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Record Information
Version5.0
StatusDetected but not Quantified
Creation Date2021-09-11 08:59:29 UTC
Update Date2021-09-26 23:03:43 UTC
HMDB IDHMDB0251621
Secondary Accession NumbersNone
Metabolite Identification
Common NameDronedarone
DescriptionDronedarone, also known as multaq or SR 33589, belongs to the class of organic compounds known as aryl-phenylketones. These are aromatic compounds containing a ketone substituted by one aryl group, and a phenyl group. Dronedarone (development codename SR33589 and marketed as Multaq) is a drug by Sanofi-Aventis, mainly for the indication of cardiac arrhythmias. " Dronedarone is also associated with rare cases of severe liver damage, including liver failure. Dronedarone has been termed a “multichannel blocker” however it is unclear which channel(s) play a pivotal role in its success. Thus, dronedarone's actions at the cellular level are controversial with most studies suggesting an inhibition in multiple outward potassium currents including rapid delayed rectifier, slow delayed rectifier and ACh-activated inward rectifier. It is also believed to reduce inward rapid Na current and L-type Ca channels. The reduction in K current in some studies was shown to be due to the inhibition of K-ACh channel or associated GTP-binding proteins. Reduction of K+ current by 69% led to increased AP duration and increased effective refractory periods, thus shown to suppress pacemaker potential of the SA node and return patients to a normal heart rhythm. In a European trial, the average time to recurrence of an arrhythmia was 41 days in the placebo group vs. 96 days in the dronedarone group (similar results obtained in the non-European trial, 59 and 158 days respectively).Chemically, dronedarone is a benzofuran derivative related to amiodarone, a popular antiarrhythmic. The use of amiodarone is limited by toxicity due its high iodine content (pulmonary fibrosis, thyroid disease) as well as by liver disease. In dronedarone, the iodine moieties are not present, reducing toxic effects on the thyroid and other organs. A methylsulfonamide group is added to reduce solubility in fats (lipophobicity) and thus reduce neurotoxic effects. Dronedarone displays amiodarone-like class III antiarrhythmic activity in vitro and in clinical trials. The drug also appears to exhibit activity in each of the 4 Vaughan-Williams antiarrhythmic classes. Dronedarone is less lipophilic than amiodarone, has a much smaller volume of distribution, and has an elimination half-life of 13–19 hours—this stands in contrast to amiodarone's half-life of several weeks. As a result of these pharmacokinetic characteristics, dronedarone dosing may be less complicated than amiodarone. Permanent AF (patients in whom normal sinus rhythm will not or cannot be restored)Recently decompensated heart failure requiring hospitalization or Class IV heart failure. Second-or third-degree AV block or sick sinus syndrome (except when used in conjunction with a functioning pacemaker)BradycardiaConcomitant use of a strong CYP3A inhibitorConcomitant use of drugs or herbal products that prolong the QT interval and may induce Torsade de PointesLiver or lung toxicity related to the previous use of amiodaroneSevere hepatic impairmentQTc Bazett interval ≥500 ms, or use with drugs or herbal supplements that prolong QT interval or increase risk of torsades de points (Class I or III antiarrhythmic agents, phenothiazines, tricyclic antidepressants, certain oral macrolides, ephedra).Pregnancy and nursing mothersHypersensitivity to dronedaroneHepatic impairment. In Jan 2011 the FDA advised about cases of rare, but severe, liver injury, including two cases of acute liver failure leading to liver transplant in patients treated with dronedarone (Multaq). It is not known whether routine periodic monitoring of serum liver enzymes (ALT, AST, and alkaline phosphatase) and bilirubin in patients taking dronedarone will prevent the development of severe liver injury. PR interval exceeding 280 msUse of cytochrome P-450 (CYP) 3a isoenzyme inhibitors (includes: clarithromycin, cyclosporine, itraconazole, ketoconazole, nefazodone, ritonavir, telithromycin, voriconazole)Clinical trials have compared dronedarone to placebo and to amiodarone, for its ability to reduce atrial fibrillation, to reduce mortality overall and from cardiac causes, and for its adverse effects, including excess mortality. Dronedarone is a non-iodinated class III anti-arrhythmic drug which helps patients return to normal sinus rhythm. This treatment for AF is also known to reduce associated mortality and hospitalizations compared to other similar antiarrhythmic agents. In the EURIDIS and ADONIS trials in atrial fibrillation (2007), dronedarone was significantly more effective than placebo in maintaining sinus rhythm, with no difference in lung and thyroid function in the short term. However, in the ANDROMEDA study (2007), dronedarone doubled the death rate compared to placebo, and the trial was halted early. ANDROMEDA enrolled patients with moderate to severe congestive heart failure, a relatively sicker patient population. In a more recent atrial fibrillation trial, ATHENA, with 4628 subjects, dronedarone was significantly more effective than placebo in reducing the composite endpoint of first hospitalization due to cardiovascular events or death. There was a significant reduction in the rate of cardiovascular death, but not in the rate of death from any cause. Later post-hoc analysis of the ATHENA-results showed a significant reduction in the rate of stroke. Patients randomized to dronedarone were more likely to develop bradycardia and QT-interval prolongation (but only 1 case of Torsades). Nausea, diarrhea, rash, and creatinine elevation also were more common in the dronedarone arm. The PALLAS trial (2011) was stopped for safety concerns due to the finding that "dronedarone increased rates of heart failure, stroke, and death from cardiovascular causes in patients with permanent atrial fibrillation who were at risk