Author: kodiac

  • PPAP-HCl

    Catecholaminergic activity enhancer (CAE) and dopamine transporter reuptake inhibitor derived from the phenylalkylamine/substituted amphetamine scaffold

    A selegiline-derived catecholaminergic activity enhancer that potentiates impulse-dependent dopamine and norepinephrine release in the brain without monoamine oxidase inhibition, distinguished from classical psychostimulants by a broad therapeutic dose window and absence of uncontrolled monoamine efflux.

    Abstract

    PPAP-HCl, the hydrochloride salt of (-)-(R)-1-phenyl-2-propylaminopentane, is an experimental catecholaminergic activity enhancer (CAE) compound originally synthesized by Jozsef Knoll and colleagues at Semmelweis University in Budapest in the late 1980s as a structural derivative of selegiline (L-deprenyl) designed to retain the catecholaminergic enhancer activity of the parent compound while eliminating its monoamine oxidase (MAO) inhibitory property. The compound occupies a mechanistically distinct position in the catecholaminergic pharmacology space: at low-to-moderate concentrations, PPAP potentiates the impulse-propagation-mediated (action-potential-dependent) release of dopamine and norepinephrine from catecholaminergic nerve terminals without producing the uncontrolled, impulse-independent monoamine efflux characteristic of amphetamine and methamphetamine. This “enhancer” mechanism, first formally described by Knoll in 1992 and subsequently elaborated in a series of publications through 2005, operates independently of MAO inhibition, presynaptic autoreceptor blockade, and classical reuptake inhibition, and instead potentiates the vesicular exocytotic release event coupled to the arriving action potential. Recent pharmacological characterization reported in 2025 has expanded the mechanistic profile by demonstrating that PPAP also acts as a potent dopamine transporter (DAT) reuptake inhibitor with an IC50 of 57.5 nM, a norepinephrine transporter (NET) inhibitor at 571 nM, and a weak serotonin transporter (SERT) inhibitor at 19,000 nM, placing it in a dual-mechanism category that combines enhancer activity with catecholamine reuptake inhibition. Additional evidence suggests that PPAP and related synthetic enhancer compounds may exert their catecholaminergic effects through agonism at trace amine-associated receptor 1 (TAAR1), an intracellular G-protein-coupled receptor that modulates vesicular dopamine release through protein kinase C (PKC)-mediated phosphorylation of exocytotic machinery.

    In preclinical behavioral pharmacology, PPAP facilitates learning and retention in shuttle-box avoidance paradigms, potently antagonizes tetrabenazine-induced behavioral depression, reduces immobility in the forced swimming test, and increases locomotor activity across a broad dose range (2 to 50 mg/kg in rodents) without the narrow therapeutic window and stereotypy induction that characterize amphetamine-class stimulants. The therapeutic index in animal models exceeds that of amphetamine. Structure-activity relationship studies identified the (R)-enantiomer as the pharmacologically active form, while the racemic mixture (designated MK-306) retains partial activity. PPAP served as the reference catecholaminergic activity enhancer compound in the Knoll laboratory and led directly to the development of the more potent and serotonergically active successor compound BPAP [(-)1-(benzofuran-2-yl)-2-propylaminopentane] in 1999. PPAP has been proposed as a candidate for clinical development in depression, attention deficit hyperactivity disorder (ADHD), and Alzheimer’s disease, though no human clinical trials have been completed or published. The compound is not approved by any regulatory authority for therapeutic use and is available exclusively as a research-grade preparation. This monograph reviews the chemistry, synthesis, and stereochemistry of PPAP-HCl; the dual enhancer and reuptake-inhibitor pharmacology; the preclinical behavioral and neurochemical evidence base; the comparative assessment of five catecholaminergic and monoaminergic enhancer or stimulant candidates against PPAP on five competency standards; and the sourcing, reconstitution, and handling considerations for laboratory work.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1528Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Dianabol

    Synthetic 17-alpha-alkylated anabolic-androgenic steroid; testosterone derivative with C1-C2 dehydrogenation

    A 17-alpha-methylated, delta-1-dehydrogenated testosterone derivative developed at CIBA as an orally bioavailable anabolic agent, historically prescribed for catabolic wasting, osteoporosis, and nitrogen-balance restoration, and now principally encountered as a controlled substance of research interest in androgen receptor pharmacology, steroid metabolism, and anabolic-androgenic steroid toxicology.

    Abstract

    Metandienone (International Nonproprietary Name), known commercially as Dianabol and chemically as 17-alpha-methyl-delta-1-testosterone, is a synthetic anabolic-androgenic steroid (AAS) of the androstane class first synthesized at CIBA Pharmaceuticals in Switzerland in the mid-1950s and introduced to the United States prescription market in 1958. The compound is a structural modification of testosterone bearing two critical alterations: a methyl group at the C17-alpha position that confers oral bioavailability by resisting hepatic first-pass metabolism, and a delta-1 (C1-C2) double bond that modifies the anabolic-to-androgenic activity ratio relative to the parent hormone. Metandienone binds the androgen receptor (AR) in skeletal muscle, prostate, and other androgen-responsive tissues, initiating genomic signaling cascades that increase protein synthesis, nitrogen retention, and glycogenolysis. The compound undergoes aromatization by the CYP19A1 (aromatase) enzyme to 17-alpha-methylestradiol, producing dose-dependent estrogenic effects including fluid retention and gynecomastia. Hepatic metabolism proceeds principally through CYP3A4-catalyzed 6-beta-hydroxylation, with additional pathways including 5-beta-reduction, 3-alpha and 3-beta oxidation, and 17-epimerization; the 17-alpha-alkylation that confers oral bioavailability simultaneously produces the hepatotoxicity characteristic of this structural class.

    The compound was originally developed and marketed for the treatment of catabolic states, post-surgical recovery, osteoporosis, and hypogonadism. Clinical trials conducted in the late 1950s and 1960s demonstrated significant positive nitrogen balance at oral doses of 5 to 10 mg per day, with measurable increases in lean body mass and appetite stimulation. However, escalating recognition of the hepatotoxic, cardiovascular, endocrine-suppressive, and estrogenic adverse-effect profile led to progressive restriction of approved indications, and the United States Food and Drug Administration withdrew approval in 1983. The compound is currently classified as a Schedule III controlled substance in the United States under the Controlled Substances Act and is prohibited by the World Anti-Doping Agency. It is not approved for any medical indication in any major regulatory jurisdiction.

