Page last updated: 2024-12-09

ximelagatran

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Description

ximelagatran: prodrug (via hydroxylation) of melagatran & a direct thrombin inhibitor; liver toxicity concerns so AZD0837 being developed to replace this [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

ximelagatran : A member of the class of azetidines that is melagatran in which the carboxylic acid group has been converted to the corresponding ethyl ester and in which the amidine group has been converted into the corresponding amidoxime. A prodrug for melagatran, ximelagatran was the first orally available direct thrombin inhibitor to be brought to market as an anticoagulant, but was withdrawn in 2006 following reports of it causing liver damage. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID5478933
CHEMBL ID522038
CHEBI ID65172
SCHEMBL ID19065093
MeSH IDM0388208

Synonyms (15)

Synonym
ximelagatran
h 376-95
h 376/95
192939-46-1
CHEMBL522038
chebi:65172 ,
ethyl 2-[[(1r)-1-cyclohexyl-2-[(2s)-2-[[4-[(e)-n'-hydroxycarbamimidoyl]phenyl]methylcarbamoyl]azetidin-1-yl]-2-oxoethyl]amino]acetate
ethyl 2-[[(1r)-1-cyclohexyl-2-[(2s)-2-[[4-(n'-hydroxycarbamimidoyl)phenyl]methylcarbamoyl]azetidin-1-yl]-2-oxoethyl]amino]acetate
exanta (proposed)
gtpl6381
SCHEMBL19065093
bdbm50505290
ximelagatran, >=98% (hplc)
Q3570984
ethyl 2-[[(1r)-1-cyclohexyl-2-[(2s)-2-[[4-[(e)-(hydroxyhydrazinylidene)methyl]phenyl]methylcarbamoyl]azetidin-1-yl]-2-oxoethyl]amino]acetate

Research Excerpts

Toxicity

ExcerptReferenceRelevance
"One of the major goals of pharmacogenetics is to elucidate mechanisms and identify patients at increased risk of adverse events (AEs)."( Genome-wide pharmacogenetic investigation of a hepatic adverse event without clinical signs of immunopathology suggests an underlying immune pathogenesis.
Andersson, TB; Armstrong, M; Barratt, BJ; Bengtsson, OF; Billing-Clason, SM; Brown, EM; Cardon, LR; Carlsson, S; Cederbrant, KE; Dellsén, A; Dukes, C; Firth, MA; Gibson, NJ; Harbron, CG; Harrod, GO; Jawaid, A; Jenkins, SC; Kindmark, A; Lagerström-Fermér, ME; March, RE; Pinel, TH; Thornton, M, 2008
)
0.35

Pharmacokinetics

After oral administration of ximelagatran to healthy male subjects, the pharmacokinetic and pharmacodynamic profile of melag atran is predictable and reproducible. Peak plasma melagAtran concentrations are reached approximately 2 hours after oral dosing of xiclagatr to healthy volunteers, and melagat Ran is eliminated with a half-life of approximately 3 hours wi. No pharmacokinetics interactions were detected between ximalagatan and amoxicillin, doxycycline, or ciprofloxacin.

