Benznidazole

Identification

Summary

Benznidazole is a trypanocidal agent used to treat Chagas disease.

Generic Name
Benznidazole
DrugBank Accession Number
DB11989
Background

Benznidazole was granted accelerated approval for the treatment of Chagas disease in children 2-12 years of age by the FDA on August 29, 2017 9. It is the first treatment made available in the United States for Chagas disease.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 260.253
Monoisotopic: 260.090940262
Chemical Formula
C12H12N4O3
Synonyms
  • Benznidazol
  • Benznidazole
  • Benznidazolum
External IDs
  • NSC-299972
  • RO 07-1051
  • Ro 71051

Pharmacology

Indication

For use in the treatment of Chagas disease in children 2-12 years of age 9.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Benznidazole is a trypanocidal agent which kills the causative organism in Chagas disease, Trypanosoma cruzi 1.

Mechanism of action

Benznidazole is thought to be reduced to various electrophilic metabolites by nitroreductases present in Trypanosoma cruzi 1. These metabolites likely bind to proteins, lipids, DNA, and RNA resulting in damage to these macromolecules. Benznidazole has been found to increase trypanosomal death through interferon-γ which is likely present in increased amounts due to inflammation caused by macromolecule damage 3. DNA in parasites affected by benznidazole has been found to undergo extensive unpacking with overexpression of DNA repair proteins supporting the idea of DNA damage contributing to the mechanism of the drug 2.

Absorption

Benznidazole has a bioavailability of 91.7% and a Tmax of 2.93 h 4,5.

Volume of distribution

The apparent volume of distribution is 39.19 L 5.

Protein binding

Not Available

Metabolism

Benznidazole is metabolized by nitroreductases in Trypanosoma cruzi and by cytochrome P450 enzymes 5,6.

Route of elimination

The metabolites of benznidazole appear to be primarily exreted in the urine 6.

Half-life

The half life of elimination is 13.27 h 5.

Clearance

The apparent oral clearance is 2.04 L/h 5.

Adverse Effects
Adverseeffects
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Toxicity

At clinically relevant dosages, benznidazole can produce hepatotoxicity, peripheral neuropathy, and angioedema 7,8.

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
AbacavirAbacavir may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Benznidazole which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcrivastineAcrivastine may decrease the excretion rate of Benznidazole which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Benznidazole which could result in a higher serum level.
Adefovir dipivoxilAdefovir dipivoxil may decrease the excretion rate of Benznidazole which could result in a higher serum level.
Interactions
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Food Interactions
  • Take with or without food.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
BenznidazoleTablet100 mg/1OralExeltis Usa, Inc.2018-03-30Not applicableUS flag
BenznidazoleTablet12.5 mg/1OralExeltis Usa, Inc.2018-03-30Not applicableUS flag

Categories

ATC Codes
P01CA02 — Benznidazole
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as nitroaromatic compounds. These are c-nitro compounds where the nitro group is C-substituted with an aromatic group.
Kingdom
Organic compounds
Super Class
Organic 1,3-dipolar compounds
Class
Allyl-type 1,3-dipolar organic compounds
Sub Class
Organic nitro compounds
Direct Parent
Nitroaromatic compounds
Alternative Parents
N-substituted imidazoles / Benzene and substituted derivatives / Heteroaromatic compounds / Secondary carboxylic acid amides / Propargyl-type 1,3-dipolar organic compounds / Organic oxoazanium compounds / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Organic zwitterions
show 3 more
Substituents
Aromatic heteromonocyclic compound / Azacycle / Azole / Benzenoid / Carbonyl group / Carboxamide group / Carboxylic acid derivative / Heteroaromatic compound / Hydrocarbon derivative / Imidazole
show 14 more
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
Not Available
Affected organisms
  • Trypanosoma cruzi

Chemical Identifiers

UNII
YC42NRJ1ZD
CAS number
22994-85-0
InChI Key
CULUWZNBISUWAS-UHFFFAOYSA-N
InChI
InChI=1S/C12H12N4O3/c17-11(14-8-10-4-2-1-3-5-10)9-15-7-6-13-12(15)16(18)19/h1-7H,8-9H2,(H,14,17)
IUPAC Name
N-benzyl-2-(2-nitro-1H-imidazol-1-yl)acetamide
SMILES
[O-][N+](=O)C1=NC=CN1CC(=O)NCC1=CC=CC=C1

