xanomeline   Click here for help

GtoPdb Ligand ID: 57

Synonyms: LY 246708
PDB Ligand
Compound class: Synthetic organic
Comment: Xanomeline is a muscarinic receptor agonist, with preference for the M1 and M4 receptor subtypes [2,8,12]. It also has antagonist activity at 5-HT2 receptors, and agonist activity at 5-HT1 receptors [10]. Xanomeline was investigated for potential to improve cognition in Alzheimer's disease (AD) patients, but activation of muscarinic receptors in the gastrointestinal tract caused severe nausea and diarrhoea, and this adverse effect led to discontinuation of xanomeline's clinical development for AD.
Click here for help
2D Structure
Click here for help
Click here for structure editor
Physico-chemical Properties
Click here for help
Hydrogen bond acceptors 3
Hydrogen bond donors 0
Rotatable bonds 7
Topological polar surface area 66.49
Molecular weight 281.16
XLogP 3.34
No. Lipinski's rules broken 0
SMILES / InChI / InChIKey
Click here for help
Canonical SMILES CCCCCCOc1nsnc1C1=CCCN(C1)C
Isomeric SMILES CCCCCCOc1nsnc1C1=CCCN(C1)C
InChI InChI=1S/C14H23N3OS/c1-3-4-5-6-10-18-14-13(15-19-16-14)12-8-7-9-17(2)11-12/h8H,3-7,9-11H2,1-2H3
InChI Key JOLJIIDDOBNFHW-UHFFFAOYSA-N
References
1. Breier A, Brannan SK, Paul SM, Miller AC. (2023)
Evidence of trospium's ability to mitigate cholinergic adverse events related to xanomeline: phase 1 study results.
Psychopharmacology (Berl), 240 (5): 1191-1198. [PMID:37036495]
2. Christopoulos A, Pierce TL, Sorman JL, El-Fakahany EE. (1998)
On the unique binding and activating properties of xanomeline at the M1 muscarinic acetylcholine receptor.
Mol Pharmacol, 53 (6): 1120-30. [PMID:9614217]
3. Correll CU, Abi-Dargham A, Howes O. (2022)
Emerging Treatments in Schizophrenia.
J Clin Psychiatry, 83 (1). [PMID:35172048]
4. Correll CU, Angelov AS, Miller AC, Weiden PJ, Brannan SK. (2022)
Safety and tolerability of KarXT (xanomeline-trospium) in a phase 2, randomized, double-blind, placebo-controlled study in patients with schizophrenia.
Schizophrenia (Heidelb), 8 (1): 109. [PMID:36463237]
5. Dean B, Scarr E. (2020)
Muscarinic M1 and M4 receptors: Hypothesis driven drug development for schizophrenia.
Psychiatry Res, 288: 112989. [PMID:32315882]
6. Grant MK, El-Fakahany EE. (2005)
Persistent binding and functional antagonism by xanomeline at the muscarinic M5 receptor.
J Pharmacol Exp Ther, 315 (1): 313-9. [PMID:16002459]
7. Kaul I, Sawchak S, Correll CU, Kakar R, Breier A, Zhu H, Miller AC, Paul SM, Brannan SK. (2024)
Efficacy and safety of the muscarinic receptor agonist KarXT (xanomeline-trospium) in schizophrenia (EMERGENT-2) in the USA: results from a randomised, double-blind, placebo-controlled, flexible-dose phase 3 trial.
Lancet, 403 (10422): 160-170. [PMID:38104575]
8. McDonald JK, van der Westhuizen ET, Pham V, Thompson G, Felder CC, Paul SM, Thal DM, Christopoulos A, Valant C. (2022)
Biased Profile of Xanomeline at the Recombinant Human M4 Muscarinic Acetylcholine Receptor.
ACS Chem Neurosci, 13 (8): 1206-1218. [PMID:35380782]
9. Powers AS, Pham V, Burger WAC, Thompson G, Laloudakis Y, Barnes NW, Sexton PM, Paul SM, Christopoulos A, Thal DM et al.. (2023)
Structural basis of efficacy-driven ligand selectivity at GPCRs.
Nat Chem Biol, 19 (7): 805-814. [PMID:36782010]
10. Watson J, Brough S, Coldwell MC, Gager T, Ho M, Hunter AJ, Jerman J, Middlemiss DN, Riley GJ, Brown AM. (1998)
Functional effects of the muscarinic receptor agonist, xanomeline, at 5-HT1 and 5-HT2 receptors.
Br J Pharmacol, 125 (7): 1413-20. [PMID:9884068]
11. Weiden PJ, Breier A, Kavanagh S, Miller AC, Brannan SK, Paul SM. (2022)
Antipsychotic Efficacy of KarXT (Xanomeline-Trospium): Post Hoc Analysis of Positive and Negative Syndrome Scale Categorical Response Rates, Time Course of Response, and Symptom Domains of Response in a Phase 2 Study.
J Clin Psychiatry, 83 (3). [PMID:35552528]
12. Wood MD, Murkitt KL, Ho M, Watson JM, Brown F, Hunter AJ, Middlemiss DN. (1999)
Functional comparison of muscarinic partial agonists at muscarinic receptor subtypes hM1, hM2, hM3, hM4 and hM5 using microphysiometry.
Br J Pharmacol, 126 (7): 1620-4. [PMID:10323594]