    Despite the absence of current clinical approval, metandienone remains a compound of substantial research interest. Its well-characterized androgen receptor pharmacology, its defined hepatotoxic mechanism as a model 17-alpha-alkylated steroid, its known metabolic pathways and urinary metabolite profile (exploited extensively in anti-doping analytical chemistry), and its historical clinical dataset in nitrogen-balance and muscle-wasting research provide a comprehensive pharmacological record. Preclinical studies in rat models have demonstrated that metandienone stimulates levator ani muscle hypertrophy through androgen receptor activation, suppresses the hypothalamic-pituitary-testicular axis, and modulates myostatin signaling pathways. This monograph reviews the chemistry, synthesis, and stereochemistry of metandienone; the androgen receptor pharmacology and mechanism of action; the comprehensive pharmacokinetic record including hepatic metabolism and urinary metabolite detection; the historical clinical evidence base; sourcing and quality verification considerations for research-grade material; reconstitution and handling; stack-interaction considerations; the adverse-event and safety signal across hepatic, cardiovascular, endocrine, and estrogenic domains; and a comparative assessment of five alternative anabolic-androgenic steroids (testosterone, oxandrolone, oxymetholone, stanozolol, nandrolone decanoate) against metandienone on five competency standards (oral bioavailability, anabolic efficacy, hepatotoxicity profile, estrogenic burden, and overall risk-benefit in research contexts).

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1552Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Dapoxetine

    Short-acting selective serotonin reuptake inhibitor (SSRI) with rapid-onset, rapid-elimination pharmacokinetics developed for on-demand treatment of premature ejaculation

    A naphthalene-derived phenylpropylamine SSRI originally developed at Eli Lilly as an antidepressant candidate, repositioned as the first and only oral pharmacotherapy specifically approved for on-demand treatment of premature ejaculation, distinguished from conventional SSRIs by rapid absorption, short initial half-life, and suitability for event-based rather than chronic dosing.

    Abstract

    Dapoxetine (LY 210448) is a short-acting selective serotonin reuptake inhibitor (SSRI) and the first oral pharmacotherapy specifically developed and approved for the on-demand treatment of premature ejaculation (PE) in adult men aged 18 to 64 years. Originally synthesized at Eli Lilly and Company as an antidepressant candidate in the late 1980s, the compound was shelved after failing to demonstrate sufficient efficacy in depression, subsequently licensed to Pharmaceutical Product Development (PPD) in 2003, and then advanced through Phase 3 clinical development by ALZA Corporation (a Johnson and Johnson subsidiary) for the PE indication. Dapoxetine received its first regulatory approvals in Finland and Sweden in 2009 under the trade name Priligy and has since been registered in over 60 countries across Europe, Asia, Latin America, and Oceania. The compound has not been approved by the United States Food and Drug Administration, which issued a not-approvable letter in 2005 citing the need for additional efficacy and safety data.

    The pharmacological mechanism of dapoxetine is inhibition of the serotonin transporter (SERT) at both peripheral and central sites, increasing serotonin availability at postsynaptic receptors in the ejaculatory pathway. Preclinical electrophysiology studies in anaesthetized rats demonstrated that dapoxetine inhibits the ejaculatory expulsion reflex at a supraspinal level, specifically modulating activity of lateral paragigantocellular nucleus (LPGi) neurons that project to spinal ejaculatory motor centers. The compound exhibits high selectivity for the serotonin transporter over the norepinephrine and dopamine transporters, with Ki values of approximately 1.0 nM for SERT, 66 nM for the norepinephrine transporter, and greater than 1000 nM for the dopamine transporter.

    The critical pharmacokinetic distinction of dapoxetine from conventional SSRIs (paroxetine, fluoxetine, sertraline, citalopram) is its rapid absorption and elimination profile. After oral administration, dapoxetine reaches maximum plasma concentration (Cmax) within approximately 1.0 to 1.3 hours, with an initial distribution half-life of 1.3 to 1.4 hours and a terminal elimination half-life of 18.7 to 21.9 hours. Oral bioavailability is approximately 42 percent, with substantial interindividual variability (range 15 to 76 percent) attributable to first-pass hepatic metabolism. Metabolism proceeds through CYP3A4, CYP2D6, and flavin-containing monooxygenase 1 (FMO1) pathways, producing dapoxetine N-oxide (inactive), N-desmethyldapoxetine (active), and N,N-didesmethyldapoxetine (active) as the principal circulating metabolites. Plasma protein binding exceeds 99 percent.

    Five pivotal Phase 3 randomized, double-blind, placebo-controlled trials enrolling 6,081 men across more than 25 countries established the clinical efficacy of dapoxetine at 30 mg and 60 mg on-demand doses. Integrated analysis demonstrated that mean intravaginal ejaculatory latency time (IELT) increased from a baseline of 0.9 minutes to 3.2 minutes with dapoxetine 30 mg and 3.5 minutes with dapoxetine 60 mg, compared to 1.9 minutes with placebo. Statistically significant improvements were observed across all patient-reported outcome domains including ejaculatory control, satisfaction with sexual intercourse, ejaculation-related personal distress, and interpersonal difficulty. The safety profile is consistent with the SSRI pharmacological class; the most common adverse events are nausea (8.7 to 20.1 percent), dizziness (5.8 to 10.9 percent), headache (5.6 to 8.8 percent), diarrhea (3.9 to 6.8 percent), and somnolence. A specific safety concern is vasovagal-mediated syncope, observed at rates of 0.06 percent with 30 mg and 0.23 percent with 60 mg compared to 0.05 percent with placebo. Dapoxetine is contraindicated with potent CYP3A4 inhibitors, monoamine oxidase inhibitors, other serotonergic agents, and in patients with significant cardiovascular disease or a history of syncope.

