User:Mr. Ibrahem/Mipomersen

Mr. Ibrahem/Mipomersen
Clinical data
Trade names	Kynamro
Synonyms	ISIS 301012
AHFS/Drugs.com	Monograph
Pregnancy; category	;
Routes of; administration	Subcutaneous injection
Drug class	Antisense oligonucleotide
Legal status
Legal status	US: ℞-only ;
Pharmacokinetic data
Protein binding	≥90%
Metabolism	Nucleases
Elimination half-life	1–2 months
Excretion	<4% in urine in 24 hours
Identifiers
	IUPAC name 2’-O-(2-Methoxyethyl)-P-thioguanylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiocytidylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiocytidylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiouridylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiocytidylyl-(3’→5’)-2’-deoxy-P-thioadenylyl-(3’→5’)-2’-deoxy-P-thioguanylyl-(3’→5’)-P- thiothymidylyl-(3’→5’)-2’-deoxy-5-methyl-P-thiocytidylyl-(3’→5’)-P-thiothymidylyl-(3’→5’)-2’-deoxy-P-thioguanylyl-(3’→5’)-2’-deoxy-5-methyl-P-thiocytidylyl-(3’→5’)-P-thiothymidylyl-(3’→5’)-P-thiothymidylyl-(3’→5’)-2’-deoxy-5-methyl-P-thiocytidylyl-(3’→5’)-2’-O-(2-methoxyethyl)-P-thioguanylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiocytidylyl-(3’→5’)-2’-O-(2-methoxyethyl)-P-thioadenylyl- (3’→5’)-2’-O-(2-methoxyethyl)-5-methyl-P-thiocytidylyl-(3’→5’)-2’-O-(2-methoxyethyl)-5-methylcytidine nonadecasodiumsalt;
Chemical and physical data
Formula	C230H305N67Na19O122P19S19
Molar mass	7,594.76 g·mol−1
	SMILES COCCO[C@@H]1[C@H](OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H](C[C@@H]2OP(=S)(OC[C@H]2O[C@H]([C@@H]([C@@H]2OP(=S)(OC[C@H]2O[C@H]([C@@H]([C@@H]2OP(=S)(OC[C@H]2O[C@H]([C@@H]([C@@H]2OP(=S)(OC[C@H]2O[C@H]([C@@H]([C@@H]2OP(=S)(OC[C@H]2O[C@H]([C@@H]([C@@H]2O)OCCOC)n2cc(C)c(nc2=O)N)O)OCCOC)n2cc(C)c(nc2=O)N)O)OCCOC)n2cnc3c2ncnc3N)O)OCCOC)n2cc(C)c(nc2=O)N)O)OCCOC)n2cnc3c2nc(N)[nH]c3=O)O)n2cc(C)c(nc2=O)N)O)n2cc(C)c(=O)[nH]c2=O)O)n2cc(C)c(=O)[nH]c2=O)O)n2cc(C)c(nc2=O)N)O)n2cnc3c2nc(N)[nH]c3=O)O)n2cc(C)c(=O)[nH]c2=O)O)n2cc(C)c(nc2=O)N)O)n2cc(C)c(=O)[nH]c2=O)O)n2cnc3c2nc(N)[nH]c3=O)O)n2cnc3c2ncnc3N)O)[C@H](O[C@H]1n1cc(C)c(nc1=O)N)COP(=S)(O[C@@H]1[C@@H](COP(=S)(O[C@@H]2[C@@H](COP(=S)(O[C@@H]3[C@@H](COP(=S)(O[C@@H]4[C@@H](CO)O[C@H]([C@@H]4OCCOC)n4cnc5c4nc(N)[nH]c5=O)O)O[C@H]([C@@H]3OCCOC)n3cc(C)c(nc3=O)N)O)O[C@H]([C@@H]2OCCOC)n2cc(C)c(nc2=O)N)O)O[C@H]([C@@H]1OCCOC)n1cc(C)c(=O)[nH]c1=O)O;
	InChI InChI=1S/C230H324N67O122P19S19/c1-97-55-278(217(309)256-177(97)231)141-45-111(122(381-141)70-362-422(325,441)404-116-50-146(283-66-108(12)196(302)275-228(283)320)387-128(116)76-368-427(330,446)410-120-54-150(294-93-253-154-191(294)266-214(243)270-200(154)306)390-130(120)78-370-428(331,447)408-118-52-148(292-91-250-151-186(240)246-89-248-188(151)292)388-131(118)79-371-430(333,449)412-159-134(394-204(169(159)354-37-27-344-17)286-59-101(5)181(235)260-221(286)313)83-375-435(338,454)417-164-138(398-209(174(164)359-42-32-349-22)291-68-110(14)198(304)277-230(291)322)87-377-434(337,453)415-162-136(396-207(172(162)357-40-30-347-20)289-62-104(8)184(238)263-224(289)316)85-376-433(336,452)414-161-133(393-206(171(161)356-39-29-346-19)288-61-103(7)183(237)262-223(288)315)82-374-432(335,451)411-158-121(69-298)391-211(168(158)353-36-26-343-16)296-95-254-155-192(296)267-215(244)271-201(155)307)401-420(323,439)365-74-127-117(51-147(386-127)284-67-109(13)197(303)276-229(284)321)406-425(328,444)369-77-129-119(53-149(389-129)293-92-252-153-190(293)265-213(242)269-199(153)305)409-426(329,445)367-71-123-112(46-142(382-123)279-56-98(2)178(232)257-218(279)310)402-421(324,440)364-73-125-115(49-145(384-125)282-65-107(11)195(301)274-227(282)319)405-424(327,443)366-75-126-114(48-144(385-126)281-64-106(10)194(300)273-226(281)318)403-423(326,442)363-72-124-113(47-143(383-124)280-57-99(3)179(233)258-219(280)311)407-429(332,448)373-81-139-166(176(361-44-34-351-24)212(400-139)297-96-255-156-193(297)268-216(245)272-202(156)308)419-438(341,457)379-86-137-163(173(358-41-31-348-21)208(397-137)290-63-105(9)185(239)264-225(290)317)416-436(339,455)380-88-140-165(175(360-43-33-350-23)210(399-140)295-94-251-152-187(241)247-90-249-189(152)295)418-437(340,456)378-84-135-160(170(355-38-28-345-18)205(395-135)287-60-102(6)182(236)261-222(287)314)413-431(334,450)372-80-132-157(299)167(352-35-25-342-15)203(392-132)285-58-100(4)180(234)259-220(285)312/h55-68,89-96,111-150,157-176,203-212,298-299H,25-54,69-88H2,1-24H3,(H,323,439)(H,324,440)(H,325,441)(H,326,442)(H,327,443)(H,328,444)(H,329,445)(H,330,446)(H,331,447)(H,332,448)(H,333,449)(H,334,450)(H,335,451)(H,336,452)(H,337,453)(H,338,454)(H,339,455)(H,340,456)(H,341,457)(H2,231,256,309)(H2,232,257,310)(H2,233,258,311)(H2,234,259,312)(H2,235,260,313)(H2,236,261,314)(H2,237,262,315)(H2,238,263,316)(H2,239,264,317)(H2,240,246,248)(H2,241,247,249)(H,273,300,318)(H,274,301,319)(H,275,302,320)(H,276,303,321)(H,277,304,322)(H3,242,265,269,305)(H3,243,266,270,306)(H3,244,267,271,307)(H3,245,268,272,308)/t111-,112-,113-,114-,115-,116-,117-,118-,119-,120-,121+,122+,123+,124+,125+,126+,127+,128+,129+,130+,131+,132+,133+,134+,135+,136+,137+,138+,139+,140+,141+,142+,143+,144+,145+,146+,147+,148+,149+,150+,157+,158+,159+,160+,161+,162+,163+,164+,165+,166+,167+,168+,169+,170+,171+,172+,173+,174+,175+,176+,203+,204+,205+,206+,207+,208+,209+,210+,211+,212+,420?,421?,422?,423?,424?,425?,426?,427?,428?,429?,430?,431?,432?,433?,434?,435?,436?,437?,438?/m0/s1; Key:XLTMQWVJFPYGMC-QVKFEXRMSA-N;

