Repositioning Candidate Details
| Candidate ID: | R0145 |
| Source ID: | DB00512 |
| Source Type: | approved |
| Compound Type: | small molecule |
| Compound Name: | Vancomycin |
| Synonyms: | |
| Molecular Formula: | C66H75Cl2N9O24 |
| SMILES: | CN[C@H](CC(C)C)C(=O)N[C@@H]1[C@H](O)C2=CC=C(OC3=C(O[C@@H]4O[C@H](CO)[C@@H](O)[C@H](O)[C@H]4O[C@H]4C[C@](C)(N)[C@H](O)[C@H](C)O4)C4=CC(=C3)[C@@H](NC(=O)[C@H](CC(N)=O)NC1=O)C(=O)N[C@@H]1C3=CC(=C(O)C=C3)C3=C(O)C=C(O)C=C3[C@H](NC(=O)[C@@H](NC1=O)[C@H](O)C1=CC(Cl)=C(O4)C=C1)C(O)=O)C(Cl)=C2 |
| Structure: |
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| DrugBank Description: | Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. As of January 29 2018, CutisPharma's Firvanq is the only FDA approved vancomycin oral liquid treatment option available for the the treatment of _Clostridium difficile_ associated diarrhea and enterocolitis caused by _Staphylococcus aureus_, including methicillin-resistant strains [LP1196]. Such an oral liquid formulation is expected to make _Clostridium difficile_ associated diarrhea therapy more accessible in comparison to previously available specialty compounding products [LP1196]. |
| CAS Number: | 1404-90-6 |
| Molecular Weight: | 1449.254 |
| DrugBank Indication: | A variety of dosage forms (for example, oral, injections, etc.) exist for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci [FDA Label]. Additionally, a unique FDA approved oral liquid treatment is also available and indicated for the treatment of Clostridium difficile associated diarrhea and enterocolitis caused by _Staphylococcus aureus_, including methicillin-resistant strains [L1196]. |
| DrugBank Pharmacology: | Vancomycin is a branched tricyclic glycosylated nonribosomal peptide often reserved as the "drug of last resort", used only after treatment with other antibiotics has failed. Vancomycin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections: <i>Listeria monocytogenes</i>, <i>Streptococcus pyogenes</i>, <i>Streptococcus pneumoniae</i> (including penicillin-resistant strains), <i>Streptococcus agalactiae</i>, <i>Actinomyces</i> species, and <i>Lactobacillus</i> species. The combination of vancomycin and an aminoglycoside acts synergistically in vitro against many strains of Staphylococcus aureus, Streptococcus bovis, enterococci, and the viridans group streptococci [FDA Label]. |
| DrugBank MoA: | The bactericidal action of vancomycin results primarily from inhibition of cell-wall biosynthesis. Specifically, vancomycin prevents incorporation of N-acetylmuramic acid (NAM)- and N-acetylglucosamine (NAG)-peptide subunits from being incorporated into the peptidoglycan matrix, which forms the major structural component of Gram-positive cell walls. Vancomycin forms hydrogen bonds with the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides, preventing the incorporation of the NAM/NAG-peptide subunits into the peptidoglycan matrix. In addition, vancomycin alters bacterial-cell-membrane permeability and RNA synthesis. There is no cross-resistance between vancomycin and other antibiotics. Vancomycin is not active in vitro against gram-negative bacilli, mycobacteria, or fungi. [FDA Label] |
| Targets: | D-Ala-D-Ala moiety of NAM/NAG peptide subunits of peptidoglycan |
| Inclusion Criteria: |
| Strategy ID | Strategy | Synonyms | Related Targets | Related Drugs | |
|---|---|---|---|---|---|
| S16 | lifestyle measures | Lifestyle measures; adequate dietary or supplemental vitamin D and calcium intake; avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies; Dietary supplementation with grains containing high β-glucan fiber; metabolic bariatric surgery; intensive lifestyle intervention; A low-glycemic, low-phosphate dietary intervention; Anti-hypertensive; Lifestyle measures; Dietary counseling; Adequate dietary or supplemental vitamin D and calcium intake; Avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies; dietary flavonoid supplementation; lifestyle modifications including exercise and an energy-restricted diet; Anti-inflammatory; Lifestyle measures; lifestyle interventions; Lifestyle measures; Anti-hypertensive; Hemodialysis; diet modifications; intensive dietary modifications | Klotho; SGLT2 | trelagliptin; trelagliptin; bisphosphonates; alendronate; risedronate; zoledronic acid; denosumab; anabolic agents; vitamin D; calcium; oat β-glucan; metformin; rosiglitazone; insulin; insulin therapy; amiloride; hydrochlorothiazide; Tolvaptan; agrochemicals; alendronate; risedronate; zoledronic acid; denosumab; anabolic agents; vitamin D; dietary flavonoid supplementation; metformin; linagliptin; fixed-dose combination of linagliptin/metformin; Kangen-karyu extract; phosphate binders; vitamin D; calcimimetics; allopurinol; testosterone gel; sodium-glucose cotransporter-2 inhibitors; glucagon-like peptide-1 receptor agonists; Sulodexide; uric acid lowering drugs; calcium salts; calcium; vitamin D; antiresorptive; anabolic agent | Details |
| S10 | dialysis therapy | individualized dialysis machine temperature control; hemodialysis; hemodialysis (HD); peritoneal dialysis (PD); haemodialysis treatment; hypoxia-inducible factor prolyl hydroxylase inhibitor for dialysis-dependent CKD anemia; haemodialysis (HD); peritoneal dialysis (PD); conversion to hemodialysis; Hemodialysis; diet modifications; Hemodialysis; Peritoneal dialysis | HIF | dialysate-containing glucose; Cisplatin; Etoposide; gadolinium-based contrast agents; gadoteric acid; non-steroidal anti-inflammatory agent; 10 calcium gluconate; insulin; dextrose; salbutamol nebulization; sodium polystyrene sulfonate; roxadustat; darbepoetin alfa; iron; warfarin; bisphosphonate; sodium thiosulfate; unfractionated heparin; uric acid lowering drugs; 5-fluorouracil; leucovorin; 1.5 glucose; 2.3 glucose | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I02 | 1184 | nephrotic syndrome | "A nephrosis characterized by marked increase in glomerular protein permeability resulting in marked elevation of urine protein levels, hypoalbuminemia, hyperlipidemia, and hypercoagulability." [url:https\://en.wikipedia.org/wiki/Nephrotic_syndrome, url:https\://www.niddk.nih.gov/health-information/kidney-disease/nephrotic-syndrome-adults] | Details | |
| I05 | 784 | chronic kidney disease | "A kidney failure that is characterized by the gradual loss of kidney function." [url:https\://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521, url:https\://www.ncbi.nlm.nih.gov/books/NBK499861/] | Details |