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1,4-Naphthalenediol, 2-methyl-, diphosphate, tetrasodium salt
Also known as: 131-13-5, Kappadione, Menadiol sodium diphosphate anhydrous, Tetrasodium2-methyl-1,4-naphthylenebis(phosphate), R2l46we615, 1,4-naphthalenediol, 2-methyl-, bis(dihydrogen phosphate), tetrasodium salt
Molecular Formula
C11H8Na4O8P2
Molecular Weight
422.08  g/mol
InChI Key
GZBACHSOZNEZOG-UHFFFAOYSA-J
FDA UNII
R2L46WE615

Kappadione is a Vitamin K derivative (chemically, it is menadiol sodium diphosphate), previously approved by FDA prior to 1982 and marketed by Lilly Marketing for this drug has been discontinued and is not available in North America. It has been found to have carcinogenic potential in mammalian cells as well as cytotoxic properties. Studies involving the active metabolite of this formulation, menadione, showed oocyte toxicity in a study of mice.
1 2D Structure

1,4-Naphthalenediol, 2-methyl-, diphosphate, tetrasodium salt

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
tetrasodium;(2-methyl-4-phosphonatooxynaphthalen-1-yl) phosphate
2.1.2 InChI
InChI=1S/C11H12O8P2.4Na/c1-7-6-10(18-20(12,13)14)8-4-2-3-5-9(8)11(7)19-21(15,16)17;;;;/h2-6H,1H3,(H2,12,13,14)(H2,15,16,17);;;;/q;4*+1/p-4
2.1.3 InChI Key
GZBACHSOZNEZOG-UHFFFAOYSA-J
2.1.4 Canonical SMILES
CC1=C(C2=CC=CC=C2C(=C1)OP(=O)([O-])[O-])OP(=O)([O-])[O-].[Na+].[Na+].[Na+].[Na+]
2.2 Other Identifiers
2.2.1 UNII
R2L46WE615
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 2-methyl-1,4-naphthohydroquinone

2. 2-methyl-1,4-naphthoquinol

3. Dihydrovitamin K3

4. Menadiol

5. Menadiol Diphosphate

6. Menadiol Diphosphate Ion

7. Menadiol Diphosphate, Monosodium Salt

8. Menadiol Diphosphate, Tetrasodium Salt

9. Menadiol, (-1)-ion

10. Menadiol, Monopotassium Salt

11. Naphtadon

12. Reduced Menadione

13. Synkavit

14. Synkavite

2.3.2 Depositor-Supplied Synonyms

1. 131-13-5

2. Kappadione

3. Menadiol Sodium Diphosphate Anhydrous

4. Tetrasodium2-methyl-1,4-naphthylenebis(phosphate)

5. R2l46we615

6. 1,4-naphthalenediol, 2-methyl-, Bis(dihydrogen Phosphate), Tetrasodium Salt

7. Synkavit

8. Kipca Water Soluble

9. Menadiol Sodium Phosphate

10. Menadione Sodium Phosphate

11. Sodium Menadione Diphosphate

12. Menadiol Tetrasodium Diphosphate

13. Einecs 205-012-1

14. Menadione Diphosphate Tetrasodium Salt

15. 1:4-naphthaquinol-bisdisodium Phosphate

16. Unii-r2l46we615

17. Menadiol Sodium Diphosphate Anhydrous [usan]

18. 2-methyl-1,4-naphthaquinol Bis(disodium Phosphate)

19. Tetrasodium 2-methyl-1,4-naphthalenediol Diphosphate

20. Tetrasodium 2-methyl-1,4-naphthohydroquinone Diphosphate

21. 1,4-naphthalenediol, 2-methyl-, Diphosphate, Tetrasodium Salt

22. Tetrasodium 2-methyl-1,4-naphthahydroquinone Diphosphoric Acid Ester

23. Tetrasodium 2-methyl-1,4-naphthalenediol Bis(dihydrogen Phosphate)

24. 2-methyl-1,4-naphthohydroquinone Diphosphoric Acid Ester Tetrasodium Salt

25. Phosphoric Acid, Diester With 2-methyl-1,4-naphthalenediol, Tetrasodium Salt

26. Tetrasodium 2-methyl-1,4-naphthylenebis(phosphate)

27. Dtxsid80156832

28. Db09332

29. 1,4-naphthalenediol, 2-methyl-, Bis(dihydrogen Phosphate), Tetrasodium

30. Menadiol Sodium Diphosphate [mi]

31. Menadiol Sodium Diphosphate [who-dd]

32. Q6367106

33. 1,4-naphthalenediol, 2-methyl-, 1,4-bis(dihydrogen Phosphate), Sodium Salt (1:4)

34. 2-methyl-1,4-naphthalenediol Bis(dihydrogen Phosphate) Tetrasodium Salt

2.4 Create Date
2005-08-08
3 Chemical and Physical Properties
Molecular Weight 422.08 g/mol
Molecular Formula C11H8Na4O8P2
Hydrogen Bond Donor Count0
Hydrogen Bond Acceptor Count8
Rotatable Bond Count2
Exact Mass421.92851833 g/mol
Monoisotopic Mass421.92851833 g/mol
Topological Polar Surface Area145 Ų
Heavy Atom Count25
Formal Charge0
Complexity434
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count5
4 Drug and Medication Information
4.1 Drug Indication

Anticoagulant-induced prothrombin deficiency caused by coumadin or indanedione derivatives, prophylaxis and therapy of hemorrhagic disease of the newborn, hypoprothrombinemia due to antibacterial therapy, hypoprothrombinemia secondary to factors limiting absorption or synthesis of vitamin K (for example, obstructive jaundice, biliary fistula, sprue, ulcerative colitis, celiac disease, intestinal resection, cystic fibrosis of the pancreas, and regional enteritis, other drug-induced hypoprothrombinemia where it is definitely shown that the result is due to interference with vitamin K metabolism).