    This monograph reviews the chemistry, synthesis, and stereochemistry of dapoxetine; the serotonin transporter pharmacology and supraspinal ejaculatory reflex modulation mechanism in molecular and electrophysiological detail; the comprehensive human pharmacokinetic record including CYP2D6 and CYP3A4 metabolic polymorphism; the clinical evidence base across premature ejaculation and combination therapy with phosphodiesterase type 5 inhibitors; the reconstitution, sourcing, and quality verification considerations for laboratory work; stack-interaction implications; adverse-event signal including syncope and serotonin syndrome risk; and a comparative assessment of five alternative premature ejaculation pharmacotherapies against dapoxetine on five competency standards (novelty, effect size, promising potential, side-effect profile, and overall validation).

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1518Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Vesugen

    Synthetic tripeptide bioregulator (Lys-Glu-Asp) targeting vascular endothelial gene expression through epigenetic modulation

    A Khavinson-class synthetic tripeptide bioregulator derived from vascular wall protein sequences, characterized by epigenetic modulation of endothelial proliferation markers, endothelin-1 normalization, sirtuin-1 upregulation, and neuroprotective gene regulation in preclinical aging and Alzheimer’s disease models.

    Abstract

    Vesugen (Lys-Glu-Asp; KED) is a synthetic tripeptide bioregulator developed at the Saint Petersburg Institute of Bioregulation and Gerontology under the direction of Professor Vladimir Khavinson as part of a decades-long program investigating short-chain peptide regulation of age-associated tissue decline. The compound belongs to the Khavinson class of ultrashort (two to four amino acid residue) bioregulatory peptides, a family of synthetic sequences derived from organ-specific protein fractions that are proposed to penetrate cell nuclei and modulate gene expression through direct interactions with DNA promoter regions and epigenetic regulatory mechanisms. Vesugen is the synthetic analog corresponding to the vascular-wall-derived peptide fraction originally isolated as the active component of Ventfort, a polypeptide complex extracted from bovine aortic tissue. The tripeptide sequence Lys-Glu-Asp was identified as the minimal bioactive motif responsible for the vasoprotective activity of the parent extract.

    The molecular pharmacology of Vesugen is characterized by epigenetic modulation of vascular endothelial cell function. In dissociated human endothelial cell cultures, Vesugen stimulates synthesis of the proliferation-associated protein Ki-67, the expression of which declines during cellular aging [1]. Molecular docking studies demonstrate that Vesugen binds to the promoter region of the MKI67 gene, making contact through the CATC sequence at the core promoter located between positions -14 and +12 relative to the transcription initiation site [1]. In models of atherosclerotic and restenotic endothelium in vitro, Vesugen normalizes the expression of endothelin-1, restores connexin (Cx37, Cx43) expression for intercellular communication, and increases sirtuin-1 (SIRT1) expression, implicating the compound in DNA repair and cellular longevity pathways [2, 3]. The compound also modulates expression of vascular endothelial growth factor (VEGF) and the apoptosis marker p53, contributing to a net pro-proliferative and anti-apoptotic phenotype in aged vascular endothelial cells.

    Beyond its primary vascular target, Vesugen has demonstrated neuroprotective activity in several preclinical models. The tripeptide regulates expression of cell aging and apoptosis genes (p16, p21), neuronal differentiation genes and proteins (NES, GAP43, nestin), and genes implicated in Alzheimer’s disease pathogenesis (SUMO, APOE, IGF1) [4]. In hippocampal neuron cultures exposed to amyloid-beta synaptotoxicity, Vesugen increased the number of mushroom-type dendritic spines by 20 percent [5]. Oral administration of Vesugen improved memory and attention in elderly individuals with functional central nervous system disorders in a small clinical cohort [4]. In a 32-patient clinical study of elderly individuals with chronic polymorbidity and organic brain syndrome, Vesugen demonstrated anabolic properties and improved central nervous system activity, slowing the rate of aging as measured by biological age indicators [6].

    The compound is not approved by any national regulatory authority as a pharmaceutical product. It is supplied as a research-grade synthetic peptide and as a dietary supplement (capsule form) in certain jurisdictions. The primary literature on Vesugen originates predominantly from Russian research institutions, principally the Saint Petersburg Institute of Bioregulation and Gerontology and affiliated laboratories. Independent replication by Western laboratories using contemporary structural biology and pharmacology methodologies remains limited. This monograph reviews the chemistry, proposed mechanism of action, preclinical pharmacology, limited clinical evidence, sourcing and handling considerations, and a comparative assessment against five alternative vasoprotective and geroprotective peptide candidates.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1510Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Thymalin

    Plain-language summaryIntrigue 58 / 100

    Thymalin is a Russian-developed bovine thymus peptide preparation used as an immunomodulator for elderly patients and immune disorders. Combined with epitalon in Khavinson’s longevity research. Not stocked by Kodiac. This monograph is provided for research and educational reference.

    Intrigue 0–100 blends mechanism novelty, evidence strength, and translational potential. Kodiac editorial, not peer-reviewed.

    Thymic polypeptide bioregulator complex with immunomodulatory and geroprotective activity

    A heterogeneous polypeptide complex isolated from calf thymus, developed at the Military Medical Academy in Leningrad as a thymic bioregulator for immune restoration, distinguished from other thymic peptide preparations by its multicomponent composition containing the immunomodulatory dipeptides L-glutamyl-L-tryptophan and L-lysyl-L-glutamic acid and the tripeptide L-glutamyl-L-aspartyl-L-proline.

