New Release: Alpha testing version has been released.

Risdiplam

M09A - Other drugs for disorders of the musculo-skeletal system ATC M09AX10 Small molecule approved 2020 Oral

JFDA label: Evrysdi powder for oral solution 0.75mg/ml

Mechanism of Action

Positive Modulator of SMN2 pre-mRNA — SMN2 pre-mRNA positive modulator

TargetActionGene / class
SMN2 pre-mRNA efficacy POSITIVE MODULATOR

Indications

Approved

  • Atrophy — Atrophy
  • Muscular Atrophy, Spinal — spinal muscular atrophy

Contraindications

Source: openFDA

  • None. None. ( 4 ) Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Gastrointestinal disorders (3)

Not Known Constipation · Diarrhea · Vomiting

General disorders and administration site conditions (2)

Not Known Double-Blinded · Later-Onset Sma

Dosing

Source: openFDA

Administer once daily with or without food per the table below ( 2.1 ): Age and Body Weight Recommended Daily Dosage Dosage Form Less than 2 months of age 0.15 mg/kg EVRYSDI for Oral Solution 2 months to less than 2 years of age 0.2 mg/kg 2 years of age and older weighing less than 20 kg 0.25 mg/kg 2 years of age and older weighing 20 kg or more 5 mg EVRYSDI for Oral Solution or EVRYSDI Tablet Swallow EVRYSDI tablet whole with water or dispersed in non-chlorinated drinking water (e.g., filtered water). ( 2.2 ) Administer EVRYSDI for oral solution with the provided oral syringe. ( 2.2 ) EVRYSDI for oral solution must be constituted by a healthcare provider prior to dispensing. ( 2.4 ) See Full Prescribing Information for important preparation and administration instructions. ( 2.2 , 2.4 ) 2.1 Dosing Information EVRYSDI is administered orally once daily with or without food at approximately the same time each day. The recommended dosage is determined by age and body weight (see Table 1 ). EVRYSDI tablets are available for patients prescribed the 5 mg dose. Table 1 Adult and Pediatric Dosing Regimen by Age and Body Weight Age and Body Weight Recommended Daily Dosage Dosage Form Less than 2 months of age 0.15 mg/kg EVRYSDI for Oral Solution 2 months to less than 2 years of age 0.2 mg/kg 2 years of age and older weighing less than 20 kg 0.25 mg/kg 2 years of age and older weighing 20 kg or more 5 mg EVRYSDI for Oral Solution or EVRYSDI Tablet 2.2 Important Administration Instructions It is recommended that a healthcare provider discuss with the patient or caregiver how to prepare the prescribed daily dose prior to administration of the first dose [see Instructions for Use for EVRYSDI for Oral Solution and EVRYSDI Tablets and Patient Information ]. EVRYSDI for Oral Solution In infants who are breastfed, EVRYSDI for oral solution can be administered before or after breastfeeding. EVRYSDI cannot be mixed with formula or milk. Instruct patients or caregivers to administer the dose using the reusable oral syringe provided. EVRYSDI for oral solution must be taken immediately after it is drawn up into the oral syringe. If EVRYSDI is not taken within 5 minutes, EVRYSDI should be discarded from the oral syringe, and a new dose should be prepared. Instruct patients to drink water after taking EVRYSDI for oral solution to ensure the drug has been completely swallowed. EVRYSDI for oral solution can be administered via a nasogastric or gastrostomy tube. The tube should be flushed with water after delivering EVRYSDI for oral solution [see Instructions for Use ]. EVRYSDI Tablets Swallow EVRYSDI tablets whole with water. Do not chew, cut, or crush the tablets. Alternatively, the EVRYSDI tablet can also be dispersed in one teaspoon (5 mL) of room temperature non-chlorinated drinking water (e.g., filtered water). EVRYSDI tablets must not be dispersed in any liquid other than non-chlorinated drinking water. Do not expose the prepared dispersion to sunlight. Swirl the small cup gently for up to 3 minutes until fully mixed (though some particles will remain). Administer the dispersed tablet immediately. To ensure no particles are left in the small cup, refill it with at least one tablespoon (15 mL) of non-chlorinated drinking water, swirl, and administer immediately again. EVRYSDI must be taken immediately after it is dispersed in non-chlorinated drinking water. Discard the prepared dispersion if it is not used within 10 minutes of adding non-chlorinated drinking water. The dispersed EVRYSDI tablet can be administered via a nasogastric or gastrostomy tube that is 8 French or higher. Flush the tube with the non-chlorinated drinking water [at least one tablespoon (15 mL)] used to rinse the dispersion cup [see Instructions for Use ]. 2.3 Missed Dose If a dose of EVRYSDI is missed, EVRYSDI should be administered as soon as possible if still within 6 hours of the missed dose, and the usual dosing schedule can be resumed on the next day. Otherwise, the misse

Chemistry & Properties

2D structure
FormulaC22H23N7O
Molecular weight401.47 g/mol
IUPAC name7-(4,7-diazaspiro[2.5]octan-7-yl)-2-(2,8-dimethylimidazo[1,2-b]pyridazin-6-yl)pyrido[1,2-a]pyrimidin-4-one
CAS1825352-65-5
PubChem CID118513932
InChIKeyASKZRYGFUPSJPN-UHFFFAOYSA-N
logP1.96 (XLogP 0.5)
Polar surface area79.83 Ų
H-bond acceptors / donors8 / 1
Drug-likeness (QED)0.55
Lipinski violations0
SMILESCc1cn2nc(-c3cc(=O)n4cc(N5CCNC6(CC6)C5)ccc4n3)cc(C)c2n1

Biology & Pharmacokinetics

Pharmacokinetics predicted

Bioavailability10.0%
Half-life0.556 h
Volume of distribution2.454 L/kg
Protein binding68.4%
BBB penetrantNo

Enzyme interactions

EnzymeRoleDetail
CYP1A2Inhibitor
CYP1A2Substrate
CYP3A4Substrate

Transporters

BCRP (Inhibitor)BCRP (Inhibitor)BSEP (Inhibitor)MATE1 (Inhibitor)MDR1 (Inhibitor)MRP1 (Inhibitor)OAT1 (Inhibitor)OAT2 (Inhibitor)OAT3 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)OATP1B3 (Inhibitor)OCT2 (Inhibitor)P-gp (Inhibitor)BCRP (Substrate)MDR1 (Substrate)P-gp (Substrate)

Drug–drug interactions (2, DDInter)

Interacting drugSeverityManagement
Metformin moderate
Methylnaltrexone moderate

Registered Products (1)

BrandForm / strengthPackAgentCitizen (JOD)
Evrysdi powder for oral solution Solution 0.75 mg/ml 1 Bottle Shawi & Rushedat Drug Store