那曲酮

化合物

纳曲酮(Naltrexone,同時有 ReViaVivitrol 兩個商品名)主要用于治療酒精阿片类药物依赖药物[7]。阿片类药物依赖者在戒毒前不应服用纳曲酮[7]。有口服或肌肉注射兩者劑型可使用[7]。效果在 30 分钟内开始出现[7]。不过,对阿片类药物的渴望可能需要几周的时间才能消失[7]

那曲酮
臨床資料
读音/ˌnælˈtrɛksn/
商品名英语Drug nomenclatureRevia、Vivitrol、Depade、其它
其他名稱EN-1639A; UM-792; ALKS-6428; N-cyclopropylmethylnoroxymorphone; N-cyclopropylmethyl-14-hydroxydihydromorphinone; 17-(cyclopropylmethyl)-4,5α-epoxy-3,14-dihydroxymorphinan-6-one
AHFS/Drugs.comMonograph
MedlinePlusa685041
核准狀況
懷孕分級
给药途径口服给药, 肌肉注射, 皮下植入器英语subcutaneous implant
ATC碼
法律規範狀態
法律規範
藥物動力學數據
生物利用度5–60%[5][6]
血漿蛋白結合率20%[5][2]
药物代谢肝臟(非-CYP450[10]
代謝產物6β-Naltrexol英语6β-Naltrexol、其它[5]
藥效起始時間英语Onset of action30 分鐘[7]
生物半衰期口服 (Revia):[2]
• Naltrexone: 4 小時
6β-Naltrexol英语6β-Naltrexol: 13 小時
口服 (Contrave):[3]
• Naltrexone: 5 小時
肌肉 (Vivitrol):[4]
• Naltrexone: 5–10 天
• 6β-Naltrexol: 5–10 天
作用時間>72 小時[5][8][9]
排泄途徑尿[2]
识别信息
  • (4R,4aS,7aR,12bS)-3-(cyclopropylmethyl)-4a,9-dihydroxy-2,4,5,6,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline-7-one
CAS号16590-41-3  checkY
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard英语CompTox Chemicals Dashboard (EPA)
ECHA InfoCard100.036.939 編輯維基數據鏈接
化学信息
化学式C20H23NO4
摩尔质量341.41 g·mol−1
3D模型(JSmol英语JSmol
熔点169 °C(336 °F)
  • O=C4[C@@H]5Oc1c2c(ccc1O)C[C@H]3N(CC[C@]25[C@@]3(O)CC4)CC6CC6
  • InChI=1S/C20H23NO4/c22-13-4-3-12-9-15-20(24)6-5-14(23)18-19(20,16(12)17(13)25-18)7-8-21(15)10-11-1-2-11/h3-4,11,15,18,22,24H,1-2,5-10H2/t15-,18+,19+,20-/m1/s1 checkY
  • Key:DQCKKXVULJGBQN-XFWGSAIBSA-N checkY


副作用可能包括睡眠困难焦虑恶心头痛[7]。对于仍在使用阿片类药物的患者,可能会出现阿片类药物戒断症状[7]。不建议肝功能衰竭的患者使用[7]。目前还不清楚怀孕期间使用是否安全[7] [12]。纳曲酮是一种類阿片拮抗剂英语opioid antagonist,可以阻断類阿片(包括体内和体外)的作用[7]

纳曲酮于 1965 年首次制造,并于 1984 年在美国取得医疗使用許可[7] [13]。它被列入世界卫生组织基本药物清单[14]。在 2019 年,美国的批发成本约为每天英语defined daily dose0.80 美元[15]。缓释型注射藥剂每月花费约 1,267 美元(每天 41 美元)[15]。纳曲酮,即纳曲酮/安非他酮英语naltrexone/bupropion,也用于治疗肥胖症[16]

