Nalorphine

Nalorphine
Clinical data
Trade names	Lethidrone, Nalline
Other names	N-Allylnormorphine
AHFS/Drugs.com	International Drug Names
ATC code	V03AB02 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only) ; CA: Schedule I ; US: Schedule III ;
Identifiers
	IUPAC name 17-allyl-7,8-didehydro-4,5α-epoxymorphinan-3,6α-diol;
CAS Number	62-67-9 ;
PubChem CID	5284595;
IUPHAR/BPS	1629;
DrugBank	DB11490 ;
ChemSpider	4447643 ;
UNII	U59WB2WRY2;
KEGG	D08247;
ChEBI	CHEBI:7458;
ChEMBL	ChEMBL415284 ;
CompTox Dashboard (EPA)	DTXSID3023348 ;
ECHA InfoCard	100.000.497
Chemical and physical data
Formula	C19H21NO3
Molar mass	311.381 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O[C@H]2\C=C/[C@H]5[C@@H]4N(CC[C@@]51c3c(O[C@H]12)c(O)ccc3C4)C\C=C;
	InChI InChI=1S/C19H21NO3/c1-2-8-20-9-7-19-12-4-6-15(22)18(19)23-17-14(21)5-3-11(16(17)19)10-13(12)20/h2-6,12-13,15,18,21-22H,1,7-10H2/t12-,13+,15-,18-,19-/m0/s1 ; Key:UIQMVEYFGZJHCZ-SSTWWWIQSA-N ;

Nalorphine (INN) (brand names Lethidrone, Nalline), also known as N-allylnormorphine, is a mixed opioid agonist–antagonist with opioid antagonist and analgesic properties.^[1] It was introduced in 1954^[2] and was used as an antidote to reverse opioid overdose and in a challenge test to determine opioid dependence.^[3]

Nalorphine was the second opioid antagonist to be introduced, preceded by nalodeine (N-allylnorcodeine) in 1915 and followed by naloxone in 1960 and naltrexone in 1963.^[2] Due to potent activation of the κ-opioid receptor, nalorphine produces side effects such as dysphoria, anxiety, confusion, and hallucinations, and for this reason, is no longer used medically.^[1]^[2]^[4]

Pharmacology[]

Pharmacodynamics[]

Nalorphine acts at two opioid receptors — the μ-opioid receptor (MOR) where it has antagonistic effects, and at the κ-opioid receptor (KOR) (K_i = 1.6 nM; EC₅₀ = 483 nM; E_max = 95%) where it exerts high-efficacy partial agonist/near-full agonist characteristics.^[5]

Chemistry[]

Analogues[]

Nalorphine has a number of analogues including niconalorphine (the nicomorphine analogue), diacetylnalorphine (heroin analogue), (dihydromorphine), and a number of others as well as a number of codeine-based analogues.^[6]

Synthesis[]

Nalorphine synthesis:^[7] amended procedure:^[8]^[9]^[10]

More recently, it has become much more commonplace to use ethyl chloroformate instead of cyanogen bromide for the Von Braun degradation demethylation step. See for example the list of phenyltropanes or the synthesis of paroxetine for further examples of this.

References[]

^ ^a ^b Glatt M (6 December 2012). The Dependence Phenomenon. Springer Science & Business Media. pp. 121–. ISBN 978-94-011-7457-2.
^ ^a ^b ^c Aggrawal A. APC Essentials of Forensic Medicine and Toxicology. Avichal Publishing Company. pp. 554–. ISBN 978-81-7739-441-2.
^ "Medicine: Drug Detector". Time. 24 December 1956. Archived from the original on July 26, 2005.
^ Satoskar RS, Rege N, Bhandarkar SD (27 July 2015). Pharmacology and Pharmacotherapeutics. Elsevier Health Sciences APAC. pp. 166–. ISBN 978-81-312-4371-8.
^ Gharagozlou P, Hashemi E, DeLorey TM, Clark JD, Lameh J (January 2006). "Pharmacological profiles of opioid ligands at kappa opioid receptors". BMC Pharmacology. 6 (1): 3. doi:10.1186/1471-2210-6-3. PMC 1403760. PMID 16433932.
^ Casy AF, Parfitt RT (29 June 2013). Opioid Analgesics: Chemistry and Receptors. Springer Science & Business Media. ISBN 9781489905857 – via Google Books.
^ McCawley EL, Hart ER, Marsh DF (January 1941). "The preparation of N-allylnormorphine". Journal of the American Chemical Society. 63 (1): 314. doi:10.1021/ja01846a504.
^ Weijlard J, Erickson AE (1942). "N-Allylnormorphine". Journal of the American Chemical Society. 64 (4): 869–870. doi:10.1021/ja01256a036.
^ Hart ER, McCawley EL (November 1944). "The pharmacology of N-allylnormorphine as compared with morphine". Journal of Pharmacology and Experimental Therapeutics. 82 (3): 339–48.
^ U.S. Patent 2,364,833 (1944); Weijlard, U.S. Patent 2,891,954 (1959 to Merck & Co.).