Mipomersen, sold under the brand name Kynamro, is a medication used to treat homozygous familial hypercholesterolemia.^[2] Effects on overall risk of heart disease or death is unclear.^[2] Benefits in other types of high cholesterol is unknown.^[2] It is given by injection under the skin.^[2]

Common side effects include tiredness, nausea, headache, liver problems, fever, high blood pressure, and abdominal pain.^[2] Other side effects may include pain at the site of injection and angioedema.^[2] It is a short fragment of DNA, known as an antisense oligonucleotide, that blocks the production of apolipoprotein B.^[1]

Mipomersen was approved for medical use in the United States in 2013.^[2] In Europe it was denied approval in 2013 due to concerns of greater side effects than benefits.^[1] In the United States it costs about 407,000 USD per year.^[3]

References

↑ ^1.0 ^1.1 ^1.2 "Kynamro". Archived from the original on 8 March 2021. Retrieved 18 November 2021.
↑ ^2.00 ^2.01 ^2.02 ^2.03 ^2.04 ^2.05 ^2.06 ^2.07 ^2.08 ^2.09 "Mipomersen Monograph for Professionals". Drugs.com. Archived from the original on 24 January 2021. Retrieved 18 November 2021.
↑ "Kynamro Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 18 November 2021.

[EPAR2021-1] 1.0 ^1.1 ^1.2 "Kynamro". Archived from the original on 8 March 2021. Retrieved 18 November 2021.

[AHFS2021-2] 2.00 ^2.01 ^2.02 ^2.03 ^2.04 ^2.05 ^2.06 ^2.07 ^2.08 ^2.09 "Mipomersen Monograph for Professionals". Drugs.com. Archived from the original on 24 January 2021. Retrieved 18 November 2021.

[3] "Kynamro Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 18 November 2021.

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