参考文獻

编辑
  1. ^ Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017. Therapeutic Goods Administration (TGA). 21 June 2022 [30 March 2024]. (原始内容存档于2023-07-06). 
  2. ^ 2.0 2.1 2.2 2.3 Revia (naltrexone hydrochloride tablets USP50 mgOpioid Antagonist. DailyMed. 24 April 2015 [13 June 2022]. (原始内容存档于14 June 2022). 
  3. ^ 3.0 3.1 Contrave Extended-Release – naltrexone hydrochloride and bupropion hydrochloride tablet, extended release. DailyMed. 4 November 2021 [13 June 2022]. (原始内容存档于4 June 2020). 
  4. ^ 4.0 4.1 Vivitrol- naltrexone kit. DailyMed. 10 March 2021 [13 June 2022]. (原始内容存档于30 May 2022). 
  5. ^ 5.0 5.1 5.2 5.3 Gonzalez JP, Brogden RN. Naltrexone. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of opioid dependence. Drugs. March 1988, 35 (3): 192–213. PMID 2836152. S2CID 195697174. doi:10.2165/00003495-198835030-00002. 
  6. ^ Lee MW, Fujioka K. Naltrexone for the treatment of obesity: review and update. Expert Opinion on Pharmacotherapy. August 2009, 10 (11): 1841–1845. CiteSeerX 10.1.1.496.9477 . PMID 19537999. S2CID 207477935. doi:10.1517/14656560903048959. 
  7. ^ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 Naltrexone Monograph for Professionals - Drugs.com. Drugs.com. American Society of Health-System Pharmacists. [9 November 2017]. (原始内容存档于9 November 2017). 
  8. ^ Colasanti A, Lingford-Hughes A, Nutt D. Opioids Neuroimaging. Miller PM (编). Biological Research on Addiction. Comprehensive Addictive Behaviors and Disorders 2. Elsevier. 2013: 675–687. ISBN 9780123983350. doi:10.1016/B978-0-12-398335-0.00066-2. 
  9. ^ Lee MC, Wagner HN, Tanada S, Frost JJ, Bice AN, Dannals RF. Duration of occupancy of opiate receptors by naltrexone. Journal of Nuclear Medicine. July 1988, 29 (7): 1207–1211 [29 October 2021]. PMID 2839637. (原始内容存档于29 October 2021). 
  10. ^ Sevarino KA, Kosten TR. Naltrexone for Initiation and Maintenance of Opiate Abstinence. Dean RL, Bilsky EJ, Negus SS (编). Opiate Receptors and Antagonists. Humana Press. 2009: 227–245. ISBN 978-1-58829-881-2. doi:10.1007/978-1-59745-197-0_12. 
  11. ^ Anvisa. RDC Nº 784 – Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control]. Diário Oficial da União英语Diário Oficial da União. 31 March 2023 (4 April 2023) [16 August 2023]. (原始内容存档于3 August 2023) (巴西葡萄牙语). 
  12. ^ Tran TH, Griffin BL, Stone RH, Vest KM, Todd TJ. Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women. Pharmacotherapy. July 2017, 37 (7): 824–839. PMID 28543191. doi:10.1002/phar.1958. 
  13. ^ Sadock, Benjamin J.; Sadock, Virginia A.; Sussman, Norman. Kaplan & Sadock's Pocket Handbook of Psychiatric Drug Treatment. Lippincott Williams & Wilkins. 2012: 265. ISBN 9781451154467. (原始内容存档于2017-12-05) (英语). 
  14. ^ World Health Organization. The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. 2023. WHO/MHP/HPS/EML/2023.02. 
  15. ^ 15.0 15.1 NADAC as of 2019-07-17 | Data.Medicaid.gov. Centers for Medicare and Medicaid Services. [16 July 2019]. (原始内容存档于2019-07-16) (英语). 
  16. ^ Naltrexone/bupropion for obesity. Drug and Therapeutics Bulletin. November 2017, 55 (11): 126–129. PMID 29117992. doi:10.1136/dtb.2017.11.0550.