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Neurokinin Antagonists intermediate

Ulefipant

NK1 receptor antagonist peptide under investigation for chemotherapy-induced nausea and vomiting.

By Encyclopeptide Editorial | 2 min read
NK1-antagonist antiemetic CINV substance-P

Chemical Identity

PropertyValue
Molecular Weight~1200 Da
Peptide ClassNK1 Receptor Antagonist
RouteIV, oral

Structure

Ulefipant is a peptidomimetic NK1 receptor antagonist that blocks substance P signaling. While not a classical peptide, it represents the development of peptide-mimetic therapeutics targeting neuropeptide receptors involved in emesis and pain pathways.

Mechanism of Action

Ulefipant competitively blocks the neurokinin 1 (NK1) receptor, the primary receptor for substance P in the brainstem vomiting center. By blocking substance P binding in the area postrema and nucleus tractus solitarius, it prevents both acute and delayed phases of chemotherapy-induced nausea and vomiting.

Clinical Applications

  • Chemotherapy-induced nausea and vomiting: Highly emetogenic regimens
  • Delayed CINV: Particularly effective for delayed phase
  • Combination therapy: With 5-HT3 antagonists and dexamethasone
  • Investigational: Newer NK1 antagonists in development

Pharmacology

  • Brain penetration: High (crosses BBB)
  • Duration: 24-48 hours
  • Combination: Enhanced with 5-HT3 antagonists
  • Selectivity: High affinity for NK1 receptor

References

  • Gralla, R.J., et al. (2014). NK1 receptor antagonists for CINV. Lancet Oncology, 15, 894-898.
  • Navari, R.M. (2013). Management of chemotherapy-induced nausea. New England Journal of Medicine, 368, 1614-1621.

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