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naltrexone 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
opioid receptor antagonists/agonists related to normorphine	1765	16590-41-3

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: naltrexone cyclopropylmethylnoroxymorphone naltrel naltrexone hydrochloride naltrexone hydrochloride dihydrate naltrexone HCl	Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. Molecular weight: 341.41 Formula: C20H23NO4 CLOGP: 0.36 LIPINSKI: 0 HAC: 5 HDO: 2 TPSA: 70 ALOGS: -2.05 ROTB: 2 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

naltrexone
cyclopropylmethylnoroxymorphone
naltrel
naltrexone hydrochloride
naltrexone hydrochloride dihydrate
naltrexone HCl

Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.

Molecular weight: 341.41
Formula: C20H23NO4
CLOGP: 0.36
LIPINSKI: 0
HAC: 5
HDO: 2
TPSA: 70
ALOGS: -2.05
ROTB: 2

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
50	mg	O

ADMET properties:

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Property	Value	Reference
Vd (Volume of distribution)	7.60 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	57 mL/min/kg	Lombardo F, Berellini G, Obach RS
BA (Bioavailability)	22 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
S (Water solubility)	100 mg/mL	Benet LZ, Broccatelli F, Oprea TI
t_half (Half-life)	1.90 hours	Lombardo F, Berellini G, Obach RS
EoM (Fraction excreted unchanged in urine)	1 %	Benet LZ, Broccatelli F, Oprea TI
BDDCS (Biopharmaceutical Drug Disposition Classification System)	1	Benet LZ, Broccatelli F, Oprea TI
fu (Fraction unbound in plasma)	0.79 %	Lombardo F, Berellini G, Obach RS
MRTD (Maximum Recommended Therapeutic Daily Dose)	0.44 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD

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Approvals:

Date	Agency	Company	Orphan
Nov. 20, 1984	FDA	TEVA WOMENS

FDA Adverse Event Reporting System (Female)

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MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Injection site reaction	3811.77	19.15	1221	21217	57303	63409281
Injection site mass	2738.71	19.15	733	21705	17923	63448661
Injection site pain	1479.51	19.15	777	21661	129023	63337561
Injection site induration	1057.26	19.15	299	22139	8927	63457657
Therapeutic response shortened	449.10	19.15	166	22272	11722	63454862
Product administered at inappropriate site	392.07	19.15	109	22329	3040	63463544
Injection site swelling	293.09	19.15	192	22246	47380	63419204
Feeling abnormal	264.83	19.15	293	22145	148099	63318485
Withdrawal syndrome	258.89	19.15	131	22307	19866	63446718
Injection site abscess	242.70	19.15	61	22377	1137	63465447

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FDA Adverse Event Reporting System (Male)

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MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Injection site reaction	5480.39	28.73	1315	19556	11718	34924342
Injection site pain	2928.74	28.73	1032	19839	37973	34898087
Injection site mass	1500.71	28.73	410	20461	6216	34929844
Injection site induration	665.56	28.73	181	20690	2679	34933381
Feeling abnormal	655.07	28.73	429	20442	62806	34873254
Therapeutic response shortened	586.92	28.73	205	20666	7199	34928861
Product administered at inappropriate site	513.18	28.73	140	20731	2096	34933964
Needle issue	425.23	28.73	154	20717	6011	34930049
Injection site swelling	395.59	28.73	174	20697	11353	34924707
Withdrawal syndrome	360.69	28.73	167	20704	12288	34923772

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FDA Adverse Event Reporting System (Geriatric)

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MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Injection site reaction	7767.91	21.29	2213	34707	52572	79654896
Injection site pain	3776.48	21.29	1610	35310	128228	79579240
Injection site mass	3691.00	21.29	999	35921	19185	79688283
Injection site induration	1583.62	21.29	441	36479	9378	79698090
Feeling abnormal	778.15	21.29	620	36300	158579	79548889
Therapeutic response shortened	766.08	21.29	285	36635	15578	79691890
Product administered at inappropriate site	717.13	21.29	195	36725	3770	79703698
Injection site swelling	597.65	21.29	333	36587	46799	79660669
Withdrawal syndrome	540.71	21.29	259	36661	26595	79680873
Needle issue	509.71	21.29	201	36719	12867	79694601

