Segesterone acetate

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Segesterone acetate
Nestorone.svg
Clinical data
Trade names Nestorone, Elcometrine
Synonyms Nestorone; Nestoron; Elcometrine; ST-1435; AC-6844; CS-0411; 16-Methylene-17α-acetoxy-19-norprogesterone; 16-Methylene-17α-acetoxy-19-norpregn-4-ene-3,20-dione
Routes of
administration
Subcutaneous implant, vaginal ring, transdermal patch[1]
Drug class Progestogen; Progestogen ester
ATC code
  • None
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability 10% (oral)[1][2]
Protein binding Albumin[1][3]
Biological half-life 1–2 hours (oral)[1]
Identifiers
CAS Number
PubChem CID
ChemSpider
Chemical and physical data
Formula C23H30O4
Molar mass 370.482 g/mol
3D model (JSmol)

Segesterone acetate, sold under the brand names Nestorone and Elcometrine, is a progestin of the 19-norprogesterone group which is used as a hormonal contraceptive and in the treatment of endometriosis in several South American countries.[1][4]

Medical uses[edit]

Segesterone acetate is used as a hormonal contraceptive and in the treatment of endometriosis.[1][4]

Pharmacology[edit]

Pharmacodynamics[edit]

Segesterone acetate acts primarily as a high-affinity agonist of the progesterone receptor.[3] It does not bind significantly to the androgen receptor, estrogen receptor, or mineralocorticoid receptor.[3][5] Segesterone acetate does however have some affinity for the glucocorticoid receptor, where it appears to act as an agonist, but it does not appear to produce any glucocorticoid side effects unless used at high doses.[3][1][6]

Pharmacokinetics[edit]

Segesterone acetate is only weakly active orally, and is instead given as a subcutaneous implant.[7] It is more than 100-fold times as potent when delivered via this route compared to orally.[1]

Segesterone acetate is bound to albumin.[1][3] It does not bind to sex hormone-binding globulin.[1][3]

Chemistry[edit]

Segesterone acetate is a norpregnane steroid and synthetic derivative of progesterone and is also known as 16-methylene-17α-acetoxy-19-norprogesterone or as 16-methylene-17α-acetoxy-19-norpregn-4-ene-3,20-dione. In addition to progesterone, segesterone acetate is a combined derivative of 17α-hydroxyprogesterone and 19-norprogesterone, or a derivative of gestronol (17α-hydroxy-19-norprogesterone). The drug is the C17α acetate ester of segesterone, which, in contrast, was never marketed, but is a metabolite of segesterone acetate.[8] Other 19-nortestosterone derivatives include demegestone, gestonorone caproate, nomegestrol acetate, promegestone, and trimegestone.

History[edit]

Segesterone acetate was developed by the Population Council.[9] It has been marketed since at least 2000.[4]

Society and culture[edit]

Generic names[edit]

Segesterone acetate is the USAN of the drug.[10][11] It is also known much more commonly by its brand names nestorone (or nestoron) and elcometrine.[12]

Segesterone acetate is also known by its former developmental code names ST-1435, AC-6844, and CS-0411.[13]

Brand names[edit]

Segesterone acetate is marketed under the brand names Nestorone and Elcometrine.[4]

Availability[edit]

Segesterone acetate is available in several South American countries, including Brazil.[1] It is not available in the United States.[1]

References[edit]

  1. ^ a b c d e f g h i j k l Thomas L. Lemke; David A. Williams; Victoria F. Roche; S. William Zito (24 January 2012). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. p. 1403. ISBN 978-1-60913-345-0. Retrieved 13 September 2012. 
  2. ^ A.R. Genazzani (15 May 2001). Hormone Replacement Therapy and Cardiovascular Disease: The Current Status of Research and Practice. CRC Press. pp. 95–. ISBN 978-1-84214-038-3. 
  3. ^ a b c d e f Kuhl, H (2009). "Pharmacology of estrogens and progestogens: influence of different routes of administration" (PDF). Climacteric. 8 (sup1): 3–63. doi:10.1080/13697130500148875. ISSN 1369-7137. PMID 16112947. 
  4. ^ a b c d Croxatto, H (2000). "Progestin implants". Steroids. 65 (10-11): 681–685. doi:10.1016/S0039-128X(00)00124-0. ISSN 0039-128X. 
  5. ^ Hussain R, El-Etr M, Gaci O, et al. (October 2011). "Progesterone and Nestorone facilitate axon remyelination: a role for progesterone receptors". Endocrinology. 152 (10): 3820–31. doi:10.1210/en.2011-1219. PMID 21828184. 
  6. ^ Kumar N, Koide SS, Tsong Y, Sundaram K (2000). "Nestorone: a progestin with a unique pharmacological profile". Steroids. 65 (10-11): 629–36. doi:10.1016/S0039-128X(00)00119-7. PMID 11108869. 
  7. ^ Sanjay Rajagopalan; Debabrata Mukherjee; Emile R. Mohler (31 August 2004). Manual of Vascular Diseases. Lippincott Williams & Wilkins. p. 803. ISBN 978-0-7817-4499-7. Retrieved 13 September 2012. 
  8. ^ Prasad PV, Bashir M, Sitruk-Ware R, Kumar N (2010). "Single-dose pharmacokinetics of Nestorone, a potential female-contraceptive". Steroids. 75 (3): 252–64. doi:10.1016/j.steroids.2009.12.011. PMID 20064539. 
  9. ^ Prasad, P. V., & Shrivastav, T. G. (2015). Nestorone®: A new hope for Gynecologists, Andrologists and Neurologists. of, 3, 2.
  10. ^ http://www.ama-assn.org/resources/doc/usan/x-pub/segesterone-acetate.pdf
  11. ^ [1]
  12. ^ Martin Negwer; Hans-Georg Scharnow (2001). Organic-chemical drugs and their synonyms: (an international survey). Wiley-VCH. ISBN 978-3-527-30247-5. Retrieved 13 September 2012. 
  13. ^ http://scientonline.org/open-access/nestorone-a-new-hope-for-gynecologists-andrologists-and-neurologists.pdf