Solifenacin (YM905)
(Synonyms: 索利那新; YM905 free base) 目录号 : GC30822Solifenacin (YM905) is a competitive muscarinic receptor antagonist. The binding of acetylcholine to these receptors, particularly the M3 receptor subtype, plays a critical role in the contraction of smooth muscle.
Cas No.:242478-37-1
Sample solution is provided at 25 µL, 10mM.
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Cell experiment: |
Cytosolic Ca2+ mobilization is determined in guinea pig detrusor cells. Briefly, single detrusor cells are prepared from epithelium-free bladders, loaded with Fura 2, and suspended in phenol red-free Hanks’ balanced salt solution supplemented with 20 mM HEPES (pH=7.4) and 0.1% bovine serum albumin (HBSS-H/B). A 490 μL aliquot of the cell suspension is continuously stirred, kept at 28°C and monitored for the ratio of fluorescence at 500 nm with excitation at 340 nm to that at 380 nm. To each aliquot, 5 μL of test drug (including Solifenacin) and stimulant solutions are serially added with a 2 min interval, and the peak increase over the level just before stimulation is used for data analysis[1]. |
Animal experiment: |
Male rats (270 to 320 g) are used in this study. After the measurement of neurological deficits, cystometry is performed. Briefly, conscious rats showing a moderate to severe neurological deficit (score: 4 to13) are placed in a restraining cage. To facilitate drug (including Solifenacin) evaluation, only those animals showing urinary frequency are eligible for study. The bladder is emptied by drainage of urine through the catheter and then continuously re-infused with saline. After stable voiding cycles are established, each rat receives a single intravenous administration of test drug (including Solifenacin) at a volume of 1 ml/kg[2]. |
References: [1]. Ikeda K, et al. M(3) receptor antagonism by the novel antimuscarinic agent solifenacin in the urinary bladder and salivary gland. Naunyn Schmiedebergs Arch Pharmacol. 2002 Aug;366(2):97-103. |
Solifenacin (YM905) is a competitive muscarinic receptor antagonist. The binding of acetylcholine to these receptors, particularly the M3 receptor subtype, plays a critical role in the contraction of smooth muscle.
Cas No. | 242478-37-1 | SDF | |
别名 | 索利那新; YM905 free base | ||
Canonical SMILES | O=C(O[C@@]1([H])C[N@]2CC[C@@H]1CC2)N3CCC4=CC=CC=C4[C@@H]3C5=CC=CC=C5 | ||
分子式 | C23H26N2O2 | 分子量 | 362.46 |
溶解度 | DMSO : ≥ 50 mg/mL (137.95 mM);Water : < 0.1 mg/mL (insoluble) | 储存条件 | Store at -20°C |
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1 mg | 5 mg | 10 mg | |
1 mM | 2.7589 mL | 13.7946 mL | 27.5893 mL |
5 mM | 0.5518 mL | 2.7589 mL | 5.5179 mL |
10 mM | 0.2759 mL | 1.3795 mL | 2.7589 mL |
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Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder
Aim: We conducted a meta-analysis to evaluate the safety and efficacy of mirabegron (50 mg) and solifenacin (5 mg) monotherapy for overactive bladder (OAB) during a 12-week cycle. Methods: Randomized controlled trials (RCTs) of mirabegron and solifenacin for OAB were searched systematically by using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of retrieved studies were also perused. Results: Five RCTs which compared solifenacin with mirabegron were studied. Mirabegron achieved the same effect as solifenacin in treating OAB. The mean number of incontinence episodes per 24 h (P = 0.20), mean number of micturitions per 24 h (P = 0.11), mean number of urgency episodes per 24 h (P = 0.23), and mean volume voided per micturition (P = 0.05) suggested that mirabegron and solifenacin had no significant differences in terms of OAB treatment. With regard to drug-related treatment-emergent adverse events (DR-TEAEs) and dry mouth, mirabegron showed better tolerance than solifenacin. Post-voiding residual volume showed a distinct difference in the two groups. Hypertension and tachycardia did not show a significant difference between the two groups, but the pulse rate did. Conclusion: The therapeutic effect of mirabegron is similar to that of solifenacin, and mirabegron does not increase the risk of adverse events (AEs).