ExcerptReferenceRelevance
" Pharmacokinetic studies in healthy volunteers: H 376/95 is converted to melagatran in man."( The direct thrombin inhibitor melagatran and its oral prodrug H 376/95: intestinal absorption properties, biochemical and pharmacodynamic effects.
Abrahamsson, A; Antonsson, T; Bredberg, U; Bylund, R; Carlsson, S; Elg, M; Eriksson, U; Gustafsson, D; Gyzander, E; Hoffmann, K; Någård, S; Nyström, J; Sörensen, H; Ungell, A, 2001
)
0.31
"By the use of the prodrug principle, H 376/95 endows the direct thrombin inhibitor melagatran with pharmacokinetic properties required for oral administration without compromising the promising pharmacodynamic properties of melagatran."( The direct thrombin inhibitor melagatran and its oral prodrug H 376/95: intestinal absorption properties, biochemical and pharmacodynamic effects.
Abrahamsson, A; Antonsson, T; Bredberg, U; Bylund, R; Carlsson, S; Elg, M; Eriksson, U; Gustafsson, D; Gyzander, E; Hoffmann, K; Någård, S; Nyström, J; Sörensen, H; Ungell, A, 2001
)
0.31
"To determine the influence of ethnic origin on the pharmacokinetic and pharmacodynamic properties of melagatran after oral administration of ximelagatran, a novel oral direct thrombin inhibitor."( No influence of ethnic origin on the pharmacokinetics and pharmacodynamics of melagatran following oral administration of ximelagatran, a novel oral direct thrombin inhibitor, to healthy male volunteers.
Andersson, M; Eriksson, UG; Fager, G; Gustafsson, D; Johansson, LC, 2003
)
0.32
" Blood and urine samples for pharmacokinetic evaluation were collected up to 12 and 24 hours after administration, respectively."( No influence of ethnic origin on the pharmacokinetics and pharmacodynamics of melagatran following oral administration of ximelagatran, a novel oral direct thrombin inhibitor, to healthy male volunteers.
Andersson, M; Eriksson, UG; Fager, G; Gustafsson, D; Johansson, LC, 2003
)
0.32
"After oral administration of ximelagatran, the pharmacokinetic and pharmacodynamic properties of melagatran are independent of ethnic origin."( No influence of ethnic origin on the pharmacokinetics and pharmacodynamics of melagatran following oral administration of ximelagatran, a novel oral direct thrombin inhibitor, to healthy male volunteers.
Andersson, M; Eriksson, UG; Fager, G; Gustafsson, D; Johansson, LC, 2003
)
0.32
"There were no statistically significant differences in the pharmacokinetic properties of melagatran between obese and non-obese subjects."( No influence of obesity on the pharmacokinetics and pharmacodynamics of melagatran, the active form of the oral direct thrombin inhibitor ximelagatran.
Eriksson, UG; Homolka, R; Peters, GR; Sarich, TC; Svensson, M; Teng, R; Wollbratt, M, 2003
)
0.32
"After oral administration of ximelagatran to healthy male subjects, the pharmacokinetic and pharmacodynamic profile of melagatran is predictable and reproducible."( Pharmacokinetics and pharmacodynamics of ximelagatran, a novel oral direct thrombin inhibitor, in young healthy male subjects.
Ahnoff, M; Bredberg, U; Eriksson, UG; Frison, L; Gislén, K; Gustafsson, D; Johansson, LC, 2003
)
0.32
" Melagatran has a wide therapeutic interval that enables it to be administered safely across a wide range of doses with no increased risk of bleeding, in contrast with warfarin whose narrow therapeutic window necessitates monitoring of its pharmacodynamic effect."( The pharmacodynamics and pharmacokinetics of the oral direct thrombin inhibitor ximelagatran and its active metabolite melagatran: a mini-review.
Elg, M; Gustafsson, D, 2003
)
0.32
" Nonlinear mixed-effects modelling was used to evaluate rich data of melagatran pharmacokinetics (3326 observations) and the pharmacodynamic effect on APTT (2319 observations) in samples from 216 patients collected in the three dose-guiding trials."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
"The relatively low impact of individualised dosage on the pharmacokinetic and pharmacodynamic variability of melagatran supported the use of a fixed-dose regimen in the studied population of orthopaedic surgery patients, including those with mild to moderate renal impairment."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
"For the volunteers with severe renal impairment, the area under the plasma concentration-time curve (AUC) and the half-life of melagatran were significantly higher than in the control group with normal renal function."( Influence of severe renal impairment on the pharmacokinetics and pharmacodynamics of oral ximelagatran and subcutaneous melagatran.
Attman, PO; Eriksson, UG; Fager, G; Frison, L; Johansson, S; Mulec, H; Samuelsson, O, 2003
)
0.32
"After administration of subcutaneous melagatran and oral ximelagatran, subjects with severe renal impairment had significantly higher melagatran exposure and longer half-life because of lower CL(R) of melagatran compared with the control group with normal renal function, suggesting that a decrease in dose and/or an increase in the administration interval in patients with severe renal impairment would be appropriate."( Influence of severe renal impairment on the pharmacokinetics and pharmacodynamics of oral ximelagatran and subcutaneous melagatran.
Attman, PO; Eriksson, UG; Fager, G; Frison, L; Johansson, S; Mulec, H; Samuelsson, O, 2003
)
0.32
"To investigate the influence of mild-to-moderate hepatic impairment on the pharmacokinetic and pharmacodynamic properties of ximelagatran."( No influence of mild-to-moderate hepatic impairment on the pharmacokinetics and pharmacodynamics of ximelagatran, an oral direct thrombin inhibitor.
Eriksson, UG; Eriksson-Lepkowska, M; Fager, G; Frison, L; Wåhlander, K, 2003
)
0.32
" Plasma and urine samples were collected for pharmacokinetic and pharmacodynamic analyses."( No influence of mild-to-moderate hepatic impairment on the pharmacokinetics and pharmacodynamics of ximelagatran, an oral direct thrombin inhibitor.
Eriksson, UG; Eriksson-Lepkowska, M; Fager, G; Frison, L; Wåhlander, K, 2003
)
0.32
