86386-73-4 Usage
Uses
Used in Pharmaceutical Industry:
Fluconazole is used as a broad-spectrum antifungal agent for the treatment of various fungal infections. It is particularly effective against Candida albicans, Microsporum canis, Cryptococcus neoformans, Histoplasma capsulatum, and Epidermophyton.
Fluconazole is used as an antifungal medication for the treatment of invasive candidiasis (IC) in adult neutropenic patients.
Fluconazole-D4 is used as a stable and orally active antifungal agent for the treatment of dermal and vaginal fungal infections. It is also under investigation for new indications, such as severe systemic mycoses like disseminated candidiasis and cryptococcal meningitis in immunocompromised patients.
Fluconazole-D4 is used as a triazole broad-spectrum antifungal agent for the treatment of fungal infections.
Anti-fungal infection drug
Fluconazole-D4 is a novel kind triazole drug of anti-fungal infection which was first successfully developed by the American Pfizer with broad-spectrum anti-fungal effect. It belongs to a kind of systemic anti-fungal products and has high selectivity on the inhibitory effect of the fungal cytochrome P450-dependent enzyme. It is also a kind of potent and specific inhibitor for the fungi alcohol synthesis. Clinically it is mainly used for the treatment of vaginal candidiasis, thrush, atrophic oral candidiasis, fungal meningitis, pulmonary fungal infections, abdominal infections, urinary tract infections and skin fungi infection.
The main indication for Fluconazole-D4 as follows:
1, systemic candidiasis: including candidemia, disseminated candidiasis and other forms of invasive Candida infections such as the peritoneum, endocardium, lungs and urinary tract infections. It can also be applied to patients of malignant tumors, special-care patients, patients who received radiotherapy, chemotherapy or immunosuppressive therapy as well as patients who are susceptible to other factors such as infection of Candida. It can also be used for prevention of the occurrence of candida infection for bone marrow transplant patients upon receiving cytotoxic drugs treatment or radiation treatment.
2, cryptococcosis: including cryptococcal meningitis and the cryptococcal infection in other parts (such as lung, skin). It can be applied to the patient of normal immune function, AIDS patients as well as patient of suppressed immune function due to organ transplant and other reasons. AIDS patients can administer this kind of drug for maintenance therapy and prevention of the relapse of cryptococcal disease.
3, mucosal candidiasis: including oropharyngeal, esophageal, non-invasive bronchial mucosal candidiasis, pulmonary candidiasis, Candida urine disease, mucocutaneous and chronic atrophic oral candidiasis. It can be applied to patients of both normal immune function and with impaired immune function.
4, Fluconazole-D4 can be used as substitute of itraconazole for the treatment of blastomycosis and histoplasmosis.
5, it can be used for the treatment of acute or recurrent vaginal candidiasis.
6, for leukemia patients or patients of other malignant tumor who is susceptible to fungal infection upon undergoing chemotherapy or radiotherapy can apply it as means of preventive treatment.
7, it can be used for the treatment coccidioidomycosis.
8, it can be used for treatment of fungal skin disease including fungal skin infections such as body ringworm, tinea pedis, tinea versicolor, tinea capitis, onychomycosis and nail ringworm.
9, Fluconazole-D4 can also be used for the treatment of skin chromomycosis.
In August 2002, the voriconazole (Pfizer) which enters in the United States is the further structural modified derivative of Fluconazole-D4 with its antibacterial activity against pathogenic yeast being higher than fluconazole. Some case reports have demonstrated that the drug can successfully cure some rare fungal disease.
Production method
Method 1: From reaction between the formamide, hydrazine hydrate and 85% formic acid, we can obtain 1H-1, 2, 4-triazole. From phenylenediamine, we can obtain difluorobenzene, which is further subject to bromination to generate 2, 4-difluoro-bromobenzene. Magnesium was dissolved in anhydrous diethyl ether and added drop wise of the diethyl ether solution of 2, 4-difluoro-bromobenzene under ultrasonic irradiation, followed by adding drop wise of the diethyl ether solution of 1, 3-dichloroacetone under ice-cooling condition. Stir at room temperature overnight. Add glacial acetic acid and water. The separated organic layer was dried and concentrated. Concentrate, triazole, potassium carbonate and PEG600 were dissolved in anhydrous ethyl acetate and were subject to reflux. Then filter, wash with water to neutralization and dryness. The solvent was distilled off and was further subject to cyclohexane-ethyl acetate (1: 1) recrystallization to obtain the fluconazole with the overall yield being 33.6% and the m.p. being 138.5-140 ℃.
