Diprenorfin

Diprenorfin

Clinical data
AHFS/Drugs.com	International Drug Names
ATCvet code	Template:Infobox drug/formatATCvet Template:Infobox drug/formatATCvet
Identifiers
IUPAC name (5α,7α)-17-(Cyclopropylmethyl)- 4,5-epoxy- 18,19-dihydro- 3-hydroxy- 6-methoxy- α,α-dimethyl- 6,14-ethenomorphinan- 7-methanol
CAS Number	14357-78-9 N
PubChem CID	443408
IUPHAR/BPS	1617
DrugBank	DB01548 Y
ChemSpider	391634 Y
UNII	1F0L5N25ZZ
KEGG	D07863 Y
ChEMBL	ChEMBL281786 Y
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C26H35NO4
Molar mass	425.56 g/mol
3D model (JSmol)	Interactive image
SMILES CC(C)([C@H]1C[C@@]23CC[C@@]1([C@H]4[C@@]25CCN([C@@H]3CC6=C5C(=C(C=C6)O)O4)CC7CC7)OC)O
InChI InChI=1S/C26H35NO4/c1-23(2,29)18-13-24-8-9-26(18,30-3)22-25(24)10-11-27(14-15-4-5-15)19(24)12-16-6-7-17(28)21(31-22)20(16)25/h6-7,15,18-19,22,28-29H,4-5,8-14H2,1-3H3/t18-,19-,22-,24-,25+,26-/m1/s1 Y Key:OIJXLIIMXHRJJH-KNLIIKEYSA-N Y
NY (what is this?)  (verify)

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Evidence Based Medicine
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Clinical Trials
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diprenorphine (diprenorfin, Revivon, M5050) is an non-selective opioid antagonist, though it may have some slight partial agonist activity at the kappa-opioid receptor. It is used to reverse the effects of super-potent opioid analgesics such as etorphine and carfentanil that are used for tranquilizing large animals in veterinary medicine.

Diprenorphine is the strongest opiate antagonist that is commercially available (some 100 times more potent as an antagonist than nalorphine), and is used for reversing the effects of very strong opioids for which the binding affinity is so high that naloxone does not effectively or reliably reverse the narcotic effects. These super-potent opioids, with the single exception of buprenorphine, are not used in humans because the dose for a human is so small that it would be difficult to measure properly, so there is an excessive risk of overdose leading to fatal respiratory depression. However conventional opioid derivatives are not strong enough to rapidly tranquilize large animals such as elephants and rhinos, so drugs such as etorphine or carfentanil are available for this purpose.

Diprenorphine is considered the specific antagonist for etorphine and carfentanil, and is normally used to remobilise animals once veterinary procedures have been completed. Because diprenorphine also has some agonistic properties of its own, it should not be used on humans in the event that they are accidentally exposed to etorphine or carfentanil. Naloxone or naltrexone are the preferred human antagonists.

In theory, diprenorphine could also be used as an antidote for treating overdose of certain opioid derivatives which are used in humans, such as buprenorphine, for which the binding affinity is so high that naloxone does not reliably reverse the narcotic effects. However, diprenorphine is not generally available in hospitals; instead a vial of diprenorphine is supplied with etorphine or carfentanil specifically for reversing the effects of these drugs, so use of diprenorphine for treating e.g. a buprenorphine overdose is not usually carried out in practice.