"There were no differences in the pharmacokinetic or pharmacodynamic properties of melagatran following oral administration of ximelagatran between the hepatically impaired and control volunteers."( No influence of mild-to-moderate hepatic impairment on the pharmacokinetics and pharmacodynamics of ximelagatran, an oral direct thrombin inhibitor.
Eriksson, UG; Eriksson-Lepkowska, M; Fager, G; Frison, L; Wåhlander, K, 2003
)
0.32
"To investigate the influence of nonvalvular atrial fibrillation (NVAF) on the pharmacokinetic (PK) properties of the oral direct thrombin inhibitor ximelagatran and its active form, melagatran."( Consistent pharmacokinetics of the oral direct thrombin inhibitor ximelagatran in patients with nonvalvular atrial fibrillation and in healthy subjects.
Eriksson, UG; Grind, M; Svensson, M; Wåhlander, K; Wollbratt, M; Wolzt, M, 2003
)
0.32
" There were no differences between NVAF patients and controls for the area under the plasma concentration versus time curve, Cmax, half-life (t1/2), or bioavailability (F) of melagatran after oral dosing with ximelagatran."( Consistent pharmacokinetics of the oral direct thrombin inhibitor ximelagatran in patients with nonvalvular atrial fibrillation and in healthy subjects.
Eriksson, UG; Grind, M; Svensson, M; Wåhlander, K; Wollbratt, M; Wolzt, M, 2003
)
0.32
" In the 15 subjects completing the study, no pharmacokinetic interaction was detected between atorvastatin and ximelagatran for all parameters investigated, including melagatran (the active form of ximelagatran) area under the plasma concentration versus time curve (AUC) and maximum plasma concentration, atorvastatin acid AUC, and AUC of active 3-hydroxy-3-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors."( No pharmacokinetic or pharmacodynamic interaction between atorvastatin and the oral direct thrombin inhibitor ximelagatran.
Dorani, H; Eriksson, UG; Kalies, I; Ohlsson, L; Sarich, TC; Schützer, KM; Wall, U, 2004
)
0.32
" In conclusion, no pharmacokinetic or pharmacodynamic interaction between digoxin and ximelagatran was observed in this study."( No pharmacokinetic or pharmacodynamic interaction between digoxin and the oral direct thrombin inhibitor ximelagatran in healthy volunteers.
Eriksson, UG; Kessler, E; Sarich, TC; Schützer, KM; Wall, U; Wollbratt, M, 2004
)
0.32
" Evaluation of the safety of the combination is needed to confirm that the relatively small pharmacokinetic changes in this study are of no clinical significance."( A pharmacokinetic study of the combined administration of amiodarone and ximelagatran, an oral direct thrombin inhibitor.
Carlson, GF; Eriksson, UG; Gillette, S; Hamer, JE; Kowey, PR; Sarich, TC; Schützer, KM; Teng, R, 2004
)
0.32
" The half-life of melagatran, ximelagatran's active metabolite, is consistent with twice-daily dosing and fixed-dose administration without the need for monitoring."( Ximelagatran: pharmacokinetics and pharmacodynamics of a new strategy for oral direct thrombin inhibition.
Kereiakes, DJ, 2004
)
0.32
"A population pharmacokinetic analysis was performed on samples from patients with deep vein thrombosis participating in a randomized dose-finding study (THRombin Inhibitor in Venous thrombo-Embolism [THRIVE I])."( Pharmacokinetics of ximelagatran and relationship to clinical response in acute deep vein thrombosis.
Cullberg, M; Eriksson, H; Eriksson, UG; Karlsson, MO; Schulman, S; Wåhlander, K, 2005
)
0.33
" Peak plasma melagatran concentrations are reached approximately 2 hours after oral dosing of ximelagatran to healthy volunteers, and melagatran is eliminated with a half-life of approximately 3 hours with clearance predominantly by renal excretion."( Pharmacokinetics and pharmacodynamics of ximelagatran.
Eriksson, UG; Sarich, TS; Wolzt, M, 2005
)
0.33
" These large dose response variations are markedly influenced by pharmacokinetic aspects that are determined by genetic, environmental and possibly other yet unknown factors."( Comparative pharmacokinetics of vitamin K antagonists: warfarin, phenprocoumon and acenocoumarol.
Ufer, M, 2005
)
0.33
"A pharmacokinetic interaction between erythromycin and ximelagatran, an oral direct thrombin inhibitor, was demonstrated in this study in healthy volunteers."( Influence of erythromycin on the pharmacokinetics of ximelagatran may involve inhibition of P-glycoprotein-mediated excretion.
Dorani, H; Eriksson, UG; Fritsch, H; Hoffmann, KJ; Karlsson, J; Olsson, L; Sarich, TC; Schützer, KM; Wall, U, 2006
)
0.33
"A population pharmacokinetic model was developed based on data from three phase II studies (1177 plasma concentration observations in 167 patients, treated for up to 18 months) and confirmed by including data from two phase III studies (8702 plasma concentration observations in 3188 patients, treated for up to 24 months)."( Population pharmacokinetics of melagatran, the active form of the oral direct thrombin inhibitor ximelagatran, in atrial fibrillation patients receiving long-term anticoagulation therapy.
Bååthe, S; Eriksson, UG; Grind, M; Hamrén, B; Karlsson, MO; Wollbratt, M, 2006
)
0.33
" Simulations suggested that dose adjustment based on renal function or trough plasma concentration had a minor effect on overall pharmacokinetic variability and the number of patients with high melagatran exposure."( Population pharmacokinetics of melagatran, the active form of the oral direct thrombin inhibitor ximelagatran, in atrial fibrillation patients receiving long-term anticoagulation therapy.
Bååthe, S; Eriksson, UG; Grind, M; Hamrén, B; Karlsson, MO; Wollbratt, M, 2006
)
0.33
" Dose individualisation was predicted to have a low impact on pharmacokinetic variability, supporting the use of a fixed-dose regimen of ximelagatran for long-term anticoagulant therapy in the majority of NVAF patients."( Population pharmacokinetics of melagatran, the active form of the oral direct thrombin inhibitor ximelagatran, in atrial fibrillation patients receiving long-term anticoagulation therapy.
Bååthe, S; Eriksson, UG; Grind, M; Hamrén, B; Karlsson, MO; Wollbratt, M, 2006
)
0.33

