Uridine triacetate

Uridine triacetate
Names
Trade namesVistogard, Xuriden
Other namesVistonuridine
IUPAC name
  • [(2R,3R,4R,5R)-3,4-diacetyloxy-5-(2,4-dioxopyrimidin-1-yl)oxolan-2-yl]methyl acetate
Clinical data
Main usesHereditary orotic aciduria, poisoning due to fluorouracil or capecitabine[1]
Pregnancy
category
  • US: N (Not classified yet)
    Routes of
    use    		By mouth
    Onset of actionTmax = 2–3 hours
    External links
    AHFS/Drugs.comMonograph
    US NLMUridine triacetate
    MedlinePlusa616020
    Legal
    License data
    Legal status
    Pharmacokinetics
    MetabolismPyrimidine catabolic pathway
    Elimination half-life2–2.5 hours
    ExcretionKidney
    Chemical and physical data
    FormulaC15H18N2O9
    Molar mass370.314 g·mol−1
    3D model (JSmol)
    SMILES
    • CC(=O)OCC1C(C(C(O1)N2C=CC(=O)NC2=O)OC(=O)C)OC(=O)C
    InChI
    • InChI=1S/C15H18N2O9/c1-7(18)23-6-10-12(24-8(2)19)13(25-9(3)20)14(26-10)17-5-4-11(21)16-15(17)22/h4-5,10,12-14H,6H2,1-3H3,(H,16,21,22)/t10-,12-,13-,14-/m1/s1
    • Key:AUFUWRKPQLGTGF-FMKGYKFTSA-N

    Uridine triacetate, formerly known as vistonuridine, is a medication used to treat hereditary orotic aciduria and poisoning due to fluorouracil or capecitabine.[1] For poisoning it should be used within 4 days and in an overdose may be used regardless of the presence of symptoms.[1] It is taken by mouth.[1][2]

    Side effects may include nausea or diarrhea.[1] Use in pregnancy and breastfeeding is of unclear safety.[3] It is a prodrug of uridine; by which it acts.[2][1]

    Uridine triacetate was approved for medical use in the United States in 2015.[1] It is not approved in Europe.[4] In the United States it costs about 4,200 USD per 10 gram dose as of 2021.[5] In the United States it is only available through specialty pharmacies.[1] In Canada approval is required from the Health Canada Special Access Programme.[6] Brand names include Vistogard and Xuriden.[1]

    Medical uses

    Dosage

    For poisoning a dose of 10 gm four times per day for 5 days is typically used.[1]

    For hereditary orotic aciduria a dose of 60 mg/kg per day to a maximum of 8 gm per day is typically used.[1]

    Society and culture

    Names

    Uridine triacetate is the INN.[7] Brand names include Xuriden /ˈzʊərədɛn/ ZOOR-ə-den);[8] and Vistogard.[9][10][11]

    Cost

    The cost of the medication used to treat an overdose is about 84,000 USD in the United States as of 2021.[5]

    References

    1. 1 2 3 4 5 6 7 8 9 10 11 "Uridine Triacetate Monograph for Professionals". Drugs.com. Archived from the original on 8 December 2019. Retrieved 13 September 2021.
    2. 1 2 Saif, Muhammad Wasif (4 March 2019). "Uridine triacetate - an antidote in the treatment of 5-fluorouracil or capecitabine poisoning". Expert Opinion on Orphan Drugs. 7 (3): 95–103. doi:10.1080/21678707.2019.1591273.
    3. ↑ "Uridine Use During Pregnancy". Drugs.com. Archived from the original on 30 October 2020. Retrieved 13 September 2021.
    4. ↑ "FDA approves drug for genetic condition that affects 20 patients worldwide". The Pharmaceutical Journal. 2015. doi:10.1211/PJ.2015.20069307.
    5. 1 2 "Vistogard Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 22 January 2021. Retrieved 13 September 2021.
    6. ↑ "BC Cancer Agency Management Guidelines Management of 5-fluorouracil (5FU) infusion overdose" (PDF). Archived (PDF) from the original on 8 February 2020. Retrieved 13 September 2021.
    7. ↑ "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended International Nonproprietary Names: List 65" (PDF). World Health Organization. p. 92. Archived (PDF) from the original on 18 May 2016. Retrieved 12 March 2017.
    8. ↑ "Xuriden- uridine triacetate granule". DailyMed. 16 December 2019. Archived from the original on 23 October 2020. Retrieved 20 October 2020.
    9. ↑ "Vistogard- uridine triacetate granule". DailyMed. 15 November 2018. Archived from the original on 23 October 2020. Retrieved 20 October 2020.
    10. ↑ "BTG Announces FDA Approval of Vistogard (Uridine Triacetate) as Antidote to Overdose and Early Onset, Severe, or Life-Threatening Toxicities from Chemotherapy Drugs 5-Fluorouracil (5-FU) or Capecitabine". BTG International Ltd. 11 December 2015. Archived from the original on 8 April 2017. Retrieved 12 March 2017.
    11. ↑ "Approved Drugs — Uridine Triacetate". U.S. Food and Drug Administration. Archived from the original on 13 March 2017. Retrieved 12 March 2017.
    Identifiers:
    • "Uridine triacetate". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 8 December 2019. Retrieved 24 January 2021.
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