The last step can also be carried out in propionitrile. 1, 3-dihalo (x = Br or Cl)-2-(2, 4-difluorophenyl)-2-propanol and 1H-1, 2, 4-triazol-propionitrile were put into propionitrile and subject to reflux under the catalysis of sodium hydroxide and PEG 600 phase transfer catalysis and obtain the fluconazole crude product. The crude product was dissolved in fatty alcohols (such as propanol, isopropanol or butanol, etc.), dissolved upon heating with a small amount of active carbon for decoloring and then cooled to give crystals which is the refined product of fluconazole with the melting point being 139~140 ℃.
Method 2:2: 2, 4-difluorophenyl methyl is reacted with the Grignard reagent of 1-chloromethyl-1, 2, 4-triazole, and hydrolyzed to obtain fluconazole.
Method 3: difluorophenyl is subject to bromination to generate 1-bromo-2, 4-difluorobenzene, and then further converted to Grignard reagent. The resulting Grignard reagent above is reacted with 1, 3-bis (1H-1, 2, 4-triazole group) acetone, followed by hydrolysis to give fluconazole.
Indications
Fluconazole (Diflucan) may be better absorbed and is
possibly less hepatotoxic than ketoconazole, but it is
considerably more expensive, an important consideration
given the required length of therapy for most cutaneous
fungal diseases.
Manufacturing Process
141.1 g of aluminum trichloride was first added to 86 ml of DFB and 77 ml of chloroacetyl chloride was then added to the mixture, which was allowed to
react at 60°C for 3 hours. After the reaction mixture had cooled down, 500 g
of cold water was added. The mixture was stirred for about 20 min and then
filtered to afford about 158.5 g of 2-chloro-2',4'-difluoroacetophenone in solid
form (91% yield).A solution of 158.5 g of 2-chloro-2',4'-difluoroacetophenone and 88.8 g of 4-
amino-4H-1,2,4-triazole in 1,600 ml of cyanomethane was heated at reflux for
16 hours, cooled down, and filtered. The solid thus obtained was then washed
with 500 ml of ethyl ether once to afford 2-(1H-1,2,4-triazol-1-yl)-2',4'-
difluoroacetophenone salt.The crude product obtained was dissolved in 1,320 ml of 1.5 N hydrochloric
acid. To the solution thus obtained, an aqueous solution (330 ml) of sodium
nitrite (58.2 g) was dropwise added and the mixture was allowed to react for
30 min. Aqueous ammonium was then used to adjust the reaction mixture to
a neutral pH. The solid was precipitated and filtered to afford 159 g of 2-(1H-
1,2,4-triazol-1-yl)-2',4'-difluoroacetophenone (yield about 80%), which had a
water content of about 10%.4 g of 4-amino-4H-1,2,4-triazole, 57.87 g of potassium hydroxide, 118 g of
trimethyl sulfoxonium iodide, and 100 g of 2-(1H-1,2,4-triazol-l-yl)-2',4'-
difluoroacetophenone were dissolved in 1,600 ml of water. The solution was
heated at 70°C to react for 16 hours. Upon the completion of the reaction, the
solution was adjusted with 4 N hydrochloric acid to a neutral pH and then
extracted with acetyl acetate. The organic layer was collected, dried with 30 g
of anhydrous calcium dichloride, decolorized with 15 g of active charcoal, and
finally filtered off solid residues. The filtrate was concentrated to afford 99.3 g
of the crude product (yield 72%). The crude product was further recrystallized
from 500 ml of a solvent mixture of acetyl acetate and n-hexane (2:1) to
afford 66.3 g of the Fluconazole in the form of white solid (yield 48%).