for major vascular events". A Black Box warning was subsequently added by the FDA stating that the risk of death, stroke, and hospitalization for congestive heart failure doubled in patients with permanent atrial fibrillation. Dronedarone has been tested in some trials as a way to improve the success rate of electrical cardioversion. In one such trial by the Veteran's Administration it was used prepare patients for electrical conversion to sinus rhythm. In the ATHENA study, 25% of patients were started on dronedarone before cardioversion. The results of a recently concluded randomized study (ELECTRA) may clarify the safety and ideal modalities of dronedarone use at the time of cardioversion. Originally submitted as a New Drug Application in 2005, dronedarone was reviewed and recommended for approval on March 18, 2009 by an Advisory Committee of the United States Food and Drug Administration (FDA). The FDA is not bound by the Committee's recommendation, but it takes its advice into consideration when reviewing new drug applications. The FDA approved dronedarone on July 2, 2009. Health Canada was the second major regulatory body to approve the drug, giving its approval on August 12, 2009. The approval is for "treatment of patients with a history of, or current atrial fibrillation to reduce their risk of cardiovascular hospitalization due to this condition. Dronedarone is a very strong basic compound (based on its pKa). It was approved by the FDA on July 2, 2009. In the United States, the FDA approved label includes a claim for reducing hospitalization, but not for reducing mortality, as a reduction in mortality was not demonstrated in the clinical development program. It was recommended as an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment i.e. direct current cardioversion (DCCV) to maintain normal rhythm. It is a class III antiarrhythmic drug. A trial of the drug in heart failure was stopped as an interim analysis showed a possible increase in heart failure deaths, in patients with moderate to severe CHF.The U.S. label for dronedarone includes a boxed warning, stating that dronedarone is contraindicated in patients with NYHA Class IV heart failure, with NYHA Class II–III heart failure with a recent decompensation requiring hospitalization or referral to a specialized heart failure clinic, or with permanent atrial fibrillation. "The European Medicines Agency issued a Summary of Positive Opinion regarding dronedarone on 24 September 2009 recommending to the European Commission to grant a marketing authorization within the European Union. This compound has been identified in human blood as reported by (PMID: 31557052 ). Dronedarone is not a naturally occurring metabolite and is only found in those individuals exposed to this compound or its derivatives. Technically Dronedarone is part of the human exposome. The exposome can be defined as the collection of all the exposures of an individual in a lifetime and how those exposures relate to health. An individual's exposure begins before birth and includes insults from environmental and occupational sources.
Structure
Thumb
Synonyms
ValueSource
MultaqChEBI
N-(2-Butyl-3-(4-(3-(dibutylamino)propoxy)benzoyl)-5-benzofuranyl)-methanesulfonamideChEBI
N-(2-Butyl-3-(p-(3-(dibutylamino)propoxy)benzoyl)-5-benzofuranyl)methanesulfonamideChEBI
SR 33589ChEBI
SR 33589bChEBI
N-(2-Butyl-3-(4-(3-(dibutylamino)propoxy)benzoyl)-5-benzofuranyl)-methanesulphonamideGenerator
N-(2-Butyl-3-(p-(3-(dibutylamino)propoxy)benzoyl)-5-benzofuranyl)methanesulphonamideGenerator
Chemical FormulaC31H44N2O5S
Average Molecular Weight556.756
Monoisotopic Molecular Weight556.297093218
IUPAC NameN-(2-butyl-3-{4-[3-(dibutylamino)propoxy]benzoyl}-1-benzofuran-5-yl)methanesulfonamide
Traditional Namemultaq
CAS Registry NumberNot Available
SMILES
CCCCN(CCCC)CCCOC1=CC=C(C=C1)C(=O)C1=C(CCCC)OC2=C1C=C(NS(C)(=O)=O)C=C2
InChI Identifier
InChI=1S/C31H44N2O5S/c1-5-8-12-29-30(27-23-25(32-39(4,35)36)15-18-28(27)38-29)31(34)24-13-16-26(17-14-24)37-22-11-21-33(19-9-6-2)20-10-7-3/h13-18,23,32H,5-12,19-22H2,1-4H3
InChI KeyZQTNQVWKHCQYLQ-UHFFFAOYSA-N
Chemical Taxonomy
Description Belongs to the class of organic compounds known as aryl-phenylketones. These are aromatic compounds containing a ketone substituted by one aryl group, and a phenyl group.
KingdomOrganic compounds
Super ClassOrganic oxygen compounds
ClassOrganooxygen compounds
Sub ClassCarbonyl compounds
Direct ParentAryl-phenylketones
Alternative Parents
Substituents
  • Aryl-phenylketone
  • Sulfanilide
  • Benzofuran
  • Phenoxy compound
  • Benzoyl
  • Phenol ether
  • 3-aroylfuran
  • Alkyl aryl ether
  • Monocyclic benzene moiety
  • Organic sulfonic acid amide
  • Benzenoid
  • Organosulfonic acid amide
  • Furan
  • Heteroaromatic compound
  • Organic sulfonic acid or derivatives
  • Organosulfonic acid or derivatives
  • Aminosulfonyl compound
  • Sulfonyl
  • Tertiary amine
  • Tertiary aliphatic amine
  • Oxacycle
  • Ether
  • Organoheterocyclic compound
  • Amine
  • Organosulfur compound
  • Organonitrogen compound
  • Organic nitrogen compound
  • Organopnictogen compound
  • Organic oxide
  • Hydrocarbon derivative
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptors
Ontology
Physiological effectNot Available
Disposition
ProcessNot Available
RoleNot Available
Physical Properties
StateNot Available
Experimental Molecular Properties
PropertyValueReference
Melting PointNot AvailableNot Available
Boiling PointNot AvailableNot Available
Water SolubilityNot AvailableNot Available
LogPNot AvailableNot Available
Experimental Chromatographic PropertiesNot Available
Predicted Molecular Properties
PropertyValueSource
logP6.46ALOGPS
logP5.28ChemAxon
logS-5.4ALOGPS
pKa (Strongest Acidic)9.08ChemAxon
pKa (Strongest Basic)9.79ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area88.85 ŲChemAxon
Rotatable Bond Count17ChemAxon
Refractivity158.13 m³·mol⁻¹ChemAxon
Polarizability66.05 ųChemAxon
Number of Rings3ChemAxon
BioavailabilityNoChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted Chromatographic Properties

