Fluoxymesterone

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Fluoxymesterone
Fluoxymesterone structure.svg
Clinical data
Trade names Halotestin, Ora-Testryl, Ultandren, others
AHFS/Drugs.com Monograph
MedlinePlus a682690
Pregnancy
category
  • X
Routes of
administration		 Oral
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 100% Oral
Metabolism Hepatic
Biological half-life 9.5 hours
Excretion urine
Identifiers
Synonyms Androfluorene; NSC-12165; 9α-Fluoro-11β-hydroxy-17α-methyltestosterone
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard 100.000.875
Chemical and physical data
Formula C20H29FO3
Molar mass 336.441 g/mol
3D model (JSmol)
  (verify)

Fluoxymesterone, sold under the brand names Halotestin and Ultandren among others, is a synthetic, orally active anabolic-androgenic steroid (AAS) and a 17α-alkylated derivative of testosterone.[1][2][3] While there are legitimate medical uses of fluoxymesterone, it is also abused, leading to the development of analytical techniques by which fluoxymesterone doping can be identified.[citation needed]

Medical uses[edit]

Fluoxymesterone is or has been used in the treatment of hypogonadism, delayed puberty, and anemia in males and breast cancer in women.[4][5]

Side effects[edit]

See also: Anabolic steroid § Adverse effects

Side effects that have been associated with fluoxymesterone include acne, edema, seborrhea/seborrheic dermatitis, alopecia, hirsutism, voice deepening, virilization in general, flushing, gynecomastia, breast pain, menstrual disturbances, hypogonadism, testicular atrophy, clitoral enlargement, penile enlargement, priapism, increased aggressiveness, prostate enlargement, cardiovascular toxicity, and hepatotoxicity, among others.[4][6]

Pharmacology[edit]

Androgenic activity[edit]

As an AAS, fluoxymesterone is an agonist of the androgen receptor (AR), similarly to androgens like testosterone and DHT.[4][7] It is a substrate for 5α-reductase like testosterone, and so is potentiated in so-called "androgenic" tissues like the skin, hair follicles, and prostate gland.[4][7] As such, fluoxymesterone has a relatively high ratio of androgenic to anabolic activity, similarly to testosterone.[4][7] Fluoxymesterone has been reported to be non-aromatizable due to steric hindrance by its C11β hydroxyl group,[8] and hence is not considered to have a propensity for producing estrogenic effects such as gynecomastia or fluid retention.[4][9] However, paradoxically, a case report of severe fluoxymesterone-induced gynecomastia exists, and gynecomastia associated with fluoxymesterone has also been reported in other publications.[10] Fluoxymesterone is thought to possess little or no progestogenic activity.[4][7] Because of the presence of its 17α-methyl group, the metabolism of fluoxymesterone is impeded, resulting in it being orally active, although also hepatotoxic.[4][7]

11β-HSD inhibitor[edit]

Fluoxymesterone has been found to act as a potent inhibitor of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) (IC50 = 60–630 nM), with a potency comparable to that of the 11β-HSD2 inhibitor glycyrrhetinic acid.[11][12] This unique action of fluoxymesterone is likely related to its 11β-hydroxyl group.[11] 11β-HSD2 is responsible for the inactivation of the glucocorticoids cortisol and corticosterone (into cortisone and 11-dehydrocorticosterone, respectively).[11][12] Inhibition of 11β-HSD2 by fluoxymesterone may result in mineralocorticoid receptor overactivation and associated side effects such as hypertension and fluid retention, and has been hypothesized to be involved in the cardiovascular and other adverse effects of fluoxymesterone.[11][12]

Glucocorticoid activity[edit]

Unlike other AAS, fluoxymesterone has structural features in common with corticosteroids, including its 9α-fluoro and 11β-hydroxy groups.[13] In accordance, it has weak (micromolar) but potentially clinically significant affinity for the glucocorticoid receptor.[14]

Pharmacokinetics[edit]

Fluoxymesterone has an elimination half-life of approximately 9.2 hours, which is long relative to that of testosterone.[15] In addition, unlike testosterone, fluoxymesterone has approximately 100% oral bioavailability, as the methyl group at the C17α position of fluoxymesterone inhibits hepatic metabolism by enzymatic oxidation of 17β-hydroxyl, allowing its absorption into the bloodstream for transport around the body.[citation needed]

