Gemeprost

Gemeprost
Clinical data

AHFS/Drugs.com	International Drug Names
Routes of administration	Pessary
ATC code	G02AD03 (WHO)
Identifiers
IUPAC name methyl (2E,11α,13E,15R)-11,15-dihydroxy-16,16-dimethyl-9-oxoprosta-2,13-dien-1-oate
Synonyms	methyl (E)-7-[(1R,2S,3R)-3-hydroxy-2-[(E,3R)-3-hydroxy-4,4-dimethyl-oct-1-enyl]-5-oxo-cyclopentyl]hept-2-enoate
CAS Number	64318-79-2^Y
PubChem (CID)	5282237
DrugBank	DB08964^N
ChemSpider	4445416^Y
UNII	45KZB1FOLS^Y
KEGG	D02073^Y
ECHA InfoCard	100.058.869
Chemical and physical data
Formula	C₂₃H₃₈O₅
Molar mass	394.545 g/mol
3D model (Jmol)	Interactive image
SMILES O=C1C[C@@H](O)[C@H](/C=C/[C@@H](O)C(C)(C)CCCC)[C@H]1CCCC\C=C\C(=O)OC
InChI InChI=1S/C23H38O5/c1-5-6-15-23(2,3)21(26)14-13-18-17(19(24)16-20(18)25)11-9-7-8-10-12-22(27)28-4/h10,12-14,17-18,20-21,25-26H,5-9,11,15-16H2,1-4H3/b12-10+,14-13+/t17-,18-,20-,21-/m1/s1^Y Key:KYBOHGVERHWSSV-VNIVIJDLSA-N^Y
^NY (what is this?) (verify)

Gemeprost (16, 16-dimethyl-trans-delta2 PGE₁ methyl ester) is an analogue of prostaglandin E₁.

Clinical use

It is used as a treatment for obstetric bleeding.

It is used with mifepristone to terminate pregnancy up to 24 weeks gestation.^[1]

Side effects

Vaginal bleeding, cramps, nausea, vomiting, loose stools or diarrhea, headache, muscle weakness; dizziness; flushing; chills; backache; dyspnoea; chest pain; palpitations and mild pyrexia. Rare: Uterine rupture, severe hypotension, coronary spasms with subsequent myocardial infarctions.

References

↑ Bartley J, Brown A, Elton R, Baird DT (October 2001). "Double-blind randomized trial of mifepristone in combination with vaginal gemeprost or misoprostol for induction of abortion up to 63 days gestation". Human reproduction (Oxford, England). 16 (10): 2098–102. doi:10.1093/humrep/16.10.2098. PMID 11574498. Retrieved 2008-10-29.

Eicosanoids

Precursor

Arachidonic acid

Prostanoids

Prostaglandins (PG)

Precursor

H₂

Active

D/J	D₂

E/F	E₂ (Dinoprostone) E₁ (Alprostadil) F_2α (Dinoprost):

I	I₂ (Prostacyclin/Epoprostenol):

Thromboxanes (TX)

A₂
B₂

Leukotrienes (LT)

Precursor	Arachidonic acid 5-hydroperoxide

Initial	A₄ B₄

SRS-A	C₄ D₄ E₄

Eoxins (EX)

Precursor	Arachidonic acid 15-hydroperoxide

Eoxins	A₄ C₄ D₄ E₄

Nonclassic

Lipoxins (LX) (A₄, B₄)
Virodhamine

By function

bronchoconstriction
- PGD₂
- TXA₂
- LTC₄
- LTD₄
- LTE₄

vasoconstriction
- PGF_2α
- TXA₂
- TXB₂)
vasodilation
- PGE₂
- PGI₂
- LTC₄
- LTD₄
- LTE₄

platelets: induce
- TXA₂
inhibit
- PGD₂
- PGI₂
leukocytes: induce
- TXA₂
- LTB₄
inhibit
- PGD₂
- PGE₂

fever stimulation:
- PGE₂

labor stimulation:
- PGE₂ (Dinoprostone)
- PGF_2α (Dinoprost)