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[Glatt2012-1] Glatt M (6 December 2012). The Dependence Phenomenon. Springer Science & Business Media. pp. 121–. ISBN 978-94-011-7457-2.

[Aggrawal-2] Aggrawal A. APC Essentials of Forensic Medicine and Toxicology. Avichal Publishing Company. pp. 554–. ISBN 978-81-7739-441-2.

[3] "Medicine: Drug Detector". Time. 24 December 1956. Archived from the original on July 26, 2005.

[SatoskarRege2015-4] Satoskar RS, Rege N, Bhandarkar SD (27 July 2015). Pharmacology and Pharmacotherapeutics. Elsevier Health Sciences APAC. pp. 166–. ISBN 978-81-312-4371-8.

[GharagozlouHashemi2006-5] Gharagozlou P, Hashemi E, DeLorey TM, Clark JD, Lameh J (January 2006). "Pharmacological profiles of opioid ligands at kappa opioid receptors". BMC Pharmacology. 6 (1): 3. doi:10.1186/1471-2210-6-3. PMC 1403760. PMID 16433932.

[6] Casy AF, Parfitt RT (29 June 2013). Opioid Analgesics: Chemistry and Receptors. Springer Science & Business Media. ISBN 9781489905857 – via Google Books.

[7] McCawley EL, Hart ER, Marsh DF (January 1941). "The preparation of N-allylnormorphine". Journal of the American Chemical Society. 63 (1): 314. doi:10.1021/ja01846a504.

[8] Weijlard J, Erickson AE (1942). "N-Allylnormorphine". Journal of the American Chemical Society. 64 (4): 869–870. doi:10.1021/ja01256a036.

[9] Hart ER, McCawley EL (November 1944). "The pharmacology of N-allylnormorphine as compared with morphine". Journal of Pharmacology and Experimental Therapeutics. 82 (3): 339–48.

[10] U.S. Patent 2,364,833 (1944); Weijlard, U.S. Patent 2,891,954 (1959 to Merck & Co.).