Compound-Compound Interactions

No inhibition, or only minor inhibition, of CYP enzymes by ximelagatran, the intermediates or melag atran was shown in the in vitro studies. The plasma pharmacokinetics of melagAtran, diclofenac, diazepam, N-desmethyl-diazepam and nifedipine were determined when administered alone and in combination with ximELAGatran.

ExcerptReferenceRelevance
" The plasma pharmacokinetics of melagatran, diclofenac, diazepam, N-desmethyl-diazepam and nifedipine were determined when administered alone and in combination with ximelagatran."( Ximelagatran, an oral direct thrombin inhibitor, has a low potential for cytochrome P450-mediated drug-drug interactions.
Andersson, TB; Bredberg, E; Eriksson, UG; Eriksson-Lepkowska, M; Frison, L; Johansson, S; Larsson, M; Thuresson, A, 2003
)
0.32
"No inhibition, or only minor inhibition, of CYP enzymes by ximelagatran, the intermediates or melagatran was shown in the in vitro studies, suggesting that ximelagatran would not cause CYP-mediated drug-drug interactions in vivo."( Ximelagatran, an oral direct thrombin inhibitor, has a low potential for cytochrome P450-mediated drug-drug interactions.
Andersson, TB; Bredberg, E; Eriksson, UG; Eriksson-Lepkowska, M; Frison, L; Johansson, S; Larsson, M; Thuresson, A, 2003
)
0.32
" Together, the in vitro and in vivo studies indicate that metabolic drug-drug interactions involving the major human CYP enzymes should not be expected with ximelagatran."( Ximelagatran, an oral direct thrombin inhibitor, has a low potential for cytochrome P450-mediated drug-drug interactions.
Andersson, TB; Bredberg, E; Eriksson, UG; Eriksson-Lepkowska, M; Frison, L; Johansson, S; Larsson, M; Thuresson, A, 2003
)
0.32

Bioavailability

The only oral direct thrombin inhibitors that have reached the market, ximelagatran and dabigatran etexilat, are double prodrugs with low bioavailability in humans. The most recent setback came this year when AstraZeneca withdrew XimelAGatran after reports of serious hepatoxicity in a fraction of patients.

ExcerptReferenceRelevance
" The bioavailability of melagatran following oral administration of ximelagatran was 5 to 10% in rats, 10 to 50% in dogs, and about 20% in humans, with low between-subject variation."( Absorption, distribution, metabolism, and excretion of ximelagatran, an oral direct thrombin inhibitor, in rats, dogs, and humans.
Ahnoff, M; Bredberg, U; Ericsson, H; Eriksson, UG; Fager, G; Gabrielsson, M; Gislén, K; Gustafsson, D; Hoffmann, KJ; Thuresson, A, 2003
)
0.32
" The mean bioavailability of melagatran in young and older subjects was approximately 18 and 12% , respectively, following oral administration of ximalagratan, and 38 and 45%, respectively, following subcutaneous administration of ximelagatran."( Influence of age on the pharmacokinetics and pharmacodynamics of ximelagatran, an oral direct thrombin inhibitor.
Eriksson, UG; Fager, G; Frison, L; Gustafsson, D; Johansson, LC; Logren, U, 2003
)
0.32
" To increase the poor oral bioavailability due to its strong basic amidine functionality selected to fit the arginine side pocket of thrombin, the less basic N-hydroxylated amidine was used in addition to an ethyl ester-protecting residue."( Characterization of in vitro biotransformation of new, orally active, direct thrombin inhibitor ximelagatran, an amidoxime and ester prodrug.
Clement, B; Lopian, K, 2003
)
0.32
" The interindividual variability of melagatran AUC was low (coefficient of variation 19-26%), and the mean bioavailability of melagatran, estimated using a mean value for melagatran clearance obtained from Caucasian subjects in a previous study, was approximately 20% in all groups (range of mean values 19-23%)."( No influence of ethnic origin on the pharmacokinetics and pharmacodynamics of melagatran following oral administration of ximelagatran, a novel oral direct thrombin inhibitor, to healthy male volunteers.
Andersson, M; Eriksson, UG; Fager, G; Gustafsson, D; Johansson, LC, 2003
)
0.32
" The mean (+/- standard deviation) bioavailability of melagatran was 22."( Pharmacokinetics and pharmacodynamics of ximelagatran, a novel oral direct thrombin inhibitor, in young healthy male subjects.
Ahnoff, M; Bredberg, U; Eriksson, UG; Frison, L; Gislén, K; Gustafsson, D; Johansson, LC, 2003
)
0.32
" Although melagatran has all the pharmacodynamic properties required of a new antithrombotic agent, low oral bioavailability that is even further reduced by the concomitant intake of food precludes its development as an oral agent."( The pharmacodynamics and pharmacokinetics of the oral direct thrombin inhibitor ximelagatran and its active metabolite melagatran: a mini-review.
Elg, M; Gustafsson, D, 2003
)
0.32
" The bioavailability of melagatran after oral ximelagatran relative to subcutaneous melagatran was 23%."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
" There were no differences between NVAF patients and controls for the area under the plasma concentration versus time curve, Cmax, half-life (t1/2), or bioavailability (F) of melagatran after oral dosing with ximelagatran."( Consistent pharmacokinetics of the oral direct thrombin inhibitor ximelagatran in patients with nonvalvular atrial fibrillation and in healthy subjects.
Eriksson, UG; Grind, M; Svensson, M; Wåhlander, K; Wollbratt, M; Wolzt, M, 2003
)
0.32
" Ximelagatran was rapidly absorbed and the bioavailability of melagatran was similar after the three different administrations, fulfilling the criteria for bioequivalence."( Bioequivalence of ximelagatran, an oral direct thrombin inhibitor, as whole or crushed tablets or dissolved formulation.
Eriksson, UG; Lönnerstedt, C; Ohlsson, L; Sarich, TC; Schützer, KM; Teng, R; Wall, U, 2004
)
0.32
" Unexplained interpatient variability values in total plasma clearance and bioavailability were 19% and 21%, respectively."( Pharmacokinetics of ximelagatran and relationship to clinical response in acute deep vein thrombosis.
Cullberg, M; Eriksson, H; Eriksson, UG; Karlsson, MO; Schulman, S; Wåhlander, K, 2005
)
0.33
" The bioavailability of melagatran, the active form of ximelagatran, after oral administration of ximelagatran is approximately 20% with low inter- and intra-individual variability."( Pharmacokinetics and pharmacodynamics of ximelagatran.
Eriksson, UG; Sarich, TS; Wolzt, M, 2005
)
0.33
" The bioavailability of melagatran is not altered by co-administration with food or alcohol."( Low potential for interactions between melagatran/ximelagatran and other drugs, food, or alcohol.
Eriksson, UG; Sarich, TS; Wolzt, M, 2005
)
0.33
" These results indicate that the mechanism of the pharmacokinetic interaction between oral ximelagatran and erythromycin may involve inhibition of transport proteins, possibly P-gp, resulting in decreased melagatran biliary excretion and increased bioavailability of melagatran."( Influence of erythromycin on the pharmacokinetics of ximelagatran may involve inhibition of P-glycoprotein-mediated excretion.
Dorani, H; Eriksson, UG; Fritsch, H; Hoffmann, KJ; Karlsson, J; Olsson, L; Sarich, TC; Schützer, KM; Wall, U, 2006
)
0.33
" The most recent setback came this year when AstraZeneca withdrew Ximelagatran, the first orally bioavailable direct thrombin inhibitor that had received regulatory approval (France, 2003), after reports of serious hepatoxicity in a fraction of patients."( Direct thrombin inhibitors - a survey of recent developments.
Schwienhorst, A, 2006
)
0.33
" Its oral bioavailability in rats or dogs was not better than that of LB30870."( Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
Cho, KH; Kim, A; Kim, TH; Lee, SH; Park, HD, 2013
)
0.39
"The only oral direct thrombin inhibitors that have reached the market, ximelagatran and dabigatran etexilat, are double prodrugs with low bioavailability in humans."( Macrocyclic Prodrugs of a Selective Nonpeptidic Direct Thrombin Inhibitor Display High Permeability, Efficient Bioconversion but Low Bioavailability.
Andersson, V; Bergman, J; Bergström, F; Brånalt, J; Grönberg, G; Gustafsson, D; Karlsson, S; Kihlberg, J; Polla, M, 2016
)
0.43

