Dirithromycin

Summary

Dirithromycin is a macrolide glycopeptide antibiotic.[1]

Dirithromycin
Clinical data
Trade namesDynabac
AHFS/Drugs.comMicromedex Detailed Consumer Information
MedlinePlusa604026
License data
  • US FDA: Clarithromycin
Pregnancy
category
  • B
Routes of
administration
Oral
ATC code
Pharmacokinetic data
Bioavailability10%
Protein binding15 to 30%
MetabolismHyrolized to erythromycyclamine in 1.5 hours
Identifiers
  • (2R,3R,6R,7S,8S,9R,10R,12R,13S,15R,17S)-9-{[(2S,3R,4S,6R)-4-(dimethylamino)-3-hydroxy-6-methyloxan-2-yl]oxy}-3-ethyl-2,10-dihydroxy-7-{[(2R,4R,5S,6S)-5-hydroxy-4-methoxy-4,6-dimethyloxan-2-yl]oxy}-15-[(2-methoxyethoxy)methyl]-2,6,8,10,12,17-hexamethyl-4,16-dioxa-14-azabicyclo[11.3.1]heptadecan-5-one
CAS Number
  • 62013-04-1 checkY
PubChem CID
  • 6917067
DrugBank
  • DB00954 checkY
ChemSpider
  • 5292341 checkY
UNII
  • 1801D76STL
KEGG
  • D03865 checkY
ChEBI
  • CHEBI:474014 ☒N
ChEMBL
  • ChEMBL3039471 ☒N
CompTox Dashboard (EPA)
  • DTXSID7048956 Edit this at Wikidata
ECHA InfoCard100.152.704 Edit this at Wikidata
Chemical and physical data
FormulaC42H78N2O14
Molar mass835.086 g·mol−1
3D model (JSmol)
  • Interactive image
Melting point186 to 189 °C (367 to 372 °F) (dec.)
  • O=C4O[C@@H]([C@](O)(C)[C@H]1O[C@@H](N[C@H]([C@@H]1C)[C@H](C)C[C@](O)(C)[C@H](O[C@@H]2O[C@H](C)C[C@H](N(C)C)[C@H]2O)[C@H]([C@H](O[C@@H]3O[C@@H](C)[C@H](O)[C@@](OC)(C)C3)[C@H]4C)C)COCCOC)CC
  • InChI=1S/C42H78N2O14/c1-15-29-42(10,49)37-24(4)32(43-30(56-37)21-52-17-16-50-13)22(2)19-40(8,48)36(58-39-33(45)28(44(11)12)18-23(3)53-39)25(5)34(26(6)38(47)55-29)57-31-20-41(9,51-14)35(46)27(7)54-31/h22-37,39,43,45-46,48-49H,15-21H2,1-14H3/t22-,23-,24+,25+,26-,27+,28+,29-,30-,31+,32+,33-,34+,35+,36-,37+,39+,40-,41-,42-/m1/s1 checkY
  • Key:WLOHNSSYAXHWNR-NXPDYKKBSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Dirithromycin (Dynabac) is a more lipid-soluble prodrug derivative of 9S-erythromycyclamine prepared by condensation of the latter with 2-(2-methoxyethoxy)acetaldehyde. The 9N, 11O-oxazine ring thus formed is a hemi-aminal that is unstable under both acidic and alkaline aqueous conditions and undergoes spontaneous hydrolysis to form erythromycyclamine. Erythromycyclamine is a semisynthetic derivative of erythromycin in which the 9-ketogroup of the erythronolide ring has been converted to an amino group. Erythromycyclamine retains the antibacterial properties of erythromycin oral administration. The prodrug, dirithromycin, is provided as enteric coated tablets to protect it from acid catalyzed hydrolysis in the stomach. Orally administered dirithromycin is absorbed rapidly into the plasma, largely from the small intestine. Spontaneous hydrolysis to erythromycyclamine occurs in the plasma. Oral bioavailability is estimated to be about 10%, but food does not affect absorption of the prodrug.

Discontinuation edit

Dirithromycin is no longer available in the United States.[2] Since the production of dirithromycin is discontinued in the U.S., National Institutes of Health recommend that people taking dirithromycin should consult their physicians to discuss switching to another treatment.[3] However, dirithromycin is still available in many European countries.

References edit

  1. ^ McConnell SA, Amsden GW (April 1999). "Review and comparison of advanced-generation macrolides clarithromycin and dirithromycin". Pharmacotherapy. 19 (4): 404–15. doi:10.1592/phco.19.6.404.31054. PMID 10212011. S2CID 25018468.
  2. ^ "Dynabac Drug Details". U.S. Food and Drug Administration. Retrieved 2007-05-25.
  3. ^ "Dirithromycin". MedlinePlus. U.S. National Library of Medicine. January 1, 2006. Archived from the original on 2007-03-29. Retrieved 2007-05-25.