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FDA Adverse Event Reporting System (Pediatric)

None

Pharmacologic Action:

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Source	Code	Description
ATC	A08AA62	ALIMENTARY TRACT AND METABOLISM ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS Centrally acting antiobesity products
ATC	N02AA56	NERVOUS SYSTEM ANALGESICS OPIOIDS Natural opium alkaloids
ATC	N07BB04	NERVOUS SYSTEM OTHER NERVOUS SYSTEM DRUGS DRUGS USED IN ADDICTIVE DISORDERS Drugs used in alcohol dependence
CHEBI has role	CHEBI:35488	central nervous system depressants
CHEBI has role	CHEBI:35703	Xenobiotic
CHEBI has role	CHEBI:50137	mu-opioid receptor antagonists
CHEBI has role	CHEBI:78298	environmental contaminants
CHEBI has role	CHEBI:90755	antidote to opioid overdose
FDA EPC	N0000175691	Opioid Antagonist
FDA MoA	N0000000154	Opioid Antagonists

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Drug Use | Suggest Off label Use Form| |View source of the data|

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Disease	Relation	SNOMED_ID	DOID
Alcoholism	indication	7200002
Severe pain	indication	76948002
Chronic pain	indication	82423001
Obesity	indication	414916001	DOID:9970
Prevention of opioid abuse	indication	426928008
Therapeutic opioid induced constipation	indication	136801000119102
Severe Pain with Opioid Tolerance	indication
Chronic Pain with Opioid Tolerance	indication
Neuropathic pain	off-label use	247398009
Suicidal thoughts	contraindication	6471006

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🐶 Veterinary Drug Use

Species	Use	Relation
Cervidae	Antagonist to carfentanil citrate immobilization	Indication

🐶 Veterinary products

Product	Applicant	Ingredients
Trexonil	Wildlife Laboratories Inc.	1

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	9.31	acidic
pKa2	7.66	Basic

Orange Book patent data (new drug applications)

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Formulation strength	Trade name	Applicant	Application number	Approval date	Type	Dose form	Route	Patent number	Patent expiration date	Patent use
1.2MG;10MG	TROXYCA ER	PFIZER	N207621	Aug. 19, 2016	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8685443	July 3, 2025	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING A PLURALITY OF COMPOSITE SUBUNITS AS CLAIMED
100MG;4MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8685443	July 3, 2025	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING A PLURALITY OF COMPOSITE SUBUNITS AS CLAIMED
100MG;4MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	7682633	June 19, 2027	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED.
100MG;4MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8158156	June 19, 2027	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED.
100MG;4MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8623418	Nov. 7, 2029	TREATMENT OF MODERATE TO SEVERE CHRONIC PAIN BY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED
2.4MG;20MG	TROXYCA ER	PFIZER	N207621	Aug. 19, 2016	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8685443	July 3, 2025	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING A PLURALITY OF COMPOSITE SUBUNITS AS CLAIMED
20MG;0.8MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8685443	July 3, 2025	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING A PLURALITY OF COMPOSITE SUBUNITS AS CLAIMED
20MG;0.8MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	7682633	June 19, 2027	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED.
20MG;0.8MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8158156	June 19, 2027	MANAGEMENT OF PAIN SEVERE ENOUGH TO REQUIRE DAILY, AROUND-THE-CLOCK, LONG TERM OPIOID TREATMENT BY ORALLY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED.
20MG;0.8MG Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons	EMBEDA	ALPHARMA PHARMS	N022321	Aug. 13, 2009	DISCN	CAPSULE, EXTENDED RELEASE	ORAL	8623418	Nov. 7, 2029	TREATMENT OF MODERATE TO SEVERE CHRONIC PAIN BY ADMINISTERING AN INTACT COMPOSITION AS CLAIMED