Predicted Collision Cross Sections

PredictorAdduct TypeCCS Value (Å2)Reference
DeepCCS[M+H]+231.30930932474
DeepCCS[M-H]-228.91430932474
DeepCCS[M-2H]-261.79730932474
DeepCCS[M+Na]+237.22230932474
AllCCS[M+H]+232.032859911
AllCCS[M+H-H2O]+230.732859911
AllCCS[M+NH4]+233.132859911
AllCCS[M+Na]+233.432859911
AllCCS[M-H]-217.932859911
AllCCS[M+Na-2H]-220.932859911
AllCCS[M+HCOO]-224.432859911

Predicted Kovats Retention Indices

Underivatized

MetaboliteSMILESKovats RI ValueColumn TypeReference
DronedaroneCCCCN(CCCC)CCCOC1=CC=C(C=C1)C(=O)C1=C(CCCC)OC2=C1C=C(NS(C)(=O)=O)C=C26536.5Standard polar33892256
DronedaroneCCCCN(CCCC)CCCOC1=CC=C(C=C1)C(=O)C1=C(CCCC)OC2=C1C=C(NS(C)(=O)=O)C=C24339.8Standard non polar33892256
DronedaroneCCCCN(CCCC)CCCOC1=CC=C(C=C1)C(=O)C1=C(CCCC)OC2=C1C=C(NS(C)(=O)=O)C=C24284.9Semi standard non polar33892256