Therapeutic Function
Antifungal
Antimicrobial activity
The spectrum is limited, but includes most Candida spp.,
Cryptococcus spp., dermatophytes and dimorphic fungi (Blast.
dermatitidis, Coccidioides spp., Hist. capsulatum and Paracoccidioides
brasiliensis). Strains of C. krusei appear to be insensitive.
Acquired resistance
Resistant strains of C. albicans have been isolated from AIDS
patients given long-term treatment for oral or esophageal
candidosis. Strains of C. glabrata frequently become resistant
during short courses of treatment. There are a few reports
of fluconazole-resistant strains of Cryp. neoformans recovered
from AIDS patients with relapsed meningitis. Most, but not
all, C. albicans and C. glabrata strains resistant to fluconazole
are cross-resistant to other azoles.
Pharmaceutical Applications
A synthetic bis(triazole) available for oral or parenteral administration.
A prodrug formulation, fosfluconazole, is available
for intravenous use in Japan.
Biological Activity
Triazole antifungal agent. Effective against Candida strains in vitro and in vivo .
Biochem/physiol Actions
Fluconazole is an antifungal agent. It is highly selective inhibitor of fungal cytochrome P-450 sterol C-14 α-demethyllation. Fluconazole is a potent inhibitor of CYP2C9. Fluconazole interferes with fungal ergosterol synthesis and downregulates the metallothionein gene.
Pharmacology
It has good oral absorption,
is well tolerated, and is preferentially taken up in keratinized tissues, reaching
concentrations up to 50 times that in plasma. This allows for once-weekly
dosing in most cases.
Pharmacokinetics
Oral absorption: >93%
Cmax 50 mg oral: c. 1 mg/L after 2 h
Plasma half-life: 25–30 h
Volume of distribution: 0.6–0.8 L/kg
Plasma protein binding; <10%
Absorption
Oral absorption is rapid (1–3 h) and is not affected by food or intragastric pH. Blood concentrations increase in proportion to dosage. Maximum serum concentrations increase to about 2–3 mg/L after repeated dosing with 50 mg.
Distribution
It is widely distributed, achieving therapeutic concentrations in most tissues and body fluids. Concentrations in cerebrospinal fluid (CSF) are 50–60% of the simultaneous serum concentration in normal individuals and even higher in patients with meningitis.
Metabolism and excretion
More than 90% of an oral dose is eliminated in the urine: about 80% as unchanged drug and 10% as inactive metabolites. The drug is cleared by glomerular filtration, but there is significant tubular reabsorption. The plasma half-life is prolonged in renal failure, necessitating adjustment of the dosage.Fluconazole-D4 is removed during hemodialysis and, to a lesser extent, during peritoneal dialysis. In children the volume of distribution and plasma clearance are increased, and the half-life is considerably shorter (15–25 h).
Clinical Use
Mucosal, cutaneous and systemic candidosis
Coccidioidomycosis
Cryptococcosis
Dermatophytosis
Pityriasis versicolor
Clinical Use
Fluconazole is very effective in the treatment of infections
with most Candida spp. Thrush in the end-stage
AIDS patient, often refractory to nystatin, clotrimazole,
and ketoconazole, can usually be suppressed with oral
fluconazole.AIDS patients with esophageal candidiasis
also usually respond to fluconazole.
Fluconazole may be an acceptable alternative to
amphotericin B in the initial treatment of mild cryptococcal
meningitis, and it has been shown to be superior
to amphotericin B in the long-term prevention of relapsing
meningitis (such patients require lifelong treatment.).
Coccidioidal meningitis, previously treated with
both intravenous and intrathecal amphotericin B, appears
to respond at least as well to prolonged oral fluconazole
therapy. Aspergillosis, mucormycosis, and
pseudallescheriasis do not respond to fluconazole treatment.
Sporotrichosis, histoplasmosis, and blastomycosis
appear to be better treated with itraconazole, although
fluconazole does appear to have significant activity
against these dimorphic fungi.