    Abstract

    Thymalin is a standardized polypeptide complex isolated from the thymus gland of calves by acid hydrolysis and ultrafiltration, containing peptide fractions in the 1,000 to 10,000 dalton molecular weight range. Developed at the Military Medical Academy in Leningrad (now Saint Petersburg) by Vladimir Khavinson and Vyacheslav Morozov in the 1970s, the preparation was registered as an immunomodulatory pharmaceutical in the Soviet Union in 1982 and has remained in clinical use in the Russian Federation for more than four decades. Unlike the structurally defined thymic peptides thymosin alpha-1 (a 28-amino-acid single-sequence peptide), thymulin (a zinc-dependent nonapeptide), and thymopentin (a synthetic pentapeptide fragment of thymopoietin), Thymalin is a multicomponent extract whose principal bioactive constituents have been identified by reversed-phase high-performance liquid chromatography as the dipeptide L-glutamyl-L-tryptophan (Glu-Trp, subsequently developed independently as Thymogen), the dipeptide L-lysyl-L-glutamic acid (Lys-Glu, developed as Vilon), and the tripeptide L-glutamyl-L-aspartyl-L-proline (Glu-Asp-Pro, developed as Crystagen). The molecular mechanism of the immunoprotective activity is attributed to the capacity of these short peptides to bind selectively to double-stranded DNA sequences and to histone proteins, thereby modulating chromatin conformation, gene expression, and the synthesis of immune system proteins including interleukins, interferons, heat-shock proteins, and components of the fibrinolytic system. In experimental systems, Thymalin stimulates the differentiation and functional activity of T-lymphocyte subpopulations (CD4+ and CD8+), normalizes the ratio of T-helper to T-suppressor cells, enhances natural killer cell activity and phagocytosis, and modulates the balance between pro-inflammatory and anti-inflammatory cytokines. The geroprotective properties of Thymalin are supported by a prospective clinical observation of 266 elderly subjects over 6 to 8 years conducted at the St. Petersburg Institute of Bioregulation and Gerontology and the Institute of Gerontology of the Ukrainian Academy of Medical Sciences, in which Thymalin-treated subjects exhibited 2.0- to 2.1-fold lower mortality compared to controls receiving standard geriatric care, with further reductions (4.1-fold lower mortality) observed in a subgroup receiving annual combined Thymalin and Epithalamin treatment for 6 years. More recently, a prospective randomized single-blind controlled trial of Thymalin (10 mg intramuscular daily for 10 days) in 80 elderly patients with severe COVID-19 reported a 92 percent increase in blood lymphocytes, 6.5-fold reduction in interleukin-6, halved in-hospital mortality (19.4 percent versus 40.9 percent in controls), and more rapid clinical improvement (80.5 percent versus 59 percent). In vitro studies have demonstrated that Thymalin reduces expression of the stem cell markers CD44 and CD117 by 2- to 3-fold while increasing expression of CD28 (a marker of mature T lymphocytes) by 6.8-fold, consistent with stimulation of hematopoietic stem cell differentiation into functional T cells. The compound is administered by intramuscular or subcutaneous injection in short cyclical courses of 5 to 10 days at doses of 5 to 10 mg daily, with clinical effect reported to persist for weeks to months following each treatment course. The safety record across more than 40 years of clinical use indicates minimal adverse events, principally limited to injection-site reactions. This monograph reviews the composition, extraction, and characterization of Thymalin; the molecular pharmacology of its constituent peptides at the level of DNA binding, histone interaction, and gene expression regulation; the pharmacokinetic properties; the preclinical evidence base across immune restoration, geroprotection, and oncology models; the clinical evidence in elderly immune decline, respiratory infections, perioperative immune suppression, and COVID-19; sourcing and quality verification considerations; reconstitution and handling protocols; stack interactions with other immunomodulatory agents; the adverse-event and safety profile; and a comparative assessment of five alternative thymic and immunomodulatory peptide preparations against Thymalin on five competency standards (novelty, effect size, promising potential, side-effect profile, and overall validation).

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1504Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • NSI-189

    Plain-language summaryIntrigue 45 / 100

    NSI-189 is a small molecule developed at Neuralstem to stimulate hippocampal neurogenesis (the birth of new neurons in the dentate gyrus). Preclinical rodent studies showed proliferation of neural progenitor cells, hippocampal volume increase, and antidepressant-like behavior in chronic stress models, generating considerable hope that this could be a fundamentally new class of antidepressant. Phase 1 trials were uneventful. Phase 2 trials in major depression in 2014 and 2017 failed to beat placebo on the primary endpoints, and Neuralstem ended development. It briefly became popular in nootropic communities sourced as a research chemical, on the strength of secondary cognitive endpoints in the failed trials. The clinical case is essentially closed. Not stocked by Kodiac. This monograph is provided for research and educational reference.

    Intrigue 0–100 blends mechanism novelty, evidence strength, and translational potential. Kodiac editorial, not peer-reviewed.

    Benzylpiperazine-aminopyridine neurogenic compound with indirect brain-derived neurotrophic factor modulation and hippocampal neurogenesis stimulation

    A first-in-class small molecule neurogenic agent discovered through phenotypic screening of human hippocampal neural stem cells, developed for major depressive disorder and under investigation for cognitive impairment, diabetic neuropathy, and post-traumatic stress disorder.

    Abstract

    NSI-189 (amdiglurax; ALTO-100) is a benzylpiperazine-aminopyridine small molecule identified through a phenotypic screen of approximately 10,000 compounds against human hippocampal neural stem cells and advanced as a first-in-class hippocampal neurogenesis stimulator for the treatment of major depressive disorder (MDD). The compound was discovered by Karl Johe and colleagues at Neuralstem, Inc. (Germantown, Maryland) and is now under development by Alto Neuroscience (Mountain View, California) under the designation ALTO-100. NSI-189 is mechanistically distinct from all marketed antidepressants: it has no detectable activity at serotonin, norepinephrine, or dopamine transporters, no binding at 52 standard neurotransmitter receptor and ion channel targets, and no activity across a panel of 900 kinases. Instead, the compound stimulates proliferation and neurogenic differentiation of hippocampal neural stem cells in vitro with low-micromolar potency and, on oral administration to rodents at 10 to 30 mg/kg/day, produces dose-dependent increases in hippocampal volume (up to 66 percent at 30 mg/kg in mice), upregulation of brain-derived neurotrophic factor (BDNF), stem cell factor (SCF), glial cell line-derived neurotrophic factor (GDNF), and vascular endothelial growth factor (VEGF), and activation of the TrkB/Akt signaling pathway. The morphological effects are confined to the dentate gyrus of the hippocampus and the subventricular zone; no structural changes have been observed elsewhere in the brain. A bell-shaped dose-response relationship is observed in preclinical hippocampal volume endpoints, with 100 mg/kg producing less effect than 30 mg/kg, suggesting an optimal range for neurogenic stimulation.

