xanomeline   Click here for help

GtoPdb Ligand ID: 57

Synonyms: LY 246708
PDB Ligand
Compound class: Synthetic organic
Comment: Xanomeline is a muscarinic receptor agonist, with preference for the M1 and M4 receptor subtypes [2,8,12]. It also has antagonist activity at 5-HT2 receptors, and agonist activity at 5-HT1 receptors [10]. Xanomeline was investigated for potential to improve cognition in Alzheimer's disease (AD) patients, but activation of muscarinic receptors in the gastrointestinal tract caused severe nausea and diarrhoea, and this adverse effect led to discontinuation of xanomeline's clinical development for AD.
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2D Structure
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Physico-chemical Properties
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Hydrogen bond acceptors 3
Hydrogen bond donors 0
Rotatable bonds 7
Topological polar surface area 66.49
Molecular weight 281.16
XLogP 3.34
No. Lipinski's rules broken 0
SMILES / InChI / InChIKey
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Canonical SMILES CCCCCCOc1nsnc1C1=CCCN(C1)C
Isomeric SMILES CCCCCCOc1nsnc1C1=CCCN(C1)C
InChI InChI=1S/C14H23N3OS/c1-3-4-5-6-10-18-14-13(15-19-16-14)12-8-7-9-17(2)11-12/h8H,3-7,9-11H2,1-2H3
InChI Key JOLJIIDDOBNFHW-UHFFFAOYSA-N
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Summary of Clinical Use Click here for help
Xanomeline in combination with the peripherally restricted muscarinic receptor antagonist trospium has entered clinical evaluation to determine efficacy as a schzophrenia therapy [3,5]. Trospium is included to counteract xanomeline's cholinergic adverse events, which include nausea and vomiting, excessive sweating and salivary hypersecretion. The combination therapy has been named KarXT.
Clinical Trials
Clinical Trial ID Title Type Source Comment References
NCT02831231 Pilot Study Comparing Effects of Xanomeline Alone to Xanomeline Plus Trospium Phase 1 Interventional Karuna Therapeutics 1
NCT03697252 A Study to Assess Safety and Efficacy of KarXT in Adult Patients With Schizophrenia Phase 2 Interventional Karuna Therapeutics The EMERGENT-1 study 4,11
NCT00001693 Phase I-II Multiple-Dose Safety and Efficacy Study of a Selective Inhibitor of Cyclooxygenase - 2 (SC-58635) in Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Patients and Carriers Phase 1 Interventional National Institutes of Health Clinical Center (CC) The EMERGENT-4 study
NCT04738123 A Study to Assess Efficacy and Safety of KarXT in Acutely Psychotic Hospitalized Adult Patients With Schizophrenia (EMERGENT-3) Phase 3 Interventional Karuna Therapeutics The EMERGENT-3 study
NCT04659161 A Study to Assess Efficacy and Safety of KarXT in Acutely Psychotic Hospitalized Adult Patients With Schizophrenia (EMERGENT-2) Phase 3 Interventional Karuna Therapeutics The EMERGENT-2 study 7