Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Mepact
Drug ID BADD_D01381
Description Mifamurtide is an immunomodulator with antitumor activity via activation of macrophages and monocytes. Also called L-MTP-PE, mifamurtide may be a liposomal form of of the active ingredient MTP-PE, which is a synthetic, less pyrogenic, and longer-acting derivative of muramyl dipeptide (MDP). MDP is a motif present in all gram-positive and gram-negative bacterial walls that is recognized by different signalling molecules and activators such as nucleotide-binding and oligomerization domain (NOD)-like receptors (NLRs) and toll-like receptors present in macrophages and monocytes. The overall result of MDP recognition leads to the production of proinflammatory cytokines and promotion of bactericidal and tumoricidal effects [A31745]. As a liposomal formulation, mifamurtide demonstrates an enhanced tumoricidal effect and improved safety profile [A31745]. Mifamurtide is marketed in Europe as Mepact for intravenous infusion. It is administered as an adjuvant therapy to postoperative combination chemotherapy in pediatric, adolescent or adult patients with high-grade, resectable, non-metastatic osteosarcoma after macroscopically complete surgical resection. In the US, it is currently under investigation that holds orphan drug status for the treatment of osteosarcoma [A31746]. Osteosarcoma is the most common primary malignant bone tumor that usually arises in the metaphyses of long bone in children and adolescents [A31744]. The standard therapy for osteosarcoma is comprised of macroscopic surgical resection and multi-agent chemotherapy consisting of doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue, and ifosfamide [A31744]. While about 90% of patients with newly diagnosed osteosarcoma may achieve complete remission from first-line therapies, the prognosis is still poor for patients with non-metastatic osteosarcoma with lower 5-year event-free survival. In a large, randomized, open-label, multicenter, phase III trial, the treatment of mifamurtide in conjunction with three- or four-drug combination chemotherapy (doxorubicin, cisplatin, and high-dose methotrexate with, or without, ifosfamide) was associated with significant improvement in survival rates and good tolerance [A31746]. The adverse events (AEs) associated with mifamurtide were generally mild to moderate in severity [A31748].
Indications and Usage Indicated in children, adolescents and young adults for the treatment of high-grade, resectable, non-metastatic osteosarcoma after macroscopically complete surgical resection, typically in combination with post-operative multi-agent chemotherapy [L1203].
Marketing Status Not Available
ATC Code L03AX15
DrugBank ID DB13615
KEGG ID D06619
MeSH ID C037144
PubChem ID 23663962
TTD Drug ID D01NTX
NDC Product Code Not Available
Synonyms mifamurtide | muramyl tripeptide phosphatidylethanolamine | muramyl tripeptide-1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine conjugate | muramylNAc-Ala-isoGln-Lys-tripeptide-PE | muramylNAc-Ala-isoGln-Lys-tripeptide-phosphatidylethanolamine | N-acetylmuramyl-alanyl-isoglutaminyl-alanyl-sn-glycero-3-phosphoethanolamine | muramyl tripeptide-1,2-dipalmitoylphosphatidylethanolamine conjugate | MLV 19835 | Mepact | muramyl tripeptide phosphatidylethanolamine, monosodium salt | mifamurtide sodium | mifamurtide anhydrous | mifamurtide sodium salt | muramyl tripeptide phosphatidylethanolamine, sodium salt | CGP 19835 A | CGP-19835A | mifamurtide acid | mifamurtide free acid anhydrous
Chemical Information
Molecular Formula C59H110N6NaO20P
CAS Registry Number 838853-48-8
SMILES CCCCCCCCCCCCCCCC(=O)OCC(COP(=O)([O-])OCCNC(=O)C(C)NC(=O)CCC(C(=O)N)NC(=O)C(C)NC( =O)C(C)OC1C(C(OC(C1O)CO)O)NC(=O)C)OC(=O)CCCCCCCCCCCCCCC.O.[Na+]
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Phlebitis12.02.01.002; 24.05.03.001--
Pleural effusion22.05.02.002--
Pollakiuria20.02.02.007--
Productive cough22.02.03.005--
Pruritus23.03.12.001--
Rash23.03.13.001--Not Available
Respiratory distress22.02.01.012--Not Available
Seizure17.12.03.001--
Sepsis11.01.11.003--
Sinus congestion22.04.06.001--Not Available
Skin disorder23.03.03.007--Not Available
Somnolence19.02.05.003; 17.02.04.006--
Tachycardia02.03.02.007--Not Available
Tachypnoea22.02.01.014--Not Available
Thrombocytopenia01.08.01.002--Not Available
Thrombosis24.01.01.006--Not Available
Tinnitus17.04.07.004; 04.04.01.002--
Tremor17.01.06.002--
Upper respiratory tract infection11.01.13.009; 22.07.03.011--
Urethral disorder20.07.01.002--Not Available
Urinary tract disorder20.08.01.001--Not Available
Urinary tract infection11.01.14.004; 20.08.02.001--
Vertigo17.02.12.002; 04.04.01.003--
Vision blurred17.17.01.010; 06.02.06.007--
Vomiting07.01.07.003--
Weight decreased13.15.01.005--
Wheezing22.03.01.009--
Infusion site erythema23.03.06.016; 12.07.05.009; 08.02.05.008--Not Available
Hypoacusis04.02.01.006--
Musculoskeletal chest pain22.09.01.001; 15.03.04.012--
The 4th Page    First    Pre   4 5    Next   Last    Total 5 Pages