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v t Opioid receptor modulators
MOR	Agonists (abridged; see here for a full list): 3-HO-PCP 7-Hydroxymitragynine α-Chlornaltrexamine Acetyldihydrocodeine Acetylfentanyl Acrylfentanyl Adrenorphin (metorphamide) AH-7921 Akuammicine Alfentanil Anileridine Apparicine β-Endorphin Benzhydrocodone Benzylmorphine Bezitramide Biphalin Buprenorphine Butorphan Butorphanol Butyrfentanyl BW373U86 Carfentanil Casokefamide Cebranopadol Chloroxymorphamine Codeine DADLE DAMGO (DAGO) Dermorphin Desmetramadol (desmethyltramadol) Desomorphine Dextromoramide Dextropropoxyphene (propoxyphene) Dezocine Dimenoxadol Dimethylaminopivalophenone Eluxadoline Diamorphine (heroin) Dihydrocodeine Dihydroetorphine Dihydromorphine Dinalbuphine sebacate Diphenoxylate Dipipanone Dynorphin A Embutramide Endomorphin-1 Endomorphin-2 Eseroline Ethylmorphine Etorphine Fentanyl Fluorophen Frakefamide Furanylfentanyl Hemorphin-4 Herkinorin Hodgkinsine Hydrocodone Hydromorphinol Hydromorphone IBNtxA Ketamine Ketobemidone Kratom Laudanosine Lefetamine Leu-enkephalin Levacetylmethadol Levomethorphan Levorphanol Loperamide LS-115509 Matrine Meptazinol Met-enkephalin (metenkefalin) Methadone Metkefamide Metopon Mitragynine Mitragynine pseudoindoxyl Morphiceptin Morphine Nalbuphine Nalmexone Naltalimide NFEPP Nicocodeine Nicodicodine Nicomorphine Norketamine Nufenoxole Octreotide Oliceridine OM-3-MNZ Oripavine Oxycodone Oxymorphazone Oxymorphone Papaver somniferum (opium) Pentazocine Pericine Pethidine (meperidine) Phenazocine Phencyclidine Piminodine Piritramide Prodine Propiram PZM21 Racemethorphan Racemorphan Remifentanil SC-17599 Sinomenine Sufentanil Tapentadol Tetrahydropapaveroline Thebaine Thienorphine Tianeptine Tilidine Tramadol Trimebutine TRIMU 5 TRV734 U-47700 Valorphin Viminol Xorphanol PAMs: Antagonists: (3S,4S)-Picenadol 2-(S)-N,N-(R)-Viminol 4-Caffeoyl-1,5-quinide 4',7-Dihydroxyflavone 6β-Naltrexol 6β-Naltrexol-d4 18-MC β-Chlornaltrexamine β-Funaltrexamine Akuammine Alvimopan AM-251 Apigenin AT-076 Axelopran Bevenopran Catechin Catechin gallate Clocinnamox CTAP Cyprodime Diacetylnalorphine Diprenorphine ECG EGC Epicatechin Eptazocine Gemazocine Hyperoside Ibogaine JDTic Levallorphan Lobeline LY-255582 Methylnaltrexone Naldemedine Nalmefene Nalodeine (N-allylnorcodeine) Nalorphine Nalorphine dinicotinate Naloxazone Naloxegol Naloxol Naloxonazine Naloxone Naltrexone Naltrindole Naringenin Noribogaine Oxilorphan Pawhuskin A Rimonabant Quadazocine Samidorphan Taxifolin Unknown/unsorted: Cannabidiol Coronaridine Cyproterone acetate Tabernanthine Tetrahydrocannabinol
DOR	Agonists: 6'-GNTI 7-SIOM Alazocine (SKF-10047) Amoxapine β-Endorphin Biphalin BU-48 Butorphan Butorphanol BW373U86 Casokefamide Cebranopadol Codeine Cyclazocine DADLE Deltorphin A Deltorphin I Desmethylclozapine Desmetramadol (desmethyltramadol) Dezocine Diamorphine (heroin) Dihydroetorphine Dihydromorphine DPDPE DPI-221 DPI-3290 Ethylketazocine Etorphine Fentanyl Fluorophen Hemorphin-4 Hydrocodone Hydromorphone Ibogaine Isomethadone Kratom Laudanosine Leu-enkephalin Levomethorphan Levorphanol Lofentanil Met-enkephalin (metenkefalin) Metazocine Metkefamide Mitragynine Mitragynine pseudoindoxyl Morphine N-Phenethyl-14-ethoxymetopon Norbuprenorphine Oripavine Oxycodone Oxymorphone Pethidine (meperidine) Proglumide Racemethorphan Racemorphan RWJ-394674 Samidorphan SNC-80 TAN-67 (SB-205,607) Thebaine Thiobromadol (C-8813) Tonazocine Tramadol Xorphanol Zenazocine Antagonists: 4',7-Dihydroxyflavone 6β-Naltrexol 6β-Naltrexol-d4 β-Chlornaltrexamine Apigenin AT-076 Axelopran Bevenopran Catechin Catechin gallate Clocinnamox Diacetylnalorphine Diprenorphine ECG EGC Eluxadoline Epicatechin LY-255582 Methylnaltrexone Nalmefene Nalorphine Naltrexone Naltriben Naltrindole Naloxone Naringenin Noribogaine Pawhuskin A Quadazocine SoRI-9409 Taxifolin Thienorphine Unknown/unsorted: 18-MC Cannabidiol Coronaridine Cyproterone acetate Tabernanthine Tetrahydrocannabinol
KOR	Agonists: 6'-GNTI 8-CAC 18-MC 14-Methoxymetopon β-Chlornaltrexamine β-Funaltrexamine Adrenorphin (metorphamide) Alazocine (SKF-10047) Asimadoline Big dynorphin Bremazocine BRL-52537 Butorphan Butorphanol BW373U86 Cebranopadol Ciprefadol CR665 Cyclazocine Cyclorphan Cyprenorphine