Dosage Studied

The pharmacokinetics, pharmacodynamics, safety and tolerability of melagatran were not affected by food or repeated dosing in healthy Japanese volunteers. There were no differences between NVAF patients and controls for the area under the plasma concentration versus time curve.

ExcerptRelevanceReference
" The study did not evaluate a dose-response for efficacy, and no differences between the three dose levels of melagatran and ximelagatran were shown."( A dose-ranging study of the oral direct thrombin inhibitor, ximelagatran, and its subcutaneous form, melagatran, compared with dalteparin in the prophylaxis of thromboembolism after hip or knee replacement: METHRO I. MElagatran for THRombin inhibition in
Arfwidsson, AC; Bylock, A; Eriksson, BI; Eriksson, UG; Fager, G; Frison, L; Gustafsson, D; Kälebo, P, 2002
)
0.31
" We did a multicentre, randomised, double-blind study to examine the dose-response relation of subcutaneous melagatran, a direct thrombin inhibitor, followed by oral ximelagatran as thromboprophylaxis after total hip or knee replacement."( Ximelagatran and melagatran compared with dalteparin for prevention of venous thromboembolism after total hip or knee replacement: the METHRO II randomised trial.
Bergqvist, D; Bylock, A; Dahl, OE; Eriksson, BI; Eriksson, UG; Frison, L; Gustafsson, D; Kälebo, P; Lindbratt, S; Welin, L, 2002
)
0.31
" Furthermore, with no need for dosage adjustment or therapeutic drug monitoring there is emerging evidence that ximelagatran may replace warfarin as the anticoagulant of choice."( The METHRO trials.
Hamaad, A; Lip, GY; Tayebjee, MH, 2003
)
0.32
" To support the design of a pivotal dose-finding study, the impact of individualised dosage based on bodyweight and calculated creatinine clearance was examined."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
" The impact of individualised dosage on pharmacokinetic and pharmacodynamic variability was evaluated by simulations of the pharmacokinetic-pharmacodynamic model."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
" Simulations demonstrated that individualised dosage based on creatinine clearance or bodyweight had no clinically relevant impact on the variability in melagatran pharmacokinetics or on the effect on APTT."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
"The relatively low impact of individualised dosage on the pharmacokinetic and pharmacodynamic variability of melagatran supported the use of a fixed-dose regimen in the studied population of orthopaedic surgery patients, including those with mild to moderate renal impairment."( Pharmacokinetics of melagatran and the effect on ex vivo coagulation time in orthopaedic surgery patients receiving subcutaneous melagatran and oral ximelagatran: a population model analysis.
Eriksson, BI; Eriksson, UG; Frison, L; Gisleskog, PO; Gustafsson, D; Hamrén, B; Karlsson, MO; Mandema, JW; Wählby, U, 2003
)
0.32
" There were no differences between NVAF patients and controls for the area under the plasma concentration versus time curve, Cmax, half-life (t1/2), or bioavailability (F) of melagatran after oral dosing with ximelagatran."( Consistent pharmacokinetics of the oral direct thrombin inhibitor ximelagatran in patients with nonvalvular atrial fibrillation and in healthy subjects.
Eriksson, UG; Grind, M; Svensson, M; Wåhlander, K; Wollbratt, M; Wolzt, M, 2003
)
0.32
" In experimental models of thrombosis, melagatran has been shown to have a shallower dose-response curve than warfarin and, therefore, a better separation between efficacy and bleeding."( Oral direct thrombin inhibitors in clinical development.
Gustafsson, D, 2003
)
0.32
" The dose of ximelagatran needs to be modified in patients with renal failure; however, dosing guidelines in this specific patient population have not been established."( A review of the clinical uses of ximelagatran in thrombosis syndromes.
Bergsrud, EA; Gandhi, PJ, 2003
)
0.32
" Furthermore, vitamin K antagonists have a narrow therapeutic window that necessitates careful anticoagulation monitoring, and dosing is problematic because of multiple food and drug interactions."( Orally active direct thrombin inhibitors.
Weitz, J, 2003
)
0.32
" Its consistent and predictable pharmacokinetics and pharmacodynamics across a wide range of patient populations allow administration with fixed dosing and with no coagulation monitoring."( Ximelagatran, a new oral direct thrombin inhibitor, for the prevention of venous thromboembolic events in major elective orthopaedic surgery. Efficacy, safety and anaesthetic considerations.
Rosencher, N, 2004
)
0.32
" Results of phase II and III trials comparing ximelagatran with currently available anticoagulant therapies demonstrate that ximelagatran can be used with fixed dosing with no coagulation monitoring, dose titration, or dose adjustment, without compromising efficacy or safety."( Bleeding profiles of anticoagulants, including the novel oral direct thrombin inhibitor ximelagatran: definitions, incidence and management.
Bergqvist, D, 2004
)
0.32
" Unfortunately, many patients with atrial fibrillation may not receive warfarin because of the difficulties in dosing and maintaining desirable target goals."( Ximelagatran: a new antithrombotic option in atrial fibrillation.
Dager, WE, 2004
)
0.32
"Pertinent information from available clinical trials, including study design, patient demographics, dosing regimens, anticoagulant comparators, methods for evaluating effectiveness, treatment outcomes, adverse events, and pharmacokinetic and pharmacodynamic evaluations, was extracted."( Ximelagatran: an oral direct thrombin inhibitor.
Dager, WE; McIntosh, BA; Nutescu, EA; Vondracek, TG, 2004
)
0.32
" Traditional therapy with oral anticoagulants has several disadvatages: narrow therapeutic window, and often unpredictable dose-response so that frequent monitoring of the INR is required."( [New perspectives for anticoagulation in non-rheumatic atrial fibrillation: oral antithrombins].
Giansante, C; Scardi, S, 2004
)
0.32
" As ximelagatran can be given in fixed oral dosing without coagulation monitoring, it is an attractive choice for the prevention of venous thromboembolism in major elective orthopaedic surgery."( Clinical experience with ximelagatran in orthopaedic surgery.
Eriksson, B, 2004
)
0.32
" Efforts to achieve optimal venous thromboembolism prophylaxis by modifying the intensity of oral warfarin treatment have produced equivocal results, and there is a need for new, efficacious antithrombotic drugs providing predictable, well-tolerated oral dosing without the need for coagulation monitoring."( Treatment of venous thromboembolism and long-term prevention of recurrence: present treatment options and ximelagatran.
Eriksson, H, 2004
)
0.32
" Moreover, ximelagatran has rapid onset and offset of action, fixed oral dosing without the need for anticoagulation monitoring, low potential for food and drug interactions, and a therapeutic margin wider than that of warfarin."( New possibilities in anticoagulant management of atrial fibrillation.
Waldo, AL, 2004
)
0.32
" The Efficacy and Safety of the Oral Direct Thrombin Inhibitor Ximelagatran in Patients with Recent and Myocardial Damage (ESTEEM) trial, a placebo-controlled, double-blind study of post-MI patients, evaluated 4 dosing regimens of ximelagatran versus placebo in the initial months following an ACS and found an encouraging reduction in the end points of death, MI, and stroke with the use of an oral direct thrombin inhibitor."( Reducing cardiac events after acute coronary syndromes.
Granger, CB; Weaver, WD, 2004
)
0.32
" The half-life of melagatran, ximelagatran's active metabolite, is consistent with twice-daily dosing and fixed-dose administration without the need for monitoring."( Ximelagatran: pharmacokinetics and pharmacodynamics of a new strategy for oral direct thrombin inhibition.
Kereiakes, DJ, 2004
)
0.32
" In addition, its full anticoagulant effect usually takes at least 4-5 days after the start of therapy or any dosage change, and it has a slow offset of therapy."( Ximelagatran: pharmacology, pharmacokinetics, and pharmacodynamics.
Dobesh, PP, 2004
)
0.32
" However, both agents are difficult to dose accurately, require frequent blood testing and dosage adjustment, and can cause serious adverse effects."( The role of oral direct thrombin inhibitors in the treatment of venous thromboembolism.
Bussey, HI; Busti, AJ, 2004
)
0.32
" The best dosing regimen and optimal timing of first dose for melagatran and ximelagatran remain to be determined, as do the mechanism and impact of drug disturbance of hepatic function."( Advances in anticoagulation therapy: the role of selective inhibitors of factor Xa and thrombin in thromboprophylaxis after major orthopedic surgery.
Andersen, JC, 2004
)
0.32
" The elimination half-life of pentasaccharide is about 17 h, which allows a convenient once-daily dosing regime."( [New anticoagulants in clinical practice].
Boda, Z, 2004
)
0.32
" Oral ximelagatran dosing not only inhibits thrombin activity rapidly, competitively, and potently, but also delays and suppresses thrombin generation."( Ximelagatran--a promising new drug in thromboembolic disorders.
Petersen, P, 2005