Uterotonics/labor inducers/oxytocics (G02A)

Cervical ripening

Ergot alkaloids	Acetergamine Ergometrine^# (Syntometrine) Methylergometrine

Prostaglandins and analogues	E: Misoprostol/E1^# Gemeprost/E1 Dinoprostone/E2 Sulprostone/E2 F: Dinoprost/F2α Carboprost/F2α

Contraction induction

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

Prostanoid signaling modulators

Receptor
(ligands)

DP (D₂)

DP₁	Agonists: Prostaglandin D₂ Treprostinil Antagonists: Asapiprant Laropiprant Vidupiprant

DP₂	Agonists: Indometacin Prostaglandin D₂ Antagonists: ADC-3680 AZD-1981 Bay U3405 Fevipiprant MK-1029 MK-7246 OC-459 OC000459 QAV-680 Ramatroban Setipiprant TM30089 Vidupiprant

EP (E₂)

EP₁	Agonists: Beraprost Enprostil Iloprost (ciloprost) Latanoprost Lubiprostone Misoprostol Prostaglandin E₁ (alprostadil) Prostaglandin E₂ (dinoprostone) Sulprostone Antagonists: AH-6809 ONO-8130 SC-19220 SC-51089 SC-51322

EP₂	Agonists: Butaprost Misoprostol Prostaglandin E₁ (alprostadil) Prostaglandin E₂ (dinoprostone) Treprostinil Antagonists: AH-6809 PF-04418948 TG 4-155

EP₃	Agonists: Beraprost Carbacyclin Cicaprost Enprostil Iloprost (ciloprost) Isocarbacyclin Latanoprost Misoprostol Prostaglandin D₂ Prostaglandin E₁ (alprostadil) Prostaglandin E₂ (dinoprostone) Remiprostol Sulprostone Antagonists: L-798106

EP₄	Agonists: Lubiprostone Misoprostol Prostaglandin E₁ (alprostadil) Prostaglandin E₂ (dinoprostone) TCS-2510 Antagonists: GW-627368 L-161982 ONO-AE3-208

Unsorted	Agonists: 16,16-Dimethyl Prostaglandin E₂ Aganepag Carboprost Evatanepag Gemeprost Nocloprost Omidenepag Prostaglandin F_2α (dinoprost) Simenepag Taprenepag

FP (F_2α)

IP (I₂)

Agonists: ACT-333679
AFP-07
Beraprost
BMY-45778
Carbacyclin
Cicaprost
Iloprost (ciloprost)
Isocarbacyclin
MRE-269
NS-304
Prostacyclin (prostaglandin I₂, epoprostenol)
Prostaglandin E₁ (alprostadil)
Ralinepag
Selexipag
Taprostene
TRA-418
Treprostinil

Antagonists: RO1138452

TP (TX_A2)

Agonists: Carbocyclic thromboxane A₂
I-BOP
Thromboxane A₂
U-46619
Vapiprost

Antagonists: 12-HETE
13-APA
AA-2414
Argatroban
Bay U3405
BMS-180,291
Daltroban
Domitroban
EP-045
GR-32191
ICI-185282
ICI-192605
Ifetroban
Imitrodast
L-655240
L-670596
Linotroban
Mipitroban
ONO-3708
ONO-11120
Picotamide
Pinane thromboxane A₂
Ramatroban
Ridogrel
S-145
Samixogrel
Seratrodast
SQ-28,668
SQ-29,548
Sulotroban
Terbogrel
Terutroban
TRA-418