Chemistry[edit]

See also: List of androgens/anabolic steroids

Fluoxymesterone is an androstane steroid and a 17α-alkylated derivative of testosterone (androst-4-en-17β-ol-3-one), and is also known as 9α-fluoro-11β-hydroxy-17α-methyltestosterone or as 9α-fluoro-11β-hydroxy-17α-methylandrost-4-en-17β-ol-3-one.[1][2] It is testosterone with a fluorine atom at the C9α position, a hydroxyl group at the C11β position, and a methyl group at the C17α position.[1][2]

Synthesis[edit]

Step One: The first step in the synthesis of fluoxymesterone is the microbiological oxidation of commercially available androstenedione (1.11) by Actinomyces; this introduces a hydroxyl group to the 11α-position (1.12), which is then oxidised to a ketone using Jones’ reagent, yielding the 3,11,17-triketone, adrenosterone (1.13). Pyrrolidine then reacts to form an enamine (1.14) by reaction with the 3α-keto group, protecting it from alkylation in a subsequent step. The regioselectivity of pyrrolidine for reaction at the 3α-position occurs inherently in the structure of adrenosterone, due to the position of the sterically bulky methyl groups. In subsequent steps, alkylation of the 17-keto group (1.14) using Grignard reagent, addition of hydride at the 11-position (1.15) and regeneration of the protected 3-keto group yields the starting material (1.16) for the final steps of the fluoxymesterone synthesis. This involves more standard synthetic transformations.

Scheme showing the full synthesis of fluoxymesterone from andrestenedione

StepTwo: The 11α-hydroxyl of the starting material (1.16) is sulfonylated by p-toluenesulfonyl chloride; addition of trimethylamine (base) deprotonates the 11α-carbon, yielding an (E2) elimination of tosylate (pka - 5) to give olefin (1.17). Stereospecificity of reaction between olefin and hypobromous acid (HOBr) in base, N-bromosuccinimide (NBS), is determined by the formation of a bromonium intermediate; the electrophilic bromonium cation approaches the ring’s less sterically hindered α-face and is attacked by the π-electron density of the alkene. The hydroxide ion then attacks from above the ring (β-face) at the 11-carbon, resulting in a structure (1.18) by the stereospecific addition of hydroxyl and bromine across the double bond. Addition of sodium hydroxide results in deprotonation of the 11α-hydroxyl, and the subsequent structure undergoes an intramolecular SN2 epoxy ring formation. The epoxy ring of the β-epoxide (1.19) is protonated to give an oxironium ion intermediate. In a concerted process, fluoride attacks the ring’s α-face from below, as one of the two oxygen-carbon bonds is broken on the opposite face; hence regenerating the 11α-hydroxyl trans to the fluorine substituent. The resulting structure (1.20) is the androgenic steroid, fluoxymesterone.

Detection in body fluids[edit]

Detection of halotestin and other such illegal anabolic steroids in sports is achieved by GS-MS identification of urinary excreted anabolic steroids and their metabolites. In a test for halotestin, a dry residue obtained from a urine sample is dissolved in dimethylformamide and a sulfur trioxide-pyridine complex and is heated with 1% potassium carbonate solution. Halotestin and many of its metabolites contain two polar hydroxyl groups, leading to intermolecular hydrogen bonding that increases their boiling point and reduces volatility. In order to attain a gaseous sample for GC-MS, the products of hydrolysis are extracted, dissolved in methanol and derivatised to form volatile trimethylsilyl (TMS) esters by adding N-methyl-N-trimethylsilyl-trifluoroacetamide (MSTFA) and trimethylsilylimidazole (TMSImi).[16]

Society and culture[edit]

Brand names[edit]

Brand names of fluoxymesterone include Android-F, Halotestin, Ora-Testryl, and Ultandren, among others.[1][2][3]

Availability[edit]

United States[edit]

Fluoxymesterone is one of the few AAS that remains available for medical use in the United States.[17] The others (as of December 2016) are testosterone (and esters), methyltestosterone, nandrolone decanoate, oxandrolone, and oxymetholone.[17]

Legal status[edit]

Fluoxymesterone, along with other AAS, is a schedule III controlled substance in the United States under the Controlled Substances Act.[18]

References[edit]

