Triptorelin

Overview

Description
A medication used to treat end-stage prostate cancer that is difficult to treat.
Description
A medication used to treat end-stage prostate cancer that is difficult to treat.
DrugBank ID
DB06825
Type
Small Molecule
US Approved
YES
Other Approved
YES
Clinical Trials
Phase 0
1
Phase 1
5
Phase 2
53
Phase 3
71
Phase 4
56
Therapeutic Categories
  • Gonadotropin Releasing Hormone Receptor Agonist
Mechanism of Action

Identification

Summary

Triptorelin is a GnRH agonist indicated for the palliative treatment of advanced prostate cancer.

Brand Names
Decapeptyl, Trelstar, Triptodur
Generic Name
Triptorelin
DrugBank Accession Number
DB06825
Background

Triptorelin is a synthetic decapeptide agonist analog of luteinizing hormone releasing hormone (LHRH). Possessing greater potency than endogenous LHRH, triptorelin reversibly represses gonadotropin secretion. After chronic, continuous administration, this agent effects sustained decreases in LH and FSH production and testicular and ovarian steroidogenesis. Serum testosterone concentrations may fall to levels typically observed in surgically castrated men.

Type
Small Molecule
Groups
Approved, Vet approved
Structure
Weight
Average: 1311.473
Monoisotopic: 1310.630874772
Chemical Formula
C64H82N18O13
Synonyms
  • (6-D-Tryptophan)luteinizing hormone-releasing hormone
  • (D-Trp6)-GnRH
  • Luteinizing hormone-releasing factor (pig), 6-D-tryptophan
  • pGlu-His-Trp-Ser-Tyr-D-Trp-Leu-Arg-Pro-Gly-NH2
  • Triptorelin
  • Triptorelina
  • Triptoreline
  • Triptorelinum
External IDs
  • AY-25650
  • CL 118,532
  • CL-118532
  • WY-42462

Pharmacology

Indication

Triptorelin is indicated for the palliative treatment of advanced prostate cancer.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Symptomatic treatment ofAdvanced prostate cancer••••••••••••
Associated Therapies
Contraindications & Blackbox Warnings
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Pharmacodynamics

The first administration of triptorelin is followed by a transient surge of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol,and testosterone. The time, peak and decline of testosterone in the body varies depending on the dose administered. This initial surge is often responsible for worsening of prostate cancer symptoms such as urethral or bladder outlet obstruction, bone pain, spinal cord injury and hematuria in the early stages. A sustained decrease in FSH and LH, and significant reduction of testicular steroidogenesis is usually seen 2-4 weeks post-initiation of therapy. This result is a reduction of serum testosterone to levels which are typically seen in surgically castrated men. Ultimately, tissues and functions that require these hormones become inactive. The effects of triptorelin can usually be reversed once the drug is discontinued.

Mechanism of action

Triptorelin is a synthetic agonist analog of gonadotropin releasing hormone (GnRH). Animal studies comparing triptorelin to native GnRH found that triptorelin had 13 fold higher releasing activity for luteinizing hormone, and 21-fold higher releasing activity for follicle-stimulating hormone.

TargetActionsOrganism
AGonadotropin-releasing hormone receptor
agonist
Humans
Absorption

Following IV administration of triptorelin, triptorelin is completely absorbed.

Volume of distribution

After a single IV dose of 0.5mg, the volume of distribution of triptorelin peptide in healthy males was 30 - 33L.

Protein binding

Triptorelin does not bind to plasma proteins at clinically relevant concentrations.

Metabolism

The metabolism of triptorelin in humans is not well understood; however, metabolism likely does not involve hepatic enzymes such as cytochrome P450. Whether or not triptorelin affects, or how it affects other metabolizing enzymes is also poorly understood. Triptorelin has no identified metabolites.

Route of elimination

Elimination of triptorelin involves both the kidneys and the liver.

Half-life

The pharmacokinetics of triptorelin follows a 3 compartment model. The half lives are estimated to be 6 minutes, 45 minutes, and 3 hours respectively.

Clearance

In healthy male volunteers, total clearance of triptorelin was 211.9 mL/min.

