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Doripenem
Also known as: 148016-81-3, Doribax, S-4661, Finibax, Bhv525jobh, (4r,5s,6s)-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-3-[(3s,5s)-5-[(sulfamoylamino)methyl]pyrrolidin-3-yl]sulfanyl-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid
Molecular Formula
C15H24N4O6S2
Molecular Weight
420.5  g/mol
InChI Key
AVAACINZEOAHHE-VFZPANTDSA-N
FDA UNII
BHV525JOBH

A carbapenem derivative antibacterial agent that is more stable to renal dehydropeptidase I than IMIPENEM, but does not need to be given with an enzyme inhibitor such as CILASTATIN. It is used in the treatment of infections such as HOSPITAL-ACQUIRED PNEUMONIA, and complicated intra-abdominal or urinary-tract infections, including PYELONEPHRITIS.
Doripenem is a Penem Antibacterial.
1 2D Structure

Doripenem

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(4R,5S,6S)-6-[(1R)-1-hydroxyethyl]-4-methyl-7-oxo-3-[(3S,5S)-5-[(sulfamoylamino)methyl]pyrrolidin-3-yl]sulfanyl-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid
2.1.2 InChI
InChI=1S/C15H24N4O6S2/c1-6-11-10(7(2)20)14(21)19(11)12(15(22)23)13(6)26-9-3-8(17-5-9)4-18-27(16,24)25/h6-11,17-18,20H,3-5H2,1-2H3,(H,22,23)(H2,16,24,25)/t6-,7-,8+,9+,10-,11-/m1/s1
2.1.3 InChI Key
AVAACINZEOAHHE-VFZPANTDSA-N
2.1.4 Canonical SMILES
CC1C2C(C(=O)N2C(=C1SC3CC(NC3)CNS(=O)(=O)N)C(=O)O)C(C)O
2.1.5 Isomeric SMILES
C[C@@H]1[C@@H]2[C@H](C(=O)N2C(=C1S[C@H]3C[C@H](NC3)CNS(=O)(=O)N)C(=O)O)[C@@H](C)O
2.2 Other Identifiers
2.2.1 UNII
BHV525JOBH
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 2-(5-sulfamoylaminomethylpyrrolidin-3-ylthio)-6-(1-hydroxyethyl)-1-methylcarbapen-2-em-3-carboxylic Acid

2. S 4661

3. S-4661

4. S4661

2.3.2 Depositor-Supplied Synonyms

1. 148016-81-3

2. Doribax

3. S-4661

4. Finibax

5. Bhv525jobh

6. (4r,5s,6s)-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-3-[(3s,5s)-5-[(sulfamoylamino)methyl]pyrrolidin-3-yl]sulfanyl-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

7. S 4661

8. (4r,5s,6s)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-3-(((3s,5s)-5-((sulfamoylamino)methyl)pyrrolidin-3-yl)thio)-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

9. Ncgc00167510-01

10. Drpm

11. Dsstox_cid_26678

12. Dsstox_rid_81814

13. Dsstox_gsid_46678

14. 1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid, 3-(((3s,5s)-5-(((aminosulfonyl)amino)methyl)-3-pyrrolidinyl)thio)-6-((1r)-1-hydroxyethyl)-4-methyl-7-oxo-, (4r,5s,6s)-

15. Doripenem [inn]

16. (+)-(4r,5s,6s)-6-((1r)-1-hydroxyethyl)-4-methyl-7-oxo-3-(((3s,5s)-5-((sulfamoylamino)methyl)-3-pyrrolidinyl)thio)-1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid

17. Cas-148016-81-3

18. Doripenem (usan/inn)

19. Doripenem [usan:inn]

20. Unii-bhv525jobh

21. (4r,5s,6s)-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-3-({(3s,5s)-5-[(sulfamoylamino)methyl]pyrrolidin-3-yl}sulfanyl)-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

22. (4r,5s,6s)-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-3-{[(3s,5s)-5-[(sulfamoylamino)methyl]pyrrolidin-3-yl]sulfanyl}-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

23. Doripenem [mi]

24. Doripenem [usan]

25. (4r,5s,6s)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-3-((3s,5s)-5-((sulfamoylamino)methyl)pyrrolidin-3-ylthio)-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

26. Doripenem [vandf]

27. Doripenem [mart.]

28. Doripenem [who-dd]

29. Schembl37471

30. Doripenem [ema Epar]

31. Chembl491571

32. Doripenem [orange Book]

33. Dtxsid2046678

34. Gtpl12183

35. Chebi:135928

36. Bcpp000252

37. Hy-b0187

38. Zinc3922770

39. Tox21_112508

40. Bdbm50088382

41. Mfcd02092739

42. S5531

43. Akos015918362

44. Compound 1m [pmid: 8621362]

45. Tox21_112508_1

46. Am84446

47. Bcp9000623

48. Ccg-268891

49. Cs-2075

50. Db06211

51. Ncgc00167510-02

52. D5249

53. D03895

54. 016d813

55. Q411552

56. Sr-01000872589

57. Sr-01000872589-1

58. (4r,5s,6s)-3-[[(3s,5s)-5-[[(aminosulfonyl)amino]methyl]-3-pyrrolidinyl]thio]-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

59. (4r,5s,6s)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-3-(((3s,5s)-5-((sulfamoylamino)methyl)pyrrolidin-3-yl)thio)-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylicacid

60. 1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid, 3-((5-(((aminosulfonyl)amino)methyl)-3-pyrrolidinyl)thio)-6-(1-hydroxyethyl)-4-methyl-7-oxo-, (4r-(3(3s*,5s*),4alpha,5beta,6beta(r*)))-