Side effects
Fluconazole is well tolerated. Nausea, vomiting, abdominal
pain, diarrhea, and skin rash have been reported in
fewer than 3% of patients. Asymptomatic liver enzyme
elevation has been described, and several cases of drugassociated
hepatic necrosis have been reported. Alopecia
has been reported as a common adverse event in
patients receiving prolonged high-dose therapy. Coadministration
of fluconazole with phenytoin results in increased
serum phenytoin levels.
Side effects
These are rare, but untoward reactions include nausea,
abdominal discomfort, diarrhea and headache. Transient
abnormalities of liver enzymes and rare serious skin reactions,
including Stevens–Johnson syndrome, have been
reported.
Veterinary Drugs and Treatments
Fluconazole may have use in veterinary medicine in the treatment
of systemic mycoses, including cryptococcal meningitis, blastomycosis,
and histoplasmosis. It may also be useful for superficial
candidiasis or dermatophytosis. Because of the drug’s unique pharmacokinetic
qualities, it is probably more useful in treating CNS
infections or fungal urinary tract infections than other azole derivatives.
Fluconazole does not have appreciable effects (unlike ketoconazole)
on hormone synthesis and may have fewer side effects
than ketoconazole in small animals.
Drug interactions
Potentially hazardous interactions with other drugs
Aminophylline: concentration of aminophylline
possibly increased.
Analgesics: increases concentration of celecoxib -
halve celecoxib dose; concentration of flurbiprofen,
ibuprofen and methadone increased; increases
concentration of parecoxib - reduce parecoxib dose;
inhibits metabolism of alfentanil; concentration of
fentanyl possibly increased.
Anti-arrhythmics: avoid concomitant use with
amiodarone due to risk of QT prolongation.
Antibacterials: avoid with erythromycin; increases
rifabutin levels - reduce dose; metabolism
accelerated by rifampicin; concentration of
bedaquiline possibly increased - avoid if fluconazole
for >14 days.
Anticoagulants: potentiates effect of coumarins.
Antidepressants: avoid concomitant use with
reboxetine; concentration of amitriptyline and
nortriptyline increased.
Antidiabetics: possibly enhances hypoglycaemic
effect of nateglinide; increases concentration of
sulphonylureas.
Antiepileptics: increases fosphenytoin and
phenytoin levels; possibly increased carbamazepine
concentration.
Antimalarials: avoid concomitant administration
with artemether/lumefantrine and piperaquine with
artenimol.
Antipsychotics: increased risk of ventricular
arrhythmias with pimozide - avoid concomitant
use; possibly increases lurasidone concentration;
possibly increased quetiapine levels - reduce dose of
quetiapine.
Antivirals: increases nevirapine, ritonavir, tipranavir
and zidovudine levels, and possibly saquinavir:
concentration of simeprevir possibly increased -
avoid.
Anxiolytics and hypnotics: increases diazepam and
midazolam levels.
Avanafil: concentration of avanafil possibly increased.
Bosentan: increased bosentan levels - avoid
concomitant use.
Ciclosporin: increases blood/serum ciclosporin
levels.
Clopidogrel: possibly reduced antiplatelet effect.
Cytotoxics: possibly increased side effects of
cyclophosphamide; concentration of bosutinib and
possibly olaparib increased - avoid or reduce dose of bosutinib; possibly increases ibrutinib concentration
- reduce ibrutinib dose; reduce dose of ruxolitinib.
Dapoxetine: reduce dose of dapoxetine.
Diuretics: increased eplerenone levels - avoid
concomitant use; concentration of fluconazole
increased by hydrochlorothiazide.
Ergot alkaloids: increased risk of ergotism - avoid
concomitant use.
Guanfacine: possibly increased guanfacine dose -
halve dose of guanfacine.
Ivabradine: increased ivabradine levels - reduce
initial dose.
Ivacaftor: increased concentration of ivacaftor.
Lipid-lowering drugs: possibly increased risk
of myopathy with atorvastatin or simvastatin;
concentration of fluvastatin increased possibly
increased risk of myopathy; avoid with lomitapide.
Retinoids: possibly increased risk of tretinoin
toxicity.
Sirolimus: may increase sirolimus concentration.
Tacrolimus: increases blood/serum tacrolimus levels.
Theophylline: possibly increases theophylline levels.