Adverse Effects
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Toxicity

Some of the most commonly reported adverse effects of triptorelin are hot flushes reported in 58.6% of patients, skeletal pain in 12.1%, impotence in 7.1%, and headache in 5.0%. Other reported adverse effects include injection site pain, general body pain, leg pain, fatigue, hypertension, dizziness, diarrhea, vomiting, insomnia, emotional lability, anemia, pruritus, urinary tract infections, and urinary retention. Triptorelin is classified as Pregnancy Category X and contraindicated in pregnant women or in women who may become pregnant. Hormonal changes caused by triptorelin increase the risk for pregnancy loss. Studies done on pregnant rats demonstrated maternal toxicity and embryo-fetal toxicities.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
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.
DrugInteraction
AcarboseThe therapeutic efficacy of Acarbose can be decreased when used in combination with Triptorelin.
AcetohexamideThe therapeutic efficacy of Acetohexamide can be decreased when used in combination with Triptorelin.
AcrivastineThe risk or severity of QTc prolongation can be increased when Triptorelin is combined with Acrivastine.
AdenosineThe risk or severity of QTc prolongation can be increased when Triptorelin is combined with Adenosine.
AjmalineThe risk or severity of QTc prolongation can be increased when Ajmaline is combined with Triptorelin.
Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Triptorelin acetate43OFW291R9140194-24-7HPPONSCISKROOD-OYLNGHKZSA-N
Triptorelin pamoate08AN7WA2G0124508-66-3ZBVJFYPGLGEMIN-OYLNGHKZSA-N
International/Other Brands
Diphereline (Ferring Pharmaceuticals) / Gonapeptyl (Ferring Pharmaceuticals) / Variopeptyl (Varian Darou Pajooh)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
DecapeptylSolution0.1 mg / mLSubcutaneousFerring Pharmaceuticals2012-08-09Not applicableCanada flag
TrelstarInjection, powder, lyophilized, for suspension; Kit22.5 mg/2mLIntramuscularAllergan, Inc.2010-03-11Not applicableUS flag
TrelstarInjection, powder, for suspension, extended release22.5 mg / vialIntramuscularKnight Therapeutics Inc.2013-10-16Not applicableCanada flag
TrelstarKit3.75 mg/2mLIntramuscularActavis Pharma Company2000-06-152018-10-31US flag
TrelstarInjection, powder, lyophilized, for suspension; Kit11.25 mg/2mLIntramuscularVerity Pharmaceuticals Inc.2001-06-29Not applicableUS flag

Categories

ATC Codes
L02AE04 — Triptorelin
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as polypeptides. These are peptides containing ten or more amino acid residues.
Kingdom
Organic compounds
Super Class
Organic Polymers
Class
Polypeptides
Sub Class
Not Available
Direct Parent
Polypeptides
Alternative Parents
Peptides / Tyrosine and derivatives / Phenylalanine and derivatives / Histidine and derivatives / Leucine and derivatives / N-acyl-alpha amino acids and derivatives / Proline and derivatives / Tryptamines and derivatives / Serine and derivatives / Alpha amino acid amides
show 23 more
Substituents
1-hydroxy-2-unsubstituted benzenoid / 2-pyrrolidone / 3-alkylindole / Alcohol / Alpha peptide / Alpha-amino acid amide / Alpha-amino acid or derivatives / Amphetamine or derivatives / Aromatic heteropolycyclic compound / Azacycle
show 48 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
oligopeptide (CHEBI:63633)
Affected organisms
Not Available

Chemical Identifiers

UNII
9081Y98W2V
CAS number
57773-63-4
InChI Key
VXKHXGOKWPXYNA-PGBVPBMZSA-N
InChI
InChI=1S/C64H82N18O13/c1-34(2)23-46(56(88)75-45(13-7-21-69-64(66)67)63(95)82-22-8-14-52(82)62(94)72-31-53(65)85)76-58(90)48(25-36-28-70-42-11-5-3-9-40(36)42)78-57(89)47(24-35-15-17-39(84)18-16-35)77-61(93)51(32-83)81-59(91)49(26-37-29-71-43-12-6-4-10-41(37)43)79-60(92)50(27-38-30-68-33-73-38)80-55(87)44-19-20-54(86)74-44/h3-6,9-12,15-18,28-30,33-34,44-52,70-71,83-84H,7-8,13-14,19-27,31-32H2,1-2H3,(H2,65,85)(H,68,73)(H,72,94)(H,74,86)(H,75,88)(H,76,90)(H,77,93)(H,78,89)(H,79,92)(H,80,87)(H,81,91)(H4,66,67,69)/t44-,45-,46-,47-,48+,49-,50-,51-,52-/m0/s1
IUPAC Name
(2S)-N-[(2S)-5-carbamimidamido-1-[(2S)-2-[(carbamoylmethyl)carbamoyl]pyrrolidin-1-yl]-1-oxopentan-2-yl]-2-[(2R)-2-[(2S)-2-[(2S)-3-hydroxy-2-[(2S)-2-[(2S)-3-(1H-imidazol-4-yl)-2-{[(2S)-5-oxopyrrolidin-2-yl]formamido}propanamido]-3-(1H-indol-3-yl)propanamido]propanamido]-3-(4-hydroxyphenyl)propanamido]-3-(1H-indol-3-yl)propanamido]-4-methylpentanamide
SMILES
CC(C)C[C@H](NC(=O)[C@@H](CC1=CNC2=CC=CC=C12)NC(=O)[C@H](CC1=CC=C(O)C=C1)NC(=O)[C@H](CO)NC(=O)[C@H](CC1=CNC2=C1C=CC=C2)NC(=O)[C@H](CC1=CNC=N1)NC(=O)[C@@H]1CCC(=O)N1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N1CCC[C@H]1C(=O)NCC(N)=O

References

General References
  1. Lahlou N, Carel JC, Chaussain JL, Roger M: Pharmacokinetics and pharmacodynamics of GnRH agonists: clinical implications in pediatrics. J Pediatr Endocrinol Metab. 2000 Jul;13 Suppl 1:723-37. [Article]
  2. Padula AM: GnRH analogues--agonists and antagonists. Anim Reprod Sci. 2005 Aug;88(1-2):115-26. [Article]
KEGG Drug
D06247
PubChem Compound
25074470
PubChem Substance
310264898
ChemSpider
17290424
RxNav
38782
ChEBI
63633
ChEMBL
CHEMBL1201334
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Triptorelin
FDA label
Download (691 KB)

Clinical Trials

Clinical Trials
Clinical Trial & Rare Diseases Add-on Data Package
Explore 4,000+ rare diseases, orphan drugs & condition pairs, clinical trial why stopped data, & more. Preview package
PhaseStatusPurposeConditionsCountStart DateWhy Stopped100+ additional columns
Not AvailableActive Not RecruitingNot AvailableProstate Cancer1somestatusstop reasonjust information to hide
Not AvailableActive Not RecruitingTreatmentAdenocarcinoma of Prostate / Stage I Prostate Cancer / Stage IIA Prostate Cancer / Stage IIB Prostate Cancer / Stage III Prostate Cancer1somestatusstop reasonjust information to hide
Not AvailableCompletedNot AvailableDeep Infiltrating Endometriosis (DIE)1somestatusstop reasonjust information to hide
Not AvailableCompletedNot AvailableImplantation, Embryo / Pregnancy1somestatusstop reasonjust information to hide
Not AvailableCompletedNot AvailableInfertility1somestatusstop reasonjust information to hide