    Clinical development has proceeded through Phase 1 (41 healthy volunteers, 2011), Phase 1b (24 MDD patients, Fava et al. 2016, published in Molecular Psychiatry), and Phase 2 (220 MDD outpatients, Papakostas et al. 2020, published in Molecular Psychiatry). The Phase 1b trial demonstrated safety and tolerability at 40, 80, and 120 mg daily for 28 days, with medium-to-large effect sizes on the Symptoms of Depression Questionnaire (SDQ) and the Cognitive and Physical Functioning Questionnaire (CPFQ). The Phase 2 trial, conducted using a sequential-parallel comparison design across 12 weeks, did not meet its primary endpoint (change from baseline on the Montgomery-Asberg Depression Rating Scale, MADRS) at either 40 mg or 80 mg daily. However, 40 mg daily produced statistically significant improvements on the SDQ (pooled mean difference -8.2; Cohen’s d = -0.64 in Stage 2; p = 0.04), the CPFQ (pooled mean difference -1.9; p = 0.03), and several objective cognitive measures on the CogScreen battery (Cohen’s d ranging from 0.12 to 1.12 for significant measures). Hippocampal volume was not significantly changed in MDD patients at the studied doses and duration, despite the robust preclinical volumetric signal.

    Alto Neuroscience acquired the NSI-189 program in October 2021 and redesignated the compound ALTO-100. A Phase 2b trial (301 adults with MDD, 34 U.S. sites, 6 weeks, biomarker-enriched design using a cognitive memory test) reported topline results in 2024: ALTO-100 did not demonstrate statistically significant improvement in MADRS versus placebo in the biomarker-defined population and did not meet secondary endpoints. The compound was well tolerated, with headache, nausea, and abnormal dreams as the most common adverse events at rates similar to placebo. A Phase 2b trial in bipolar depression is expected to report in 2026, and the compound remains under investigation for post-traumatic stress disorder.

    Preclinical pharmacology extends beyond depression. NSI-189 reverses cognitive and motor deficits in a rat model of ischemic stroke (30 mg/kg oral), ameliorates central and peripheral neuropathy in mouse models of type 1 and type 2 diabetes (10 to 30 mg/kg oral), enhances synaptic plasticity and reverses motor and cognitive impairments in a mouse model of Angelman syndrome through TrkB/Akt pathway activation, and enhances long-term potentiation in hippocampal slice preparations in vitro. The compound has linear pharmacokinetics across the 40 to 120 mg/day clinical dose range, an oral Tmax of 1 to 2 hours, a plasma elimination half-life of 17.4 to 20.5 hours supporting once-daily dosing, and achieves steady state within 4 to 5 days.

    This monograph reviews the chemical identity and synthesis of NSI-189; the discovery through phenotypic screening; the molecular pharmacology and neurotrophic factor cascade; the comprehensive pharmacokinetic profile; the preclinical evidence base across depression, stroke, neuropathy, and Angelman syndrome models; the clinical evidence base from Phase 1 through Phase 2b; sourcing, reconstitution, and handling considerations; stack interactions; the adverse-event and safety signal; and a structured comparative assessment of five neurogenesis-associated compounds (fluoxetine, ketamine, agomelatine, psilocybin, and 7,8-dihydroxyflavone) against NSI-189 on five competency standards. The compound is not approved by any regulatory authority for any indication. It is sold as a research-grade preparation; investigators should obtain analytical confirmation of identity and purity on every lot.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1493Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Piperlongumine

    Electrophilic alpha,beta-unsaturated delta-valerolactam alkaloid amide with pro-oxidant and multi-target anticancer activity

    A naturally occurring cinnamoyl-dihydropyridinone amide alkaloid isolated from Piper longum L. (long pepper) with selective pro-oxidant cytotoxicity toward transformed cells, multi-pathway anticancer pharmacology spanning ROS accumulation, GSTP1 and TrxR1 inhibition, NF-kB suppression, STAT3 antagonism, PI3K/Akt/mTOR pathway downregulation, and NLRP3 inflammasome blockade, and emerging senolytic activity against radiation-induced and replicative senescent fibroblasts.

    Abstract

    Piperlongumine (piplartine, 5,6-dihydro-1-[(2E)-1-oxo-3-(3,4,5-trimethoxyphenyl)-2-propenyl]-2(1H)-pyridinone; CAS 20069-09-4; molecular formula C17H19NO5; molecular weight 317.34 g/mol) is an amide alkaloid constituent of the fruit, root, and stem of Piper longum L. (long pepper), a plant of the Piperaceae family native to the Indian subcontinent and Southeast Asia with a centuries-long history of use in Ayurvedic and traditional Chinese medicine. The compound was first isolated and structurally characterized by Chatterjee and Dutta in 1963 and remained a minor phytochemical curiosity until the landmark 2011 report by Raj et al. in Nature, which identified piperlongumine through an unbiased chemical screen as a small molecule that selectively kills cancer cells and oncogene-transformed cells but not normal cells by inducing the accumulation of reactive oxygen species (ROS), irrespective of p53 status or proliferation rate [1]. That demonstration catalyzed an extensive preclinical research literature that now spans more than two dozen cancer histologies, multiple molecular targets, and several emerging non-oncologic applications including senolytic clearance of senescent cells, neuroinflammation, and metabolic disease.

    The molecular pharmacology of piperlongumine centers on its electrophilic alpha,beta-unsaturated carbonyl system, which reacts covalently with nucleophilic cysteine residues on multiple redox-regulatory and signaling proteins. Direct binding targets include glutathione S-transferase pi 1 (GSTP1), thioredoxin reductase 1 (TrxR1), and carbonyl reductase 1 (CBR1), whose inhibition impairs cellular antioxidant defenses and elevates intracellular ROS (principally hydrogen peroxide and superoxide) to levels that exceed the already elevated oxidative baseline of transformed cells [1, 2, 3]. Downstream consequences include ROS-dependent downregulation of specificity protein transcription factors Sp1, Sp3, and Sp4 and their pro-oncogenic target genes (cyclin D1, survivin, cMyc, EGFR, cMet) [4]; inhibition of the NF-kB signaling pathway with suppression of pro-inflammatory and pro-survival gene expression [5, 6]; direct inhibition of STAT3 phosphorylation and dimerization [7]; inhibition of PI3K/Akt/mTOR signaling with consequent promotion of autophagy and apoptosis [8, 9]; and blockade of NLRP3 inflammasome assembly through disruption of NLRP3-NEK7 association and NLRP3 oligomerization [10]. The compound has also been identified as a ligand for the orphan nuclear receptor NR4A1 (Nur77) [11]. The selectivity for cancer cells over normal cells is attributed to the higher basal ROS burden and the greater dependence on antioxidant buffering capacity in transformed cells; normal cells, operating at lower oxidative stress, tolerate the moderate ROS elevation induced by piperlongumine without reaching the apoptotic threshold.

