March 13, 2017 | Phase 2 |