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Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

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Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Delta-type opioid receptor	GPCR	P41143	OPRD_HUMAN	ANTAGONIST	Ki	7.99	WOMBAT-PK	CHEMBL
Kappa-type opioid receptor	GPCR	P41145	OPRK_HUMAN	ANTAGONIST	Ki	8.93	WOMBAT-PK	CHEMBL
Mu-type opioid receptor	GPCR	P35372	OPRM_HUMAN	ANTAGONIST	Ki	9.38	WOMBAT-PK	CHEMBL
Cytochrome P450 2D6	Enzyme	P10635	CP2D6_HUMAN		IC50	6	DRUG MATRIX
Neuronal acetylcholine receptor subunit alpha-7	Ion channel	P36544	ACHA7_HUMAN		IC50	4.60	CHEMBL
Mu-type opioid receptor	GPCR		OPRM_RAT		Ki	9.34	CHEMBL
Mu-type opioid receptor	GPCR		OPRM_MOUSE		Ki	9.58	CHEMBL
Mu-type opioid receptor	GPCR		OPRM_CAVPO		Ki	9.77	CHEMBL
Delta-type opioid receptor	GPCR		OPRD_MOUSE		Ki	7.91	CHEMBL
Delta-type opioid receptor	GPCR		OPRD_RAT		Ki	8.32	CHEMBL

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External reference:

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ID	Source
001615	NDDF
004662	NDDF
105069	RXNORM
11621	MMSL
1639	IUPHAR_LIGAND_ID
16676-29-2	SECONDARY_CAS_RN
20600	MMSL
3368	INN_ID
373546002	SNOMEDCT_US
4018545	VANDF

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Pharmaceutical products:

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Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Addex-1000	HUMAN PRESCRIPTION DRUG LABEL	1	57377-010	PELLET, IMPLANTABLE	1000 mg	SUBCUTANEOUS	Export only	4 sections
Addex-1000	HUMAN PRESCRIPTION DRUG LABEL	1	57377-010	PELLET, IMPLANTABLE	1000 mg	SUBCUTANEOUS	Export only	4 sections
ContraveExtended-Release	HUMAN PRESCRIPTION DRUG LABEL	2	43063-772	TABLET, EXTENDED RELEASE	8 mg	ORAL	NDA	31 sections
ContraveExtended-Release	HUMAN PRESCRIPTION DRUG LABEL	2	43063-772	TABLET, EXTENDED RELEASE	8 mg	ORAL	NDA	31 sections
ContraveExtended-Release	HUMAN PRESCRIPTION DRUG LABEL	2	50090-2945	TABLET, EXTENDED RELEASE	8 mg	ORAL	NDA	30 sections
ContraveExtended-Release	HUMAN PRESCRIPTION DRUG LABEL	2	51267-890	TABLET, EXTENDED RELEASE	8 mg	ORAL	NDA	31 sections
ContraveExtended-Release	HUMAN PRESCRIPTION DRUG LABEL	2	51267-890	TABLET, EXTENDED RELEASE	8 mg	ORAL	NDA	31 sections
EMBEDA	HUMAN PRESCRIPTION DRUG LABEL	2	16590-897	CAPSULE, EXTENDED RELEASE	0.80 mg	ORAL	NDA	14 sections
NALTREXONE HYDROCHLORIDE	HUMAN PRESCRIPTION DRUG LABEL	1	0406-1170	TABLET, FILM COATED	50 mg	ORAL	ANDA	23 sections
NALTREXONE HYDROCHLORIDE	HUMAN PRESCRIPTION DRUG LABEL	1	0406-1170	TABLET, FILM COATED	50 mg	ORAL	ANDA	23 sections

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