)
0.33
" Shallow exposure-response curves for efficacy and bleeding indicate that there is no need for individualized dosing or therapeutic drug monitoring in the patient population studied."( Pharmacokinetics of ximelagatran and relationship to clinical response in acute deep vein thrombosis.
Cullberg, M; Eriksson, H; Eriksson, UG; Karlsson, MO; Schulman, S; Wåhlander, K, 2005
)
0.33
" Otherwise, they have some important limitations (narrow therapeutic window, highly variable dose-response relationship; limitation by the need of parenteral administration for heparins and the risk of heparin-induced thrombocytopenia) which provide opportunities for new antithrombotic drugs."( [Prophylaxis and treatment of venous thromboembolism: the role of new antithrombotic drugs].
Falciani, M; Imberti, D; Prisco, D, 2005
)
0.33
"The chemistry, pharmacology, pharmacokinetics, clinical efficacy, dosage and administration, contraindications, and adverse effects of ximelagatran are reviewed."( Ximelagatran: an orally active direct thrombin inhibitor.
Gulseth, MP, 2005
)
0.33
" Despite the growing data regarding the appropriate use and dosing of agents used for chronic anticoagulation, use in clinical practice remains low, thus leading to a theoretical reduction in the risk-to-benefit ratio in the clinical setting relative to that reported in the literature."( A preliminary assessment of the critical differences between novel oral anticoagulants currently in development.
McBride, BF, 2005
)
0.33
" The combination of antithrombotic and anti-inflammatory activity with the practicality of oral dosing provided by ximelagatran represents an important new option for the treatment of arterial and venous thromboembolic disorders."( Mechanism of action of the oral direct thrombin inhibitor ximelagatran.
Carlsson, SC; Mattsson, C; Sarich, TC, 2005
)
0.33
" Peak plasma melagatran concentrations are reached approximately 2 hours after oral dosing of ximelagatran to healthy volunteers, and melagatran is eliminated with a half-life of approximately 3 hours with clearance predominantly by renal excretion."( Pharmacokinetics and pharmacodynamics of ximelagatran.
Eriksson, UG; Sarich, TS; Wolzt, M, 2005
)
0.33
" Warfarin, on the other hand, can be administered orally but requires the infrastructure for careful patient monitoring and dose adjustments because of its unpredictable dose-response relationship."( Ximelagatran for the prevention of venous thromboembolism following elective hip or knee replacement surgery.
Colwell, C; Mouret, P, 2005
)
0.33
" Warfarin has an unpredictable pharmacokinetic profile and a variable dose-response relationship that requires frequent coagulation monitoring and dose adjustments to maintain a target intensity that is both safe and effective."( Treating patients with venous thromboembolism: initial strategies and long-term secondary prevention.
Bounameaux, H; Huisman, MV, 2005
)
0.33
" This has stimulated the development of new agents with improved benefit-risk profiles, such as ximelagatran, the first of the oral direct thrombin inhibitors, which has a wider therapeutic margin and low potential for drug interactions, allowing fixed dosing without anticoagulation monitoring."( Prevention of stroke in patients with atrial fibrillation.
Halperin, JL; Olsson, SB, 2005
)
0.33
" Low-molecular-weight heparins, available in the last 20 years, are manufactured from unfractionated heparin and have superior dose-response relationships because of fewer nonspecific reactions with plasma proteins and cells."( Heparin and other rapidly acting anticoagulants.
Hyers, TM, 2005
)
0.33
" The use of vitamin K antagonists is complicated by a narrow therapeutic index and an unpredictable dose-response relationship, giving rise to frequent bleeding complications or insufficient anticoagulation."( Comparative pharmacokinetics of vitamin K antagonists: warfarin, phenprocoumon and acenocoumarol.
Ufer, M, 2005
)
0.33
" This study assessed the effects of food and repeated dosing on the pharmacokinetics and pharmacodynamics of melagatran after oral administration of ximelagatran to young healthy Japanese males."( Pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor ximelagatran in young healthy Japanese men.
Eriksson, UG; Johnsson, G; Nakanishi, T; Nyström, P; Wernevik, LC, 2006
)
0.33
" During repeated dosing, steady-state plasma concentrations of melagatran were achieved after the second dose of ximelagatran on day 1 and remained stable through the rest of the dosing period."( Pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor ximelagatran in young healthy Japanese men.
Eriksson, UG; Johnsson, G; Nakanishi, T; Nyström, P; Wernevik, LC, 2006
)
0.33
"The pharmacokinetics, pharmacodynamics, safety and tolerability of melagatran after oral administration of ximelagatran were not affected by food or repeated dosing in healthy Japanese volunteers."( Pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor ximelagatran in young healthy Japanese men.
Eriksson, UG; Johnsson, G; Nakanishi, T; Nyström, P; Wernevik, LC, 2006
)
0.33
" Changes in total thrombus area (TTA) under low shear rate (LSR; 212 s(-1)) and high shear rate (HSR; 1690 s(-1)) conditions were measured, using the ex vivo Badimon perfusion chamber model pre-dose and 2 and 5 hours after dosing on Day 6, and capillary bleeding times (CBT) were determined."( Antithrombotic effects of ximelagatran plus acetylsalicylic acid (ASA) and clopidogrel plus ASA in a human ex vivo arterial thrombosis model.
Badimon, JJ; Bylock, A; Elg, M; Eriksson, UG; Eriksson-Lepkowska, M; Kalies, I; Nyström, P; Sarich, TC; Wåhlander, K, 2006
)
0.33
" The impact of individualised dosing on pharmacokinetic variability was evaluated by simulations of melagatran concentrations based on the pharmacokinetic model."( Population pharmacokinetics of melagatran, the active form of the oral direct thrombin inhibitor ximelagatran, in atrial fibrillation patients receiving long-term anticoagulation therapy.
Bååthe, S; Eriksson, UG; Grind, M; Hamrén, B; Karlsson, MO; Wollbratt, M, 2006
)
0.33
" Dosing is difficult and requires frequent monitoring."( Ximelagatran: direct thrombin inhibitor.
Brighton, TA; Ho, SJ, 2006
)
0.33
" The oral direct thrombin inhibitors (DTIs) are potential alternatives to warfarin, offering fixed dosing without drug and dietary interactions and the need for international normalized ratio monitoring."( Direct thrombin inhibition and stroke prevention in elderly patients with atrial fibrillation: experience from the SPORTIF III and V Trials.
Choy, AM; Deedwania, P; Ford, GA; Frison, L; Karalis, DG; Lindholm, CJ; Olsson, SB; Pluta, W, 2007
)
0.34
"Ximelagatran at concentrations considerably higher than that found in plasma following therapeutic dosing had little or no effect on cellular functions studied in vitro."( Prediction of drug-induced liver injury in humans by using in vitro methods: the case of ximelagatran.
Andersson, TB; Beaune, P; Berson, A; Carlsson, S; Edebert, I; Flinois, JP; Glinghammar, B; Kenne, K; Pessayre, D; Pohl, CD; Skanberg, I, 2008
)
0.35
" It is recommended that the clinician carefully evaluate the elderly patient's creatinine clearance and weight before prescribing anticoagulants, particularly when using fixed dosing regimens."( Prevention of venous thromboembolism in the geriatric patient.
Brotman, DJ; Jaffer, AK, 2008
)
0.35
" Recent human clinical trials of drugs, including acetaminophen (APAP) and ximelagatran, have shown that the metabonomics of biofluids (plasma and urine) collected before and immediately after dosing can identify individual patients who are likely to develop DILI."( The application of metabonomics to predict drug-induced liver injury.
O'Connell, TM; Watkins, PB, 2010
)
0.36
" Efficacy and safety of oral anticoagulation is limited by a narrow therapeutical range as well as by inter- and intraindividual variability of INR-values due to genetic disposition, differences in alimentation, dosage errors, rare control of INR-levels and drug-interactions."( [Novel anticoagulants for stroke prevention in atrial fibrillation].
Baumhäkel, M; Böhm, M; Schirmer, SH, 2010
)
0.36
" The predicted dosing window is highly accordant with the final dose recommendation based upon extensive clinical studies."( Evaluation of the efficacy and safety of rivaroxaban using a computer model for blood coagulation.
Burghaus, R; Coboeken, K; Gaub, T; Kuepfer, L; Lippert, J; Mueck, W; Sensse, A; Siegmund, HU; Weiss, W, 2011
)
0.37
" We proposed a systematic classification scheme using FDA-approved drug labeling to assess the DILI potential of drugs, which yielded a benchmark dataset with 287 drugs representing a wide range of therapeutic categories and daily dosage amounts."( FDA-approved drug labeling for the study of drug-induced liver injury.
Chen, M; Fang, H; Liu, Z; Shi, Q; Tong, W; Vijay, V, 2011
)
0.37
" While efficacious, they are difficult to use due to interpatient dose-response variability and the risks of bleeding."( Design of Small-Molecule Active-Site Inhibitors of the S1A Family Proteases as Procoagulant and Anticoagulant Drugs.
Fischer, PM, 2018
)
0.48
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Roles (4)