    Pharmacokinetic characterization in rodent models indicates oral bioavailability of approximately 50 to 76 percent (dose-dependent, inversely related to dose in the 5 to 10 mg/kg range in rats), low hepatic extraction ratio (E = 0.09), plasma protein binding of approximately 93 percent, and metabolism by multiple CYP isoenzymes producing several hydroxylated and demethylated metabolites [12, 13]. The compound exhibits poor aqueous solubility (approximately 26 micrograms per milliliter in water at ambient pH) but adequate solubility in dimethyl sulfoxide, ethanol, PEG 400, and lipid-based formulations. Stability is pH-dependent, with maximum stability near pH 4 and significant degradation at alkaline pH values and under ultraviolet irradiation [14]. No human pharmacokinetic data have been published; the compound has not entered formal clinical trials as of the most recent monograph revision, though the extensive preclinical evidence base and favorable rodent safety profile support advancement to first-in-human studies.

    In vivo antitumor efficacy has been demonstrated in xenograft models of colorectal, pancreatic, lung, breast, head and neck, thyroid, prostate, and cervical cancers at intraperitoneal doses of 2.4 to 10 mg/kg per day, with significant tumor growth inhibition and no apparent systemic toxicity to normal tissues in treated animals [1, 15, 16, 17, 18]. Synergistic combinations with conventional chemotherapeutics (cisplatin, gemcitabine, paclitaxel, oxaliplatin, doxorubicin, 5-fluorouracil) have been reported across multiple tumor types, with the ROS-elevating mechanism of piperlongumine sensitizing resistant cells to cytotoxic therapy [19, 20, 21]. A second application of growing interest is the senolytic activity first reported by Wang et al. (2016), who demonstrated that piperlongumine selectively kills radiation-induced, replicative, and oncogene-induced senescent human WI-38 fibroblasts and synergizes with the BH3 mimetic ABT-263 in senescent cell clearance [22]. Subsequent medicinal chemistry optimization has produced piperlongumine analogs with up to 50-fold enhanced senolytic potency [23].

    This monograph documents the chemistry, isolation, and synthesis of piperlongumine; the multi-target molecular pharmacology; the rodent pharmacokinetic profile; the preclinical antitumor and senolytic evidence base; the absence of clinical trial data and the translational considerations for first-in-human development; sourcing and quality verification; reconstitution and handling; stack-interaction considerations; adverse-event and safety signal from animal studies; and a structured comparative assessment of five pro-oxidant or senolytic natural products (withaferin A, sulforaphane, parthenolide, curcumin, fisetin) against piperlongumine on five competency standards.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1482Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Fluvoxamine

    Plain-language summaryIntrigue 71 / 100

    Fluvoxamine (Luvox) is an SSRI with a structural backbone unlike the others in its class, developed by Solvay and approved in the US in 1994. It is a first-line drug for OCD and also useful in social anxiety. The pharmacological wrinkle that makes researchers care about it is high-affinity activation of the sigma-1 receptor, an unusual cellular target involved in stress response, neuroprotection, and possibly viral defense. That sigma-1 hook briefly made fluvoxamine a topic of pandemic-era research after small trials suggested it might reduce hospitalization risk in early COVID-19, although larger follow-up trials have been mixed. It also strongly blocks the liver enzyme CYP1A2, which raises blood levels of caffeine, theophylline, and several other common drugs. Not stocked by Kodiac. This monograph is provided for research and educational reference.

    Intrigue 0–100 blends mechanism novelty, evidence strength, and translational potential. Kodiac editorial, not peer-reviewed.

    Selective serotonin reuptake inhibitor with high-affinity sigma-1 receptor agonism

    A 2-aminoethyl oxime ether SSRI developed at Kali-Duphar as an antidepressant and anti-obsessional agent, distinguished from other serotonin reuptake inhibitors by potent sigma-1 receptor agonism and downstream anti-inflammatory, cytoprotective, and endoplasmic reticulum chaperone activity.