Unsorted

Arbaprostil
Ataprost
Ciprostene
Clinprost
Cobiprostone
Delprostenate
Deprostil
Dimoxaprost
Doxaprost
Ecraprost
Eganoprost
Enisoprost
Eptaloprost
Esuberaprost
Etiproston
Fenprostalene
Flunoprost
Froxiprost
Lanproston
Limaprost
Luprostiol
Meteneprost
Mexiprostil
Naxaprostene
Nileprost
Nocloprost
Ornoprostil
Oxoprostol
Penprostene
Pimilprost
Piriprost
Posaraprost
Prostalene
Rioprostil
Rivenprost
Rosaprostol
Spiriprostil
Tiaprost
Tilsuprost
Tiprostanide
Trimoprostil
Viprostol

Enzyme
(inhibitors)

COX (PTGS)	Aceclofenac Acemetacin Acetanilide Alclofenac Alminoprofen Aloxiprin AM404 Amfenac Ampiroxicam Anitrazafen Antrafenine Apricoxib Aspirin (acetylsalicylic acid) Azapropazone Bendazac Benorilate (benorylate) Benoxaprofen Bromfenac Bucetin Bucloxic acid (blucloxate) Bufexamac Bumadizone Butibufen Carbasalate calcium Carprofen Celecoxib Cimicoxib Cinmetacin Clobuzarit Clometacin Clonixeril Clonixin Curcumin Deracoxib Dexibuprofen Dexindoprofen Dexketoprofen Diclofenac Difenpiramide Diflunisal Dipyrocetyl Droxicam DuP-697 Enolicam Ethenzamide Etodolac Etofenamate Etoricoxib Felbinac Fenbufen Fenclofenac Fenoprofen Fentiazac Firocoxib FK-3311 Floctafenic acid (floctafenate) Floctafenine Flosulide Flufenamic acid (flufenamate) Flumizole Flunixin Flunoxaprofen Fluproquazone Flurbiprofen FR-122047 Glafenine Glimepiride Glucametacin Guacetisal Hyperforin Ibuprofen Ibuproxam Indometacin farnesil Indometacin (indomethacin) Indoprofen Isoxicam Itazigrel Ketoprofen Ketorolac L-655240 L-670596 Licofelone Lonazolac Lornoxicam Loxoprofen Lumiracoxib Magnesium salicylate Mavacoxib Meclofenamic acid (meclofenamate) Mefenamic acid (mefenamate) Meloxicam Menatetrenone (vitamin K₂) Mesalazine (5-aminosalicylic acid) Methyl salicylate Miroprofen Mofezolac Morniflumate Nabumetone Naproxcinod Naproxen NCX-466 NCX-4040 Niflumic acid (niflumate) Nimesulide NS-398 Oxametacin Oxaprozin Oxindanac Pamicogrel Paracetamol (acetaminophen) Parapropamol Parecoxib Phenacetin Piroxicam Pirprofen Polmacoxib Pranoprofen Proglumetacin Propacetamol Resveratrol Robenacoxib Rofecoxib Romazarit Rutecarpine Salacetamide Salicin Salicylamide Salicylic acid (salicylate) Salsalate Satigrel SC-236 SC-560 SC-58125 Sodium salicylate Sulindac Sulindac sulfide Suprofen Talinflumic acid (talinflumate) Tarenflurbil Tenidap Tenoxicam Tepoxalin Tiaprofenic acid (tiaprofenate) Tiflamizole Tilmacoxib Timegadine Tolfenamic acid (tolfenamate) Tolmetin Trifenagrel Triflusal Tropesin Valdecoxib Vedaprofen Zidometacin Zomepirac

PGD₂ synthase	Retinoids Selenium (selenium tetrachloride, sodium selenite, selenium disulfide)

PGE synthase	HQL-79

PGF synthase	Bimatoprost

PGI₂ synthase	Tranylcypromine

TXA synthase	Camonagrel Dazmegrel Dazoxiben Furegrelate Isbogrel Midazogrel Nafagrel Nicogrelate Ozagrel Picotamide Pirmagrel Ridogrel Rolafagrel Samixogrel Terbogrel U63557A

Others

See also: Leukotrienergics

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