RoleDescription
anticoagulantAn agent that prevents blood clotting.
prodrugA compound that, on administration, must undergo chemical conversion by metabolic processes before becoming the pharmacologically active drug for which it is a prodrug.
EC 3.4.21.5 (thrombin) inhibitorAn EC 3.4.21.* (serine endopeptidase) inhibitor that interferes with the action of thrombin (EC 3.4.21.5).
serine protease inhibitorAny protease inhibitor that restricts the action of a serine protease.
[role information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Drug Classes (8)

ClassDescription
azetidines
ethyl esterAny carboxylic ester resulting from the formal condensation of the carboxy group of a carboxylic acid with ethanol.
hydroxylaminesHydroxylamine, H2N-OH, and its hydrocarbyl derivatives.
secondary carboxamideA carboxamide resulting from the formal condensation of a carboxylic acid with a primary amine; formula RC(=O)NHR(1).
tertiary carboxamideA carboxamide resulting from the formal condensation of a carboxylic acid with a secondary amine; formula RC(=O)NHR(1)R(2).
azetidines
amidoximeAmidines of general formula RC(=NOH)NR(1)R(2), in which the imino nitrogen is substituted by a hydroxy group.
secondary amino compoundA compound formally derived from ammonia by replacing two hydrogen atoms by organyl groups.
ethyl esterAny carboxylic ester resulting from the formal condensation of the carboxy group of a carboxylic acid with ethanol.
carboxamideAn amide of a carboxylic acid, having the structure RC(=O)NR2. The term is used as a suffix in systematic name formation to denote the -C(=O)NH2 group including its carbon atom.
tertiary carboxamideA carboxamide resulting from the formal condensation of a carboxylic acid with a secondary amine; formula RC(=O)NHR(1)R(2).
secondary carboxamideA carboxamide resulting from the formal condensation of a carboxylic acid with a primary amine; formula RC(=O)NHR(1).
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Pathways (1)

PathwayProteinsCompounds
Ximelagatran Action Pathway203

Protein Targets (1)

Inhibition Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
ProthrombinHomo sapiens (human)Ki0.00200.00000.78469.0000AID1525519
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Biological Processes (33)

Processvia Protein(s)Taxonomy
positive regulation of protein phosphorylationProthrombinHomo sapiens (human)
proteolysisProthrombinHomo sapiens (human)
acute-phase responseProthrombinHomo sapiens (human)
cell surface receptor signaling pathwayProthrombinHomo sapiens (human)
G protein-coupled receptor signaling pathwayProthrombinHomo sapiens (human)
blood coagulationProthrombinHomo sapiens (human)
positive regulation of cell population proliferationProthrombinHomo sapiens (human)
regulation of cell shapeProthrombinHomo sapiens (human)
response to woundingProthrombinHomo sapiens (human)
negative regulation of platelet activationProthrombinHomo sapiens (human)
platelet activationProthrombinHomo sapiens (human)
regulation of blood coagulationProthrombinHomo sapiens (human)
positive regulation of blood coagulationProthrombinHomo sapiens (human)
positive regulation of cell growthProthrombinHomo sapiens (human)
positive regulation of insulin secretionProthrombinHomo sapiens (human)
positive regulation of collagen biosynthetic processProthrombinHomo sapiens (human)
fibrinolysisProthrombinHomo sapiens (human)
negative regulation of proteolysisProthrombinHomo sapiens (human)
positive regulation of receptor signaling pathway via JAK-STATProthrombinHomo sapiens (human)
negative regulation of astrocyte differentiationProthrombinHomo sapiens (human)
positive regulation of release of sequestered calcium ion into cytosolProthrombinHomo sapiens (human)
regulation of cytosolic calcium ion concentrationProthrombinHomo sapiens (human)
cytolysis by host of symbiont cellsProthrombinHomo sapiens (human)
positive regulation of phosphatidylinositol 3-kinase/protein kinase B signal transductionProthrombinHomo sapiens (human)
negative regulation of fibrinolysisProthrombinHomo sapiens (human)
antimicrobial humoral immune response mediated by antimicrobial peptideProthrombinHomo sapiens (human)
neutrophil-mediated killing of gram-negative bacteriumProthrombinHomo sapiens (human)
positive regulation of lipid kinase activityProthrombinHomo sapiens (human)
negative regulation of cytokine production involved in inflammatory responseProthrombinHomo sapiens (human)
positive regulation of protein localization to nucleusProthrombinHomo sapiens (human)
positive regulation of phospholipase C-activating G protein-coupled receptor signaling pathwayProthrombinHomo sapiens (human)
ligand-gated ion channel signaling pathwayProthrombinHomo sapiens (human)
positive regulation of reactive oxygen species metabolic processProthrombinHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Molecular Functions (8)

Processvia Protein(s)Taxonomy
lipopolysaccharide bindingProthrombinHomo sapiens (human)
serine-type endopeptidase activityProthrombinHomo sapiens (human)
signaling receptor bindingProthrombinHomo sapiens (human)
calcium ion bindingProthrombinHomo sapiens (human)
protein bindingProthrombinHomo sapiens (human)
growth factor activityProthrombinHomo sapiens (human)
heparin bindingProthrombinHomo sapiens (human)
thrombospondin receptor activityProthrombinHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Ceullar Components (9)

Processvia Protein(s)Taxonomy
external side of plasma membraneProthrombinHomo sapiens (human)
collagen-containing extracellular matrixProthrombinHomo sapiens (human)
extracellular regionProthrombinHomo sapiens (human)
extracellular spaceProthrombinHomo sapiens (human)
endoplasmic reticulum lumenProthrombinHomo sapiens (human)
Golgi lumenProthrombinHomo sapiens (human)
plasma membraneProthrombinHomo sapiens (human)
extracellular exosomeProthrombinHomo sapiens (human)
blood microparticleProthrombinHomo sapiens (human)
collagen-containing extracellular matrixProthrombinHomo sapiens (human)
extracellular spaceProthrombinHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (38)