61. O6p

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 420.5 g/mol
Molecular Formula C15H24N4O6S2
XLogP3-3.4
Hydrogen Bond Donor Count5
Hydrogen Bond Acceptor Count10
Rotatable Bond Count7
Exact Mass420.11372685 g/mol
Monoisotopic Mass420.11372685 g/mol
Topological Polar Surface Area196 Ų
Heavy Atom Count27
Formal Charge0
Complexity780
Isotope Atom Count0
Defined Atom Stereocenter Count6
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameDoribax
PubMed HealthDoripenem (Injection)
Drug ClassesAntibiotic
Drug LabelDORIBAX, doripenem monohydrate for injection vials contain 500 mg of doripenem on an anhydrous basis, a white to slightly-yellowish off-white sterile crystalline powder. All references to doripenem activity are expressed in terms of the active dori...
Active IngredientDoripenem
Dosage FormInjectable
RouteIv (infusion)
Strength500mg/vial; 250mg/vial
Market StatusPrescription
CompanyShionogi

2 of 2  
Drug NameDoribax
PubMed HealthDoripenem (Injection)
Drug ClassesAntibiotic
Drug LabelDORIBAX, doripenem monohydrate for injection vials contain 500 mg of doripenem on an anhydrous basis, a white to slightly-yellowish off-white sterile crystalline powder. All references to doripenem activity are expressed in terms of the active dori...
Active IngredientDoripenem
Dosage FormInjectable
RouteIv (infusion)
Strength500mg/vial; 250mg/vial
Market StatusPrescription
CompanyShionogi

4.2 Drug Indication

Doripenem is indicated in the treatment of complicated intra-abdominal infections and complicated urinary tract infections, including pyelonephritis, caused by designated susceptible bacteria.


FDA Label


Doribax is indicated for the treatment of the following infections in adults:

- nosocomial pneumonia (including ventilator-associated pneumonia);

- complicated intra-abdominal infections;

- complicated urinary tract infections.

Consideration should be given to official guidance on the appropriate use of antibacterial agents.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Similar to other beta-lactam antimicrobial agents, the time that unbound plasma concentration of doripenem exceeds the MIC (T>MIC) of the infecting organism has been shown to best correlate with efficacy in animal models of infection.


5.2 MeSH Pharmacological Classification

Anti-Bacterial Agents

Substances that inhibit the growth or reproduction of BACTERIA. (See all compounds classified as Anti-Bacterial Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
DORIPENEM
5.3.2 FDA UNII
BHV525JOBH
5.3.3 Pharmacological Classes
Established Pharmacologic Class [EPC] - Penem Antibacterial
5.4 ATC Code

J01DH04


J - Antiinfectives for systemic use

J01 - Antibacterials for systemic use

J01D - Other beta-lactam antibacterials

J01DH - Carbapenems

J01DH04 - Doripenem


5.5 Absorption, Distribution and Excretion

Absorption

Doripenem is administered intravenously as an infusion. There was no accumulation of doripenem following mulitiple infusions of either 500mg or 1g administered every 8 hours for 7-10 days in subjects with normal renal function.


Route of Elimination

Doripenem is primarily eliminated unchanged by the kidneys and undergoes glomerular filtration and active tubular secretion. A mean of 71% and 15% of the dose was recovered in urine as unchanged drug and the ring-opened metabolite, respectively, within 48 hours of 500 mg dose in healthy adults. Following the administration of a single 500 mg dose of radiolabeled doripenem to healthy adults, less than 1% of the total radioactivity was recovered in feces after one week.


Volume of Distribution

The average Vd is 16.8 L (8.09-55.5 L) at steady-state in healthy subjects. Doripenem penetrates into many tissues and fluids, including potential sites of approved indication infections.


Clearance

10.3 L/hour.


5.6 Metabolism/Metabolites

Metabolism of doripenem is via dehydropeptidase-I (also called dipeptidase-1) into a microbiologically inactive ring-opened metabolite, doripenem-M1. Doripenem does not appear to be a substrate of the hepatic CYP450 enzymes.


5.7 Biological Half-Life

1 hour, in healthy non-elderly adults.


5.8 Mechanism of Action

Doripenem is a broad-spectrum carbapenem antibiotic with activity against many gram-positive and gram-negative aerobic bacteria, as well as a variety of anaerobes. Like other beta-lactam antibiotics, doripenem's bactericidal mechanism of action is mostly due to cell death after inhibition of bacterial enzymes called penicillin-bindng proteins (PBPs), which are responsible for peptidoglycan cross-linking during the synthesis of the bacterial cell wall. Carbapenems mainly have high affinity for PBPs 1a, 1b, 2 and 3. Inhibition of each PBP usually results in a different inactivating mechanism. Inhibition of PBPs 1a and 1b results in fast bacterial killing through the formation of spheroplasts, inhibition of PBP 2 results in rod-shaped bacteria to become spherical, and inhibition of PBP 3 results in filamentous-shaped organisms. The PBPs preferentially bound by different carbapenems depend on the organism. In E.coli and P.aeruginosa, doripenem binds to PBP 2, which is involved in the maintenance of cell shape, as well as to PBPs 3 and 4. Doripenem has a 1-beta-methyl side chain, which allows it to be relatively resistant to dehydropeptidase, as well as a trans-alpha-1-hydroxyethyl group at position 6 which provides beta-lactamase resistance. Like other carbapenems, doripenem is different from most beta-lactams due to its stability against hydrolysis by most beta-lactamases, including penicillinases, cephalosporinases, ESBL, and Amp-C producing enterobacteriaceae.


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  • INJECTABLE;INTRAVENOUS - 250MG/VIAL **Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons**
  • INJECTABLE;INTRAVENOUS - 500MG/VIAL **Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons**
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