References

General References
  1. Maya JD, Cassels BK, Iturriaga-Vasquez P, Ferreira J, Faundez M, Galanti N, Ferreira A, Morello A: Mode of action of natural and synthetic drugs against Trypanosoma cruzi and their interaction with the mammalian host. Comp Biochem Physiol A Mol Integr Physiol. 2007 Apr;146(4):601-20. Epub 2006 Mar 12. [Article]
  2. Rajao MA, Furtado C, Alves CL, Passos-Silva DG, de Moura MB, Schamber-Reis BL, Kunrath-Lima M, Zuma AA, Vieira-da-Rocha JP, Garcia JB, Mendes IC, Pena SD, Macedo AM, Franco GR, de Souza-Pinto NC, de Medeiros MH, Cruz AK, Motta MC, Teixeira SM, Machado CR: Unveiling benznidazole's mechanism of action through overexpression of DNA repair proteins in Trypanosoma cruzi. Environ Mol Mutagen. 2014 May;55(4):309-21. doi: 10.1002/em.21839. Epub 2013 Dec 18. [Article]
  3. Romanha AJ, Alves RO, Murta SM, Silva JS, Ropert C, Gazzinelli RT: Experimental chemotherapy against Trypanosoma cruzi infection: essential role of endogenous interferon-gamma in mediating parasitologic cure. J Infect Dis. 2002 Sep 15;186(6):823-8. Epub 2002 Aug 16. [Article]
  4. Raaflaub J, Ziegler WH: Single-dose pharmacokinetics of the trypanosomicide benznidazole in man. Arzneimittelforschung. 1979;29(10):1611-4. [Article]
  5. Wiens MO, Kanters S, Mills E, Peregrina Lucano AA, Gold S, Ayers D, Ferrero L, Krolewiecki A: Systematic Review and Meta-analysis of the Pharmacokinetics of Benznidazole in the Treatment of Chagas Disease. Antimicrob Agents Chemother. 2016 Nov 21;60(12):7035-7042. Print 2016 Dec. [Article]
  6. Perin L, Moreira da Silva R, Fonseca KD, Cardoso JM, Mathias FA, Reis LE, Molina I, Correa-Oliveira R, Vieira PM, Carneiro CM: Pharmacokinetics and Tissue Distribution of Benznidazole after Oral Administration in Mice. Antimicrob Agents Chemother. 2017 Mar 24;61(4). pii: e02410-16. doi: 10.1128/AAC.02410-16. Print 2017 Apr. [Article]
  7. Miller DA, Hernandez S, Rodriguez De Armas L, Eells SJ, Traina MM, Miller LG, Meymandi SK: Tolerance of benznidazole in a United States Chagas Disease clinic. Clin Infect Dis. 2015 Apr 15;60(8):1237-40. doi: 10.1093/cid/civ005. Epub 2015 Jan 18. [Article]
  8. Davies C, Dey N, Negrette OS, Parada LA, Basombrio MA, Garg NJ: Hepatotoxicity in mice of a novel anti-parasite drug candidate hydroxymethylnitrofurazone: a comparison with Benznidazole. PLoS Negl Trop Dis. 2014 Oct 16;8(10):e3231. doi: 10.1371/journal.pntd.0003231. eCollection 2014 Oct. [Article]
  9. FDA: Benznidazole Announcement [Link]
KEGG Drug
D02489
PubChem Compound
31593
PubChem Substance
347828309
ChemSpider
29299
BindingDB
50089916
RxNav
18994
ChEBI
133833
ChEMBL
CHEMBL110
ZINC
ZINC000000056949
Wikipedia
Benznidazole
MSDS
Download (133 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedDiagnosticChagas Disease1
4CompletedTreatmentChagas Disease2
3CompletedTreatmentCardiovascular Disease (CVD) / Chagas Disease / Trypanosomiasis1
3CompletedTreatmentChagas Disease1
3RecruitingTreatmentChagas Disease3
2Active Not RecruitingTreatmentChagas Disease / Trypanosoma Cruzi Infection1
2CompletedTreatmentChagas Disease2
2Unknown StatusTreatmentChagas Disease1
2Unknown StatusTreatmentChagas Disease / Trypanosoma Cruzi Infection1
2Unknown StatusTreatmentChronic Chagas Disease, Indeterminate1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
TabletOral100 mg
TabletOral100 mg/1
TabletOral12.5 mg/1
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
PropertyValueSource
melting point (°C)190-192MSDS
Predicted Properties
PropertyValueSource
Water Solubility0.383 mg/mLALOGPS
logP0.92ALOGPS
logP1.32ChemAxon
logS-2.8ALOGPS
pKa (Strongest Acidic)13.68ChemAxon
pKa (Strongest Basic)0.2ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count4ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area90.06 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity67.12 m3·mol-1ChemAxon
Polarizability24.96 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
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/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSNot Available
MS/MS Spectrum - , positiveLC-MS/MSsplash10-00kf-7921100000-e7c8d6322a8bca6ef40f

Drug created on October 20, 2016 21:08 / Updated on February 21, 2021 18:53