    Abstract

    Fluvoxamine, the (E)-5-methoxy-1-[4-(trifluoromethyl)phenyl]pentan-1-one O-(2-aminoethyl)oxime, is a selective serotonin reuptake inhibitor (SSRI) of the 2-aminoethyl oxime ether structural class, first introduced in Switzerland in 1983 as Floxyfral and approved by the United States Food and Drug Administration in December 1994 for the treatment of obsessive-compulsive disorder (OCD). It is marketed in approximately 80 countries under the trade names Luvox, Fevarin, Faverin, Floxyfral, and Dumyrox for indications including OCD, social anxiety disorder (SAD), and major depressive disorder (MDD), with the extended-release formulation (Luvox CR) approved in the United States in 2008 for both OCD and SAD. Fluvoxamine is pharmacologically distinguished from the other marketed SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram) by its potent agonism at the sigma-1 receptor, a ligand-regulated endoplasmic reticulum chaperone protein, with a binding affinity (Ki approximately 36 nM) that is the highest of any clinically used SSRI and approximately 10-fold greater than that of sertraline, the next most potent sigma-1 ligand in the class [1, 2]. The sigma-1 receptor activity, formally characterized by Narita et al. (1996) and subsequently extended by multiple laboratory groups in rodent models and by Hashimoto and colleagues in translational studies, drives a pharmacological profile that extends substantially beyond serotonin reuptake inhibition: activation of the sigma-1 receptor chaperone at the mitochondria-associated endoplasmic reticulum membrane (MAM) modulates the inositol 1,4,5-trisphosphate receptor (IP3R), stabilizes the IRE1-BiP complex under endoplasmic reticulum stress, suppresses NLRP3 inflammasome and NF-kappaB-driven proinflammatory cytokine release, and potentiates nerve growth factor-induced neurite outgrowth in neuronal cell models [3, 4, 5]. These properties have positioned fluvoxamine as a candidate for drug repositioning in inflammatory and infectious disease, most notably in the SARS-CoV-2 pandemic, where the TOGETHER trial (Reis et al. 2022) demonstrated a 32 percent relative risk reduction in the composite endpoint of emergency department retention or hospitalization among high-risk COVID-19 outpatients treated with fluvoxamine 100 mg twice daily for 10 days compared to placebo [6]. Pharmacokinetics in humans are characterized by near-complete gastrointestinal absorption, approximately 53 percent oral bioavailability due to first-pass hepatic metabolism, a plasma elimination half-life of 12 to 15 hours after single doses (extended at steady state owing to nonlinear pharmacokinetics from autoinhibition of CYP1A2 and CYP2C19), and oxidative demethylation through CYP2D6 and CYP1A2 followed by glucuronide conjugation and renal excretion [7, 8]. Fluvoxamine is itself a potent inhibitor of CYP1A2 and CYP2C19 and a moderate inhibitor of CYP3A4 and CYP2C9, producing clinically significant drug-drug interactions with theophylline, tizanidine, alosetron, clozapine, warfarin, and ramelteon, among others [9]. The compound is well tolerated at registered doses; the principal adverse events are nausea (up to 40 percent), somnolence, insomnia, headache, and asthenia, with serotonin syndrome as a rare but serious risk in combination with other serotonergic agents or monoamine oxidase inhibitors. This monograph reviews the chemistry, synthesis, and structural class of fluvoxamine; the dual SSRI and sigma-1 receptor pharmacology in molecular and translational detail; the comprehensive human pharmacokinetic record; the clinical evidence base across OCD, SAD, MDD, COVID-19, and investigational anti-inflammatory indications; sourcing and quality verification considerations; reconstitution and handling; stack-interaction considerations; adverse-event signal; and a comparative assessment of five serotonergic or sigma-1-active compounds against fluvoxamine on five competency standards.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1465Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • MitoQ

    Plain-language summaryIntrigue 75 / 100

    MitoQ is mitochondria-targeted ubiquinone (a derivative of CoQ10 with a positively charged triphenylphosphonium group that drives accumulation in mitochondria). Concentrates antioxidant activity at the mitochondrial inner membrane where oxidative damage occurs. Not stocked by Kodiac. This monograph is provided for research and educational reference.

    Intrigue 0–100 blends mechanism novelty, evidence strength, and translational potential. Kodiac editorial, not peer-reviewed.

    Mitochondria-targeted ubiquinone-derived antioxidant conjugated to a triphenylphosphonium cation

    A synthetic coenzyme Q10 analog covalently linked to a lipophilic triphenylphosphonium moiety that drives selective mitochondrial accumulation, enabling targeted quenching of reactive oxygen species at the inner mitochondrial membrane with demonstrated vascular, hepatoprotective, and anti-inflammatory activity in human clinical studies.

    Abstract

    Mitoquinone mesylate (MitoQ) is a mitochondria-targeted antioxidant composed of a ubiquinone moiety covalently linked via a ten-carbon alkyl chain to a triphenylphosphonium (TPP+) cation, enabling rapid permeation of lipid bilayers and accumulation within the mitochondrial matrix at concentrations up to several hundred-fold above extracellular levels, driven by the large negative mitochondrial membrane potential (approximately negative 150 to negative 180 millivolts). The compound was developed in the 1990s by Robin Smith and Michael Murphy at the University of Otago, New Zealand, as an approach to overcoming the failure of conventional untargeted antioxidants (including native coenzyme Q10) to achieve therapeutically meaningful concentrations within mitochondria, the principal intracellular source of reactive oxygen species (ROS). Within the mitochondrion, MitoQ adsorbs to the matrix-facing leaflet of the inner mitochondrial membrane, where the ubiquinone head group is reduced to the active antioxidant ubiquinol form by complex II (succinate:ubiquinone oxidoreductase) of the electron transport chain. The ubiquinol form scavenges superoxide, hydroxyl radicals, and peroxyl radicals, preventing lipid peroxidation of cardiolipin and other mitochondrial membrane phospholipids. Following oxidation during radical quenching, the resulting ubiquinone is re-reduced by complex II, establishing a catalytic antioxidant cycle that permits repeated radical neutralization from a single molecule. This recycling mechanism distinguishes MitoQ from stoichiometric antioxidants such as alpha-tocopherol that are consumed in the quenching reaction. Preclinical pharmacology has demonstrated protective effects in rodent models of ischemia-reperfusion injury, diabetic nephropathy, nonalcoholic fatty liver disease, sepsis-associated organ failure, pulmonary hypertension, Alzheimer’s disease, doxorubicin-induced cardiomyopathy, cisplatin nephrotoxicity, and metabolic syndrome, with consistent reductions in mitochondrial oxidative damage markers, preservation of mitochondrial membrane potential, and attenuation of downstream inflammatory signaling through suppression of NF-kappaB activation and NLRP3 inflammasome assembly. Four completed human clinical trials define the current clinical evidence base. The Snow et al. (2010) PROTECT study, a 12-month randomized double-blind placebo-controlled trial in 128 newly diagnosed untreated Parkinson’s disease patients at 40 or 80 mg per day, found no difference between MitoQ and placebo on any measure of disease progression, establishing an important negative result for the oxidative stress hypothesis in early Parkinson’s disease. The Gane et al. (2010) phase II trial in 30 patients with chronic hepatitis C virus infection demonstrated significant decreases in serum alanine aminotransferase and aspartate aminotransferase at 40 and 80 mg per day over 28 days, without change in viral load, suggesting hepatoprotective activity through reduction of mitochondrial oxidative necroinflammation. The Rossman et al. (2018) randomized crossover trial in 20 healthy older adults (60 to 79 years) with impaired endothelial function demonstrated that 6 weeks of MitoQ at 20 mg per day produced a 42 percent improvement in brachial artery flow-mediated dilation versus placebo, with concurrent reductions in plasma oxidized low-density lipoprotein and aortic pulse wave velocity, establishing the first human evidence for mitochondria-targeted antioxidant improvement of age-related vascular dysfunction. A 2024 exploratory pilot trial (Jain et al. 2024) of MitoQ as post-exposure prophylaxis against SARS-CoV-2 infection reported reduced infection rates and symptom duration in the treatment group versus matched controls. The compound is well tolerated in human studies at doses up to 80 mg per day for 12 months, with nausea and gastrointestinal discomfort as the principal dose-limiting adverse events. MitoQ is not approved as a pharmaceutical by any regulatory authority; it is marketed globally as a dietary supplement at doses of 5 to 10 mg per day and is available as a research-grade compound from multiple chemical suppliers. This monograph reviews the chemistry, synthesis, and mitochondrial targeting mechanism of MitoQ; the comprehensive preclinical pharmacology across disease models; the complete human clinical evidence base; pharmacokinetics including the low oral bioavailability and extensive first-pass metabolism; sourcing, reconstitution, and handling; stack-interaction considerations; adverse-event signal; and a structured comparative assessment of five mitochondria-targeted antioxidant candidates (SkQ1, elamipretide, MitoTEMPO, MitoVitE, idebenone) against MitoQ on five competency standards.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1466Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.

  • Pirenzepine

    Selective M1 muscarinic acetylcholine receptor antagonist of the pyridobenzodiazepinone structural class

    A peripherally selective, M1-preferring muscarinic antagonist developed at Dr. Karl Thomae GmbH (Boehringer Ingelheim) as a gastric antisecretory agent for peptic ulcer disease, subsequently investigated as a topical ophthalmic intervention for the retardation of progressive myopia in children.

    Abstract

    Pirenzepine (LS 519, Gastrozepin) is a tricyclic pyridobenzodiazepinone and the prototypical selective antagonist of the M1 subtype of the muscarinic acetylcholine receptor. Synthesized at Dr. Karl Thomae GmbH, a subsidiary of Boehringer Ingelheim, in the mid-1970s, the compound was the first muscarinic antagonist demonstrated to discriminate pharmacologically between what were subsequently classified as M1 and M2 receptor subtypes, a finding reported by Hammer et al. in 1980 in Nature and foundational to the modern subtype classification of muscarinic receptors [1]. Pirenzepine binds the M1 muscarinic receptor with a dissociation constant (Ki) of approximately 5 to 14 nanomolar and displays 5- to 20-fold selectivity over the M2, M3, and M5 subtypes, with intermediate affinity at M4 receptors [2, 3]. The compound is peripherally selective, exhibiting negligible penetration of the blood-brain barrier at therapeutic oral doses, a property that minimizes central anticholinergic adverse effects and distinguishes it from atropine and other non-selective muscarinic antagonists. The primary registered indication is peptic ulcer disease. Pirenzepine inhibits vagally mediated and pentagastrin-stimulated gastric acid secretion through antagonism of M1 receptors on intramural gastric plexus neurons, reducing basal acid output by approximately 50 percent at oral doses of 50 mg twice daily [4, 5]. Extensive controlled trials conducted through the late 1970s and 1980s demonstrated duodenal ulcer healing rates of 60 to 76 percent at 4 to 8 weeks on pirenzepine 100 to 150 mg per day, broadly comparable to cimetidine 1 g per day and superior to placebo and gefarnate [6, 7]. The compound was registered as Gastrozepin in numerous European, Asian, and Latin American jurisdictions but was never approved by the United States Food and Drug Administration. The clinical importance of pirenzepine as a gastric antisecretory agent has diminished substantially following the introduction of histamine H2 receptor antagonists and proton pump inhibitors, which offer superior acid suppression and ulcer healing rates. A second, more recent research application is the retardation of progressive myopia (axial elongation of the globe) in children aged 8 to 12 years. Two multicenter, randomized, double-masked, placebo-controlled trials of 2% pirenzepine ophthalmic gel, conducted by Siatkowski et al. (2004, 2008), demonstrated approximately 50 percent reduction in the rate of myopia progression over 1- and 2-year treatment periods, with a clinically acceptable safety profile dominated by mild pupil dilation and accommodation difficulty [8, 9]. The mechanism of the antimyopic effect is incompletely characterized but is attributed to M1 and possibly M4 muscarinic receptor antagonism in the retina and sclera, modulating signaling cascades that regulate scleral extracellular matrix remodeling and axial elongation [10]. The ophthalmic application has not received regulatory approval; the compound remains investigational for myopia control, with atropine (a non-selective muscarinic antagonist applied at low concentrations) having advanced further in clinical development for this indication. Pharmacokinetics are characterized by low oral bioavailability (20 to 30 percent in fasted subjects, further reduced by food), a plasma elimination half-life of approximately 10 to 12 hours, negligible hepatic first-pass metabolism, predominant renal elimination of unchanged drug, and low plasma protein binding (approximately 12 percent) [11, 12]. The compound does not undergo significant cytochrome P450-mediated metabolism and has a correspondingly limited drug-drug interaction profile. The principal adverse events at registered oral doses are mild anticholinergic effects: dry mouth (approximately 14 percent), blurred vision (1 to 5 percent, dose-dependent), and constipation (approximately 3 percent), with an overall discontinuation rate of approximately 2 percent in controlled trials [6]. Serious adverse events are rare. This monograph reviews the chemistry, synthesis, and structural pharmacology of pirenzepine; the molecular pharmacology at muscarinic receptor subtypes; comprehensive human pharmacokinetics; the clinical evidence base across peptic ulcer and myopia indications; sourcing and quality verification; reconstitution and handling; stack-interaction considerations; adverse-event signal; and a structured comparative assessment of five gastric antisecretory and muscarinic antagonist alternatives (telenzepine, atropine, cimetidine, ranitidine, omeprazole) against pirenzepine on five competency standards.

    Read the full monograph

    The full reference document covers compound identification, discovery and developmental history, mechanism of action, pharmacokinetics, sourcing and quality verification, and a curated reference list. Embedded inline below; download for offline reading.

    KDC-MN-1459Open in new tab →

    Download PDF →

    FOR RESEARCH USE ONLY. Not for medical, diagnostic, or therapeutic purposes. Not for human consumption. All information is provided for research and educational purposes only.