Solifenacin
Pharacologic therapy has been the mainstay of treatment for patients who have overactive bladder. In recent years, a number of new antimuscarinic agents have been introduced. Solifenacin succinate is a new once-daily antimuscarinic agent that is an effective and well-tolerated treatment option for patients who have overactive bladder. Solifenacin increases functional bladder capacity and decreases urgency, frequency, and incontinence. In pharmacokinetic studies, solifenacin demonstrated selectivity for the bladder over the salivary gland; thus, it is likely that the bladder selectivity of this agent is responsible for the low incidence of dry mouth and constipation reported in the clinical trials.
Solifenacin pharmacology
Antimuscarinics are the drugs of choice for the treatment of overactive bladder syndrome, and their benefit/risk ratio depends largely on selectivity for the different subtypes of muscarinic receptors. Solifenacin is the antimuscarinic that presents greatest selectivity for M3 bladder receptors, which may translate into a lower incidence of undesirable effects related to other receptor subtypes. Metabolic pathways of the antimuscarinics may impact efficacy and appearance of interactions. Solifenacin is metabolized only by the CYP3A4, giving three inactive metabolites and one with a similar activity to the original compound. However, other drugs in the group are also a substrate for the CYP 2D6 which presents polymorphisms, whereby their pharmacokinetics may be modified in slow metabolizers. The risk of interactions of solifenacin is low, and it is lower than that of the antimuscarinics which are also metabolized by the CYP 2D6. The unaltered fraction of solifenacin which is eliminated in urine, together with the active metabolite, can contribute to the therapeutic effect by acting on the urothelium receptors. It is not necessary to adjust doses of solifenacin in elderly patients or those with moderate liver or kidney impairment.
Long-term Safety and Efficacy of Mirabegron and Solifenacin in Combination Compared with Monotherapy in Patients with Overactive Bladder: A Randomised, Multicentre Phase 3 Study (SYNERGY II)
Background: The long-term potential of solifenacin and mirabegron combination treatment for patients with overactive bladder (OAB) has not been previously assessed.
Objectives: To evaluate the safety and efficacy of solifenacin succinate 5mg plus mirabegron 50mg tablets (combination treatment) versus solifenacin or mirabegron monotherapy in patients with OAB over 12 mo.
Design, setting, and participants: Randomised, double-blind, multicentre, phase 3 trial (SYNERGY II) of patients with "wet" OAB symptoms (urinary frequency and urgency with incontinence) for ≥3 mo. The study was conducted from March 2014 to September 2016; with 1829 patients randomised. The full analysis set was comprised of 1794 patients.
Outcome measurements and statistical analysis: The primary objective was safety, measured as treatment-emergent adverse events (TEAEs). Efficacy was measured as the change from baseline to the end of treatment in the mean number of incontinence episodes/24h and micturitions/24h.
Results and limitations: The median age was 60 yr (range 19-86 yr) and 1434 patients (80%) were female. Overall, 856 patients (47%) experienced ≥1 TEAE. TEAE frequency was slightly higher in the combination group (596 patients, 49%; mirabegron 126 patients, 41%; solifenacin 134 patients, 44%). Serious TEAEs were reported by 67 patients (3.7%); one was considered possibly treatment-related (mirabegron group, atrial fibrillation). Dry mouth was the most common TEAE (combination 74 patients, 6.1%; solifenacin 18 patients, 5.9%; mirabegron 12 patients, 3.9%). Combination therapy was statistically superior to mirabegron and solifenacin for the number of incontinence episodes (vs mirabegron: adjusted mean difference [AMD] -0.5, 95% confidence interval [CI] -0.7 to -0.2, p<0.001; vs solifenacin: AMD -0.1, 95% CI -0.4 to 0.1, p=0.002) and micturitions (vs mirabegron: AMD -0.5, 95% CI -0.8 to -0.2, p<0.001; vs solifenacin: AMD -0.4, 95% CI -0.7 to -0.1, p=0.004).
Conclusions: Mirabegron and solifenacin combination treatment for OAB symptoms was well tolerated over 12 mo and led to efficacy improvements over each monotherapy. This innovative combination is a treatment option that could become widely used in the clinic.
Patient summary: This study looked at the safety and efficacy of a combination of solifenacin succinate 5mg plus mirabegron 50mg tablets over 12 mo in patients with the overactive bladder (OAB) symptoms of increased urination frequency, heightened urgency to urinate, and unintentional passing of urine. We compared this treatment with solifenacin succinate 5mg or mirabegron 50mg alone, and found that the combination treatment was well tolerated by patients and led to greater improvements in symptoms. This novel combination could be an improved treatment option in the clinical setting for patients with OAB. This study is registered at ClinicalTrials.gov as NCT02045862.