  1. ^ a b c d J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. pp. 568–. ISBN 978-1-4757-2085-3. 
  2. ^ a b c d Index Nominum 2000: International Drug Directory. Taylor & Francis. January 2000. p. 461. ISBN 978-3-88763-075-1. 
  3. ^ a b I.K. Morton; Judith M. Hall (6 December 2012). Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media. pp. 123–. ISBN 978-94-011-4439-1. 
  4. ^ a b c d e f g h William Llewellyn (2011). Anabolics. Molecular Nutrition Llc. ISBN 978-0-9828280-1-4. 
  5. ^ Susan M. Ford; Sally S. Roach (7 October 2013). Roach's Introductory Clinical Pharmacology. Lippincott Williams & Wilkins. pp. 502–. ISBN 978-1-4698-3214-2. 
  6. ^ Jerome Z. Litt; Neil Shear (17 December 2014). Litt's Drug Eruptions and Reactions Manual, 19th Edition. CRC Press. pp. 177–. ISBN 978-1-84214-599-9. 
  7. ^ a b c d e Kicman, A T (2008). "Pharmacology of anabolic steroids". British Journal of Pharmacology. 154 (3): 502–521. PMC 2439524 Freely accessible. PMID 18500378. doi:10.1038/bjp.2008.165. 
  8. ^ Attardi BJ, Pham TC, Radler LC, Burgenson J, Hild SA, Reel JR (2008). "Dimethandrolone (7alpha,11beta-dimethyl-19-nortestosterone) and 11beta-methyl-19-nortestosterone are not converted to aromatic A-ring products in the presence of recombinant human aromatase". J. Steroid Biochem. Mol. Biol. 110 (3-5): 214–22. PMC 2575079 Freely accessible. PMID 18555683. doi:10.1016/j.jsbmb.2007.11.009. 
  9. ^ Norman T. Adler; Donald Pfaff; Robert W. Goy (6 December 2012). Reproduction. Springer Science & Business Media. pp. 630–. ISBN 978-1-4684-4832-0. 
  10. ^ Lo TE, Andal ZC, Lantion-Ang FL (2015). "Fluoxymesterone-induced gynaecomastia in a patient with childhood aplastic anaemia". BMJ Case Rep. 2015. PMC 4434366 Freely accessible. PMID 25948845. doi:10.1136/bcr-2014-207474. 
  11. ^ a b c d Fürstenberger C, Vuorinen A, Da Cunha T, Kratschmar DV, Saugy M, Schuster D, Odermatt A (2012). "The anabolic androgenic steroid fluoxymesterone inhibits 11β-hydroxysteroid dehydrogenase 2-dependent glucocorticoid inactivation". Toxicol. Sci. 126 (2): 353–61. PMID 22273746. doi:10.1093/toxsci/kfs022. 
  12. ^ a b c Joseph JF, Parr MK (2015). "Synthetic androgens as designer supplements". Curr Neuropharmacol. 13 (1): 89–100. PMC 4462045 Freely accessible. PMID 26074745. doi:10.2174/1570159X13666141210224756. 
  13. ^ Kirschbaum J (27 October 1978). Profiles of Drug Substances, Excipients and Related Methodology. Academic Press. pp. 253–. ISBN 978-0-08-086102-9. 
  14. ^ Mayer M, Rosen F (1975). "Interaction of anabolic steroids with glucocorticoid receptor sites in rat muscle cytosol". Am. J. Physiol. 229 (5): 1381–6. PMID 173192. 
  15. ^ Seth Roberts (2009). Anabolic Pharmacology.
  16. ^ Schänzer, Willi; Opfermann, Georg; Donike, Manfred (1992-11-01). "17-Epimerization of 17α-methyl anabolic steroids in humans: metabolism and synthesis of 17α-hydroxy-17β-methyl steroids". Steroids. 57 (11): 537–550. doi:10.1016/0039-128X(92)90023-3. 
  17. ^ a b "Drugs@FDA: FDA Approved Drug Products". United States Food and Drug Administration. Retrieved 17 December 2016. 
  18. ^ Steven B. Karch, MD, FFFLM (21 December 2006). Drug Abuse Handbook, Second Edition. CRC Press. pp. 30–. ISBN 978-1-4200-0346-8. 

Further reading[edit]

Retrieved from "https://en.wikipedia.org/w/index.php?title=Fluoxymesterone&oldid=789574351"