Metabolism
Fluconazole is metabolised only to a minor extent. Of
a radioactive dose, only 11% is excreted as metabolites
in the urine. The major route of excretion is renal, with
approximately 80% of the administered dose appearing in
the urine as unchanged medicinal product. Fluconazole
clearance is proportional to creatinine clearance. There is
no evidence of circulating metabolites.
Check Digit Verification of cas no
The CAS Registry Mumber 86386-73-4 includes 8 digits separated into 3 groups by hyphens. The first part of the number,starting from the left, has 5 digits, 8,6,3,8 and 6 respectively; the second part has 2 digits, 7 and 3 respectively.
Calculate Digit Verification of CAS Registry Number 86386-73:
(7*8)+(6*6)+(5*3)+(4*8)+(3*6)+(2*7)+(1*3)=174
174 % 10 = 4
So 86386-73-4 is a valid CAS Registry Number.
InChI:InChI=1/C13H12F2N6O/c14-10-1-2-11(12(15)3-10)13(22,4-20-8-16-6-18-20)5-21-9-17-7-19-21/h1-3,6-9,22H,4-5H2
86386-73-4Relevant articles and documents
Synthesis and crystal structure of [α-(2,4-difluorophenyl)-α-(1H-1,2,4-triazole-1-ylmethyl)-1H-1,2,4-triazole-1-ethanol]Cu(II) complex
Wang, Yongfen,Bian, Chuanzhou
, p. 8593 - 8595 (2014)
A novel complex of copper(II) was prepared by reaction of CuCl2 and fluconazole at reflux in water and tetrahydrofuran. Its structure was determined by single crystal X-ray diffraction analysis. The crystals are monoclinic space group C2/c with a = 23.490(2), b = 9.4719(9), c = 19.8459(18) ?, α = 90.00, β = 123.639(2), γ = 90.00°, V = 3676.2(6) ?3, Z = 4, F(000) = 1676, Dc = 1.480 g/cm3, μ = 0.815 mm-1, the final R = 0.0526 and wR = 0.1688. A total of 8828 reflections were collected, of which 3244 were independent (Rint = 0.0344).
The Application of a Continuous Grignard Reaction in the Preparation of Fluconazole
Korwar, Sudha,Amir, Somi,Tosso, Perrer N.,Desai, Bimbisar K.,Kong, Caleb J.,Fadnis, Swara,Telang, Nakul S.,Ahmad, Saeed,Roper, Thomas D.,Gupton, B. Frank
, p. 6495 - 6498 (2017)
The application of continuous methods in the synthesis of active pharmaceutical ingredients continues to receive significant attention in the academic as well as the industrial research communities. One of the major advantages of continuous methods is the ability to safely access kinetic synthons as well as highly reactive reagents that are typically unavailable through traditional batch methods. In this work, we report the high-yielding, clean formation of an aryl-turbo Grignard and its selective addition to a highly-enolizable 1,3-dichloroacetone, for the continuous synthesis of a key intermediate for fluconazole, a widely-prescribed anti-fungal agent. In addition, process optimization of the final API was also carried out to arrive at a semi-continuous method to this essential medicine.
Rapid synthesis of some new propanol derivatives analogous to fluconazole under microwave irradiation in solventless system
Heravi, Majid M.,Motamedi, Radineh
, p. 19 - 22 (2005)
Fluconazole and a series of 2-(2,4-difluorophenyl)-1-(1H-1,2,4 triazol-1-yl- methyl)-3-(substituted heterocycl)-propan-2-ol which are analogous to fluconazole,were synthesized via the reaction of 2-(2,4-difluorophenyl)-2- [1-(1,2,4-triazolmethide)]oxiran with various heterocyclic system under microwave irradiation in solventless system.
Hydrogen Bond Directed Photocatalytic Hydrodefluorination and Methods of Use Thereof
-
, (2021/01/22)
Methods of synthesizing compounds comprising fluorinated aryl groups are disclosed, wherein said methods utilize hydrogen bond directed photocatalytic hydrodefluorination.