Derivatized

Derivative Name / StructureSMILESKovats RI ValueColumn TypeReference
Dronedarone,1TMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C)S(C)(=O)=O)=CC=C2O14186.5Semi standard non polar33892256
Dronedarone,1TMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C)S(C)(=O)=O)=CC=C2O14395.5Standard non polar33892256
Dronedarone,1TMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C)S(C)(=O)=O)=CC=C2O15344.2Standard polar33892256
Dronedarone,1TBDMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C(C)(C)C)S(C)(=O)=O)=CC=C2O14357.4Semi standard non polar33892256
Dronedarone,1TBDMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C(C)(C)C)S(C)(=O)=O)=CC=C2O14610.8Standard non polar33892256
Dronedarone,1TBDMS,isomer #1CCCCC1=C(C(=O)C2=CC=C(OCCCN(CCCC)CCCC)C=C2)C2=CC(N([Si](C)(C)C(C)(C)C)S(C)(=O)=O)=CC=C2O15311.6Standard polar33892256
Spectra

MS/MS Spectra

Spectrum TypeDescriptionSplash KeyDeposition DateSourceView
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , negative-QTOFsplash10-0a4i-0000090000-8897a71d0d4436083f2f2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , negative-QTOFsplash10-0a4i-0000090000-0412b5e5e921a14ade8e2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , negative-QTOFsplash10-0a4i-0000090000-77777b7e67d24302cc612017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , negative-QTOFsplash10-0a4i-0000090000-98e3b8bdab6f810350d02017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , negative-QTOFsplash10-0a4i-0009020000-46fc09138b4d4c98f7db2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone 10V, Negative-QTOFsplash10-0a4i-0000090000-8897a71d0d4436083f2f2021-09-20HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone 50V, Negative-QTOFsplash10-0a4i-0009020000-46fc09138b4d4c98f7db2021-09-20HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone 20V, Negative-QTOFsplash10-0a4i-0000090000-0412b5e5e921a14ade8e2021-09-20HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone 30V, Negative-QTOFsplash10-0a4i-0000090000-77777b7e67d24302cc612021-09-20HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone 40V, Negative-QTOFsplash10-0a4i-0000090000-98e3b8bdab6f810350d02021-09-20HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , positive-QTOFsplash10-0a4i-0000090000-5fc376f78fcd143923df2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , positive-QTOFsplash10-0a4i-0000090000-a4ea4fac6f54cdcb7cbc2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , positive-QTOFsplash10-0a4i-0000090000-c3aef714c9268fa971ca2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , positive-QTOFsplash10-0a4i-0100290000-55925fc920832a5623172017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-QTOF , positive-QTOFsplash10-052o-0922440000-21a75dc14e4f6eec2a802017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-000i-0011920000-b36c2c2ac812fdf862c02017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0a4i-0000090000-6af26e1e5383a45216662017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0a4i-0000090000-8a1e04d2d220b7c178b72017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0udl-1900000000-1526ae7b1c72d66d17f72017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0zfr-3900000000-5720b31639362bc77d452017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0pb9-6900000000-5862d8b2fbe4b55544fd2017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0a4i-9800000000-52425d2c67f0ee9e68332017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0a4i-0000090000-91af4261328f04d477622017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0a4i-0000090000-e6261075748cb68a66732017-09-14HMDB team, MONAView Spectrum
Experimental LC-MS/MSLC-MS/MS Spectrum - Dronedarone LC-ESI-ITFT , positive-QTOFsplash10-0udl-1900000000-b6ee80d1389866275d102017-09-14HMDB team, MONAView Spectrum
Biological Properties
Cellular LocationsNot Available
Biospecimen Locations
  • Blood
Tissue LocationsNot Available
Pathways
Normal Concentrations
BiospecimenStatusValueAgeSexConditionReferenceDetails
BloodDetected but not QuantifiedNot QuantifiedNot SpecifiedNot SpecifiedNormal details
Abnormal Concentrations
Not Available
Associated Disorders and Diseases
Disease ReferencesNone
Associated OMIM IDsNone
DrugBank IDDB04855
Phenol Explorer Compound IDNot Available
FooDB IDNot Available
KNApSAcK IDNot Available
Chemspider IDNot Available
KEGG Compound IDNot Available
BioCyc IDNot Available
BiGG IDNot Available
Wikipedia LinkDronedarone
METLIN IDNot Available
PubChem Compound208898
PDB IDNot Available
ChEBI ID50659
Food Biomarker OntologyNot Available
VMH IDNot Available
MarkerDB IDNot Available
Good Scents IDNot Available
References
Synthesis ReferenceNot Available
Material Safety Data Sheet (MSDS)Not Available
General References
  1. Barupal DK, Fiehn O: Generating the Blood Exposome Database Using a Comprehensive Text Mining and Database Fusion Approach. Environ Health Perspect. 2019 Sep;127(9):97008. doi: 10.1289/EHP4713. Epub 2019 Sep 26. [PubMed:31557052 ]