Assay IDTitleYearJournalArticle
AID1079938Chronic liver disease either proven histopathologically, or through a chonic elevation of serum amino-transferase activity after 6 months. Value is number of references indexed. [column 'CHRON' in source]
AID1079944Benign tumor, proven histopathologically. Value is number of references indexed. [column 'T.BEN' in source]
AID625276FDA Liver Toxicity Knowledge Base Benchmark Dataset (LTKB-BD) drugs of most concern for DILI2011Drug discovery today, Aug, Volume: 16, Issue:15-16
FDA-approved drug labeling for the study of drug-induced liver injury.
AID1079948Times to onset, minimal and maximal, observed in the indexed observations. [column 'DELAI' in source]
AID1079931Moderate liver toxicity, defined via clinical-chemistry results: ALT or AST serum activity 6 times the normal upper limit (N) or alkaline phosphatase serum activity of 1.7 N. Value is number of references indexed. [column 'BIOL' in source]
AID766436Oral bioavailability in dog2013Bioorganic & medicinal chemistry letters, Sep-01, Volume: 23, Issue:17
Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
AID1079939Cirrhosis, proven histopathologically. Value is number of references indexed. [column 'CIRRH' in source]
AID588210Human drug-induced liver injury (DILI) modelling dataset from Ekins et al2010Drug metabolism and disposition: the biological fate of chemicals, Dec, Volume: 38, Issue:12
A predictive ligand-based Bayesian model for human drug-induced liver injury.
AID766448Dissociation constant, pKa of the compound by potentiometric titration2013Bioorganic & medicinal chemistry letters, Sep-01, Volume: 23, Issue:17
Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
AID1079947Comments (NB not yet translated). [column 'COMMENTAIRES' in source]
AID766447Distribution coefficient, log D of the compound at pH 7 by potentiometric titration2013Bioorganic & medicinal chemistry letters, Sep-01, Volume: 23, Issue:17
Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
AID1079949Proposed mechanism(s) of liver damage. [column 'MEC' in source]
AID1079937Severe hepatitis, defined as possibly life-threatening liver failure or through clinical observations. Value is number of references indexed. [column 'MASS' in source]
AID1474167Liver toxicity in human assessed as induction of drug-induced liver injury by measuring verified drug-induced liver injury concern status2016Drug discovery today, Apr, Volume: 21, Issue:4
DILIrank: the largest reference drug list ranked by the risk for developing drug-induced liver injury in humans.
AID1079940Granulomatous liver disease, proven histopathologically. Value is number of references indexed. [column 'GRAN' in source]
AID1079934Highest frequency of acute liver toxicity observed during clinical trials, expressed as a percentage. [column '% AIGUE' in source]
AID1079942Steatosis, proven histopathologically. Value is number of references indexed. [column 'STEAT' in source]
AID1393314Oral bioavailability in human at 5 to 98 mg2018Journal of medicinal chemistry, 05-10, Volume: 61, Issue:9
Design of Small-Molecule Active-Site Inhibitors of the S1A Family Proteases as Procoagulant and Anticoagulant Drugs.
AID588211Literature-mined compound from Fourches et al multi-species drug-induced liver injury (DILI) dataset, effect in humans2010Chemical research in toxicology, Jan, Volume: 23, Issue:1
Cheminformatics analysis of assertions mined from literature that describe drug-induced liver injury in different species.
AID1079935Cytolytic liver toxicity, either proven histopathologically or where the ratio of maximal ALT or AST activity above normal to that of Alkaline Phosphatase is > 5 (see ACUTE). Value is number of references indexed. [column 'CYTOL' in source]
AID1079941Liver damage due to vascular disease: peliosis hepatitis, hepatic veno-occlusive disease, Budd-Chiari syndrome. Value is number of references indexed. [column 'VASC' in source]
AID1079936Choleostatic liver toxicity, either proven histopathologically or where the ratio of maximal ALT or AST activity above normal to that of Alkaline Phosphatase is < 2 (see ACUTE). Value is number of references indexed. [column 'CHOLE' in source]
AID1079933Acute liver toxicity defined via clinical observations and clear clinical-chemistry results: serum ALT or AST activity > 6 N or serum alkaline phosphatases activity > 1.7 N. This category includes cytolytic, choleostatic and mixed liver toxicity. Value is
AID418021Cmax in rat assessed as melagatran level at 20 mg/kg, po after 120 mins2009Bioorganic & medicinal chemistry letters, Apr-01, Volume: 19, Issue:7
Incorporation of neutral C-terminal residues in 3-amidinophenylalanine-derived matriptase inhibitors.
AID588213Literature-mined compound from Fourches et al multi-species drug-induced liver injury (DILI) dataset, effect in non-rodents2010Chemical research in toxicology, Jan, Volume: 23, Issue:1
Cheminformatics analysis of assertions mined from literature that describe drug-induced liver injury in different species.
AID766435Oral bioavailability in human2013Bioorganic & medicinal chemistry letters, Sep-01, Volume: 23, Issue:17
Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
AID1525519Inhibition of thrombin (unknown origin)2019Journal of medicinal chemistry, 11-27, Volume: 62, Issue:22
Why Some Targets Benefit from beyond Rule of Five Drugs.
AID1626787Oral bioavailability in human2016Journal of medicinal chemistry, 07-28, Volume: 59, Issue:14
Macrocyclic Prodrugs of a Selective Nonpeptidic Direct Thrombin Inhibitor Display High Permeability, Efficient Bioconversion but Low Bioavailability.
AID766437Oral bioavailability in rat2013Bioorganic & medicinal chemistry letters, Sep-01, Volume: 23, Issue:17
Antithrombotic effects of LB30870, a potent, orally active, selective and direct thrombin inhibitor, and pharmacokinetics of its prodrug.
AID1079946Presence of at least one case with successful reintroduction. [column 'REINT' in source]
AID1079943Malignant tumor, proven histopathologically. Value is number of references indexed. [column 'T.MAL' in source]
AID1393312Apparent permeability across apical to basolateral side in human Caco2 cells at 750 uM measured over 90 mins by HPLC-MS analysis2018Journal of medicinal chemistry, 05-10, Volume: 61, Issue:9
Design of Small-Molecule Active-Site Inhibitors of the S1A Family Proteases as Procoagulant and Anticoagulant Drugs.
AID588212Literature-mined compound from Fourches et al multi-species drug-induced liver injury (DILI) dataset, effect in rodents2010Chemical research in toxicology, Jan, Volume: 23, Issue:1
Cheminformatics analysis of assertions mined from literature that describe drug-induced liver injury in different species.
AID1079945Animal toxicity known. [column 'TOXIC' in source]
AID625293Drug Induced Liver Injury Prediction System (DILIps) validation dataset; compound DILI positive/negative as observed in LTKB-BD2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID418022Cmax in rat assessed as N-hydroxy-melagatran level at 20 mg/kg, po after 120 mins2009Bioorganic & medicinal chemistry letters, Apr-01, Volume: 19, Issue:7
Incorporation of neutral C-terminal residues in 3-amidinophenylalanine-derived matriptase inhibitors.
AID1474166Liver toxicity in human assessed as induction of drug-induced liver injury by measuring severity class index2016Drug discovery today, Apr, Volume: 21, Issue:4
DILIrank: the largest reference drug list ranked by the risk for developing drug-induced liver injury in humans.
AID1079932Highest frequency of moderate liver toxicity observed during clinical trials, expressed as a percentage. [column '% BIOL' in source]
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (381)

TimeframeStudies, This Drug (%)All Drugs %
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's324 (85.04)29.6817
2010's57 (14.96)24.3611
2020's0 (0.00)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials75 (18.80%)5.53%
Reviews179 (44.86%)6.00%
Case Studies1 (0.25%)4.05%
Observational0 (0.00%)0.25%
Other144 (36.09%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (2)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Long-Term Treatment With the Oral Direct Thrombin Inhibitor Ximelagatran, Compared to Warfarin, as Stroke Prophylaxis in Patients With Atrial Fibrillation. A Long Term Follow-Up Study [NCT00206063]Phase 2220 participants Interventional1999-08-31Terminated(stopped due to Melagatran/ximelagatran was withdrawn from the market and clinical development in February 2006 in the interest of patient safety.)
"The EXTEND Study: A Randomized, Double-blind, Parallel-group, Phase III b, Multi-centre Study Evaluating Extended Prophylactic Treatment With Melagatran/Ximelagatran Versus Enoxaparin for the Prevention of Venous Thromboembolic Events in Patients Undergo [NCT00206089]Phase 33,300 participants Interventional2005-09-30Terminated(stopped due to Melagatran/ximelagatran was withdrawn from the market and clinical development in February 2006 in the interest of patient safety.)
[information is prepared from clinicaltrials.gov, extracted Sep-2024]