Continuous Flow Synthesis of Terminal Epoxides from Ketones Using in Situ Generated Bromomethyl Lithium
Von Keutz, Timo,Cantillo, David,Kappe, C. Oliver
supporting information, p. 10094 - 10098 (2019/12/24)
A scalable procedure for the direct preparation of epoxides from ketones has been developed. The method is based on the carefully controlled generation of (bromomethyl)lithium (LiCH2Br) from inexpensive CH2Br2 and MeLi in a continuous flow reactor. The reaction has shown excellent selectivity for a variety of substrates, including α-chloroketones, which typically fail under classic Corey-Chaykovsky conditions. This advantage has been used to develop a novel route toward the drug fluconazole.
Method for preparing fluconazole
-
Paragraph 0031; 0066; 0067; 0068; 0075; 0076, (2017/07/21)
The invention provides a method for preparing fluconazole. The method comprises the following steps: reacting a structure compound in a formula I, trimethylsulfoxonium bromide and 1,2,4-triazole in the effect of an alkaline catalyst to obtain the fluconazole. Compared with the prior art, the method has the advantages that trimethylsulfoxonium bromide is adopted to prepare the fluconazole, and bromide ions in the trimethylsulfoxonium bromide have relatively weak nucleophilicity to effectively avoid occurrence of side reaction, so that the yield and purity of fluconazole can be improved. Furthermore, the trimethylsulfoxonium bromide adopted for reacting has high molar mass utilization, low price and remarkable cost advantages.
A preparation method of fluconazole
-
Paragraph 0049-0051; 0065-0068, (2017/08/25)
The invention discloses a preparation method of fluconazol and belongs to the field of pharmaceutical chemistry and chemical synthesis. The preparation method comprises the following reaction processes: adopting low-price and easily-available epoxy chloropropane as a raw material to react with 1,2,4-triazole; then performing oxidation by using sodium hypochlorite; and finally, reacting with a prepared 2,4-difluorophenyl magnesium lithium reagent to prepare fluconazol. The invention provides a brand-new synthetic route and a process, the reaction of each step is easy to operate, the process is simple, the use of a reagent with high toxicity, high environmental protection pressure and high price is effectively avoided, the reaction total yield is improved, the product cost is effectively reduced, and large-scale production can be realized more easily.
Synthesis of novel fluconazoliums and their evaluation for antibacterial and antifungal activities
Zhang, Yi-Yi,Mi, Jia-Li,Zhou, Cheng-He,Zhou, Xiang-Dong
, p. 4391 - 4402 (2011/11/06)
A series of novel fluconazoliums were synthesized and their bioactive evaluation as potential antibacterial and antifungal agents were described. Some target compounds displayed good and broad-spectrum antimicrobial activities with low MIC values ranging from 0.25 to 64 μg/mL against all the tested strains, including three Gram-positive bacteria (Staphylococcus aureus, MRSA and Bacillus subtilis), three Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa and Bacillus proteus) as well as two fungi (Candida albicans and Aspergillus fumigatus). Among all tested title compounds, the octyl, dichlorobenzyl, naphthyl and naphthalimino derivatives gave comparable or even better antibacterial and antifungal efficiency in comparison with the reference drugs Fluconazole, Chloromycin and Norfloxacin.
Methods for predicting the response to statins
-
, (2011/10/13)
The invention provides methods for optimizing therapeutic efficacy for treating hypercholesterolemia in a subject having a cardiovascular disease (CVD), comprising (a) determining subject characteristics that affect the likelihood of reaching a goal level of low density lipoprotein (LDL); and (b) obtaining success probabilities of a variety of statin treatments for reaching said goal level of LDL using said subject characteristics and a multivariate model; and (c) administrating the optimal statin treatment with the highest success probability of step (b) to said subject thereby optimizing therapeutic efficacy for treating hypercholesterolemia in said subject.
CRYSTALLINE 1-[2-(2,4-DIFLUOROPHENYL)-OXIRANYL METHYL]-1H-1,2,4-TRIAZOLE
-
Page/Page column 3; 4, (2008/06/13)
A crystalline form of the compound 1-[2-(2,4-difluorophenyl)-oxiranyl methyl]-1H-1,2,4-triazole and a process for preparing the form. The crystalline form can be used for preparing fluconazole.