5 Pharmacology and Biochemistry
5.1 Pharmacology

Menadiol sodium diphosphate is a highly water-soluble vitamin K analog. The presence of vitamin K is necessary for the formation of prothrombin, factor VII, factor IX and factor X. Lack of vitamin K results in an increased risk of hemorrhage, which can be minor or life-threatening.


5.2 Absorption, Distribution and Excretion

Absorption

Menadiol sodium phosphate (vitamin K3), the synthetic analog of vitamin K, being water soluble, is advised in intestinal malabsorption or in states in which bile flow is deficient. The primary disadvantage is that it takes 24 h to initiate therapeutic effects, however, this effect lasts for several days. The dose is 540 mg orally, daily. Menadiol sodium phosphate, even in moderate doses, may lead to hemolytic anemia and, for this reason, neonates should not receive this medication. This precautionary measure is valid especially those that are deficient in glucose 6-phosphate dehydrogenase (G6PD); their immature livers are unable to compensate for the heavy bilirubin load and there is an increased risk of kernicterus.


Route of Elimination

Vitamin K is heavily metabolized in the liver and excreted in the urine and bile. In tracer studies, it was found that approximately 20% of an injected dose of phylloquinone (Vitamin K metabolite) was found in the urine whereas about 40-50 % was excreted in the feces via the biliary system. The proportion of drug excreted was the same regardless of whether the injected dose was 1 mg or 45 g. It can, therefore, be inferred that about 60-70% percent of the amounts of phylloquinone absorbed from each vitamin-K containing meal will be lost to the body by excretion. Two major human excretion products have been identified: carboxylic acids with 5 and 7-carbon sidechains that are excreted in the urine as glucuronide conjugates. The biliary metabolites have not been clearly identified but are initially excreted as water-soluble conjugates and become lipid soluble during their passage through the gut, probably through deconjugation by the gut flora. There is no evidence for body stores of vitamin K being conserved by an enterohepatic circulation. Vitamin K itself is too lipophilic to be excreted in the bile and the sidechain-shortened carboxylic acid metabolites are not biologically active.


Volume of Distribution

In a study of rabbits, the apparent volume of distribution (V(d)/F) in plasma was 30.833 12.835 L.


Clearance

The plasma clearance (CL/F) of VK3 was 0.822 0.254 L min-1. [LI572]


5.3 Metabolism/Metabolites

Menadione or 2-methyl-1,4-naphthoquinone is a synthetic vitamin K analog, undergoes 1-electron reduction by enzymes such as microsomal NADPHcytochrome P450 reductase and mitochondrial NADHubiquinone oxidoreductase (complex I), resulting in redox cycling, or it detoxification via two-electron reduction by NAD(P)Hquinone oxidoreductase. Vitamin K is a group of lipophilic, hydrophobic vitamins that exist naturally in two forms (and in 3 synthetic forms): vitamin K1, which is found in plants, and vitamin K2, which is synthesized by bacteria. Vitamin K is an important dietary component because it is necessary as a cofactor in the activation of vitamin K dependent proteins. Metabolism of vitamin K occurs mainly in the liver. In the first step, vitamin K is reduced to its quinone form by a quinone reductase such as NADPH dehydrogenase. Reduced vitamin K is the form required to convert vitamin K dependent protein precursors to their active states. It acts as a cofactor to the integral membrane enzyme vitamin K-dependent gamma-carboxylase (along with water and carbon dioxide as co-substrates), which carboxylates glutamyl residues to gamma-carboxy-glutamic acid residues on certain proteins, activating them. Each converted glutamyl residue produces a molecule of vitamin K epoxide, and certain proteins may have more than one residue requiring carboxylation. To end the cycle, the vitamin K epoxide is returned to vitamin K via the vitamin K epoxide reductase enzyme, also an integral membrane protein. The vitamin K dependent proteins include various important coagulation factors, such as prothrombin. Warfarin and other coumarin drugs act as anticoagulants by blocking vitamin K epoxide reductase.


5.4 Biological Half-Life

Mean elimination half-life of menadione was 27.17 min in the plasma of rabbits, in one study.


5.5 Mechanism of Action

Menadiol sodium phosphate (vitamin K3) is involved as a cofactor in the posttranslational gamma-carboxylation of glutamic acid residues of various proteins in the body, allowing for propagation of the clotting cascade that results in coagulation. These proteins are comprised of the vitamin K-dependent coagulation factors II (prothrombin), VII (proconvertin), IX (Christmas factor), X (Stuart factor), protein C, protein S, protein Zv and a growth-arrest-specific factor (Gas6). The two vitamin K-dependent proteins found in bone are osteocalcin, also known as bone G1a (gamma-carboxyglutamate) protein or BGP, and the matrix G1a protein or MGP. Gamma-carboxylation is catalyzed by the vitamin K-dependent gamma-carboxylases. The reduced form of vitamin K, vitamin K hydroquinone, is the actual cofactor for the gamma-carboxylases. Proteins containing gamma-carboxyglutamate are called G1a proteins.


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