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
InjectionParenteral0.1 MG/ML
Injection, powder, for solutionIntramuscular; Subcutaneous0.1 MG/ML
Injection, powder, for suspensionIntramuscular3.75 mg
Injection, powder, for suspensionParenteral3.75 MG/2ML
Injection, powder, for suspension, extended release11.25 MG/2ML
Injection, powder, for suspension, extended release22.5 MG/2ML
SolutionSubcutaneous0.1 mg / mL
InjectionParenteral0.1 mg
Injection; solutionSubcutaneous
Injection, solutionSubcutaneous0.1 mg/mL
Powder3.75 mg
Injection, powder, for solutionIntramuscular; Subcutaneous3.75 mg/syringe
Injection, suspension, extended releaseIntramuscular; Subcutaneous3.75 mg
Capsule, extended releaseIntramuscular; Subcutaneous4.12 mg
SuspensionSubcutaneous3.75 mg
InjectionSubcutaneous100 mcg/ml
Injection, powder, for suspensionIntramuscular11.25 mg
Injection, powder, for suspension
Injection, powder, for suspension, extended releaseIntramuscular; Subcutaneous3.75 mg
Injection, powder, for suspension, extended releaseIntramuscular; Subcutaneous11.25 mg
Injection, powder, for suspension, extended releaseIntramuscular3.75 mg
Injection, solution
Injection, solution0.1 MG/1ML
Injection, solution0.1 mg/ml
SolutionSubcutaneous0.09560 mg
SolutionSubcutaneous95.6 mcg
Injection, powder, for suspension, extended releaseIntramuscular; Subcutaneous3.75 mg/ml
SuspensionOther4.1200 mg
Injection, powder, lyophilized, for solution11.25 mg
Injection, powder, lyophilized, for solution22.5 mg
Injection, powder, lyophilized, for solution3.75 mg
SuspensionParenteral3.750 MG
Injection, powder, for suspensionIntramuscular22.5 mg
Injection, powder, for suspensionParenteral11.25 mg
Injection, powder, for suspensionParenteral22.5 mg
Injection, powder, for suspensionParenteral3.75 mg
Injection, powder, lyophilized, for suspensionIntramuscular11.25 mg
Injection, powder, lyophilized, for suspensionIntramuscular22.5 mg
Injection, powder, lyophilized, for suspensionIntramuscular3.75 mg
Injection, powder, for suspension, extended releaseIntramuscular11.25 mg / vial
Injection, powder, for suspension, extended releaseIntramuscular22.5 mg / vial
Injection, powder, for suspension, extended releaseIntramuscular3.75 mg / vial
Injection, powder, lyophilized, for suspensionIntramuscular11.25 mg/2mL
Injection, powder, lyophilized, for suspensionIntramuscular22.5 mg/2mL
Injection, powder, lyophilized, for suspensionIntramuscular3.75 mg/2mL
Injection, powder, lyophilized, for suspension; kitIntramuscular11.25 mg/2mL
Injection, powder, lyophilized, for suspension; kitIntramuscular3.75 mg/2mL
KitIntramuscular11.25 mg/2mL
KitIntramuscular22.5 mg/2mL
KitIntramuscular3.75 mg/2mL
Injection, powder, lyophilized, for suspension; kitIntramuscular22.5 mg/2mL
Injection, solutionParenteral0.1 mg/ml
SolutionSubcutaneous0.1 mg/1ml
Injection, powder, for solutionIntramuscular; Subcutaneous3.75 mg/1vial
Injection, powder, for solutionIntramuscular; Subcutaneous0.1 mg/1vial
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5776885No1998-07-072015-07-07US flag
US10166181No2019-01-012029-02-10US flag

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0305 mg/mLALOGPS
logP1.07ALOGPS
logP-3.6Chemaxon
logS-4.6ALOGPS
pKa (Strongest Acidic)9.49Chemaxon
pKa (Strongest Basic)11.54Chemaxon
Physiological Charge1Chemaxon
Hydrogen Acceptor Count17Chemaxon
Hydrogen Donor Count18Chemaxon
Polar Surface Area487.92 Å2Chemaxon
Rotatable Bond Count33Chemaxon
Refractivity352.43 m3·mol-1Chemaxon
Polarizability135.23 Å3Chemaxon
Number of Rings8Chemaxon
Bioavailability0Chemaxon
Rule of FiveNoChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleYesChemaxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-01tc-1169600380-0c60a00a5ac800bcfd43
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-0006-5294211010-8bfd30b6f31e714a5f83
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-052f-3172901112-e55a0cef0995dfb164d3
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0k9f-1494100011-82f356655b43014c8ae6
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-0a59-0531900013-735e91280b0ea43848fd
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-0596-0665400329-4b680b2e25559df0f153
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-339.73056
predicted
DeepCCS 1.0 (2019)
[M+H]+341.3838
predicted
DeepCCS 1.0 (2019)
[M+Na]+347.54062
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Agonist
General Function
Receptor for gonadotropin releasing hormone (GnRH) that mediates the action of GnRH to stimulate the secretion of the gonadotropic hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This receptor mediates its action by association with G-proteins that activate a phosphatidylinositol-calcium second messenger system. Isoform 2 may act as an inhibitor of GnRH-R signaling
Specific Function
gonadotropin-releasing hormone receptor activity
Gene Name
GNRHR
Uniprot ID
P30968
Uniprot Name
Gonadotropin-releasing hormone receptor
Molecular Weight
37730.355 Da
References
  1. FDA Approved Drug Products: TRELSTAR® (triptorelin pamoate for injectable suspension) [Link]

Drug created at September 14, 2010 16:21 / Updated at November 09, 2024 06:20