Uridine triacetate

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Uridine triacetate
Uridine triacetate structure.svg
Names
Trade namesVistogard, Xuriden
Other namesVistonuridine
  • [(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
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)
  • CC(=O)OCC1C(C(C(O1)N2C=CC(=O)NC2=O)OC(=O)C)OC(=O)C
  • 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. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 "Uridine Triacetate Monograph for Professionals". Drugs.com. Retrieved 13 September 2021.
  2. 2.0 2.1 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. 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. 5.0 5.1 "Vistogard Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 13 September 2021.
  6. "BC Cancer Agency Management Guidelines Management of 5-fluorouracil (5FU) infusion overdose" (PDF). Retrieved 13 September 2021.
  7. "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended International Nonproprietary Names: List 65" (PDF). World Health Organization. p. 92. Retrieved 12 March 2017.
  8. "Xuriden- uridine triacetate granule". DailyMed. 16 December 2019. Retrieved 20 October 2020.
  9. "Vistogard- uridine triacetate granule". DailyMed. 15 November 2018. 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. Retrieved 12 March 2017.
  11. "Approved Drugs — Uridine Triacetate". U.S. Food and Drug Administration. Retrieved 12 March 2017.[dead link]

External links

Identifiers: