Drug/Small Molecule:
aminoglutethimide

2D structure

Overview

Generic Names: Dl-Aminoglutethimide; P-Aminoglutethimide
Trade Names: Cytadren; Elipten; Orimeten
PharmGKB Accession Id: PA448375

Description

An aromatase inhibitor that produces a state of "medical" adrenalectomy by blocking the production of adrenal steroids. It also blocks the conversion of androgens to estrogens. Aminoglutethimide has been used in the treatment of advanced breast and prostate cancer. It was formerly used for its weak anticonvulsant properties. (From Martindale, The Extra Pharmacopoeia, 30th ed, p454) (source: Drug Bank)

Indication

For the suppression of adrenal function in selected patients with Cushing's syndrome, malignant neoplasm of the female breast, and carcinoma in situ of the breast. (source: Drug Bank)

ATC Therapeutic Category

  • L02BG:Enzyme inhibitors

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Aminoglutethimide reduces the production of D5-pregnenolone and blocks several other steps in steroid synthesis, including the C-11, C-18, and C-21 hydroxylations and the hydroxylations required for the aromatization of androgens to estrogens, mediated through the binding of aminoglutethimide to cytochrome P-450 complexes. A decrease in adrenal secretion of cortisol is followed by an increased secretion of pituitary adrenocorticotropic hormone (ACTH), which will overcome the blockade of adrenocortical steroid synthesis by aminoglutethimide. The compensatory increase in ACTH secretion can be suppressed by the simultaneous administration of hydrocortisone. Since aminoglutethimide increases the rate of metabolism of dexamethasone but not that of hydrocortisone, the latter is preferred as the adrenal glucocorticoid replacement. Although aminoglutethimide inhibits the synthesis of thyroxine by the thyroid gland, the compensatory increase in thyroid-stimulating hormone (TSH) is frequently of sufficient magnitude to overcome the inhibition of thyroid synthesis due to aminoglutethimide. In spite of an increase in TSH, aminoglutethimide has not been associated with increased prolactin secretion. (source: Drug Bank)

Pharmacology

Aminoglutethimide inhibits the enzymatic conversion of cholesterol to D5-pregnenolone, resulting in a decrease in the production of adrenal glucocorticoids, mineralocorticoids, estrogens, and androgens. (source: Drug Bank)

Food Interactions

Take without regard to meals. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. 34-54% of the administered dose is excreted in the urine as unchanged drug during the first 48 hours, and an additional fraction as an N-acetyl derivative. (source: Drug Bank)

Protein Binding

21-25% (source: Drug Bank)

Absorption

Rapidly and completely absorbed from gastrointestinal tract. The bioavailability of tablets is equivalent to equal doses given as a solution. (source: Drug Bank)

Toxicity

Oral LD50s (mg/kg): rats, 1800; dogs, >100. Intravenous LD50s (mg/kg): rats, 156; dogs, >100. Symptoms of overdose include respiratory depression, hypoventilation, hypotension, hypovolemic shock due to dehydration, somnolence, lethargy, coma, ataxia, dizziness, fatigue, nausea, and vomiting. (source: Drug Bank)

Isomeric SMILES Code:

CCC1(CCC(=O)NC1=O)c2ccc(cc2)N (source: Drug Bank)

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
CYP19A1 Uncurated Annotation (source: Drug Bank)

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
acenocoumarol Uncurated Annotation The agent decreases the anticoagulant effect (source: Drug Bank)
dexamethasone Uncurated Annotation Decreases the effect of dexamethasone (source: Drug Bank)
dicumarol Uncurated Annotation The agent decreases the anticoagulant effect (source: Drug Bank)
tamoxifen Uncurated Annotation Decreases the effect of tamoxifen (source: Drug Bank)
warfarin Uncurated Annotation The agent decreases the anticoagulant effect (source: Drug Bank)

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00357
KEGG Compound ID:
C07617
KEGG Drug ID:
D00574
PubChem Compound ID:
2145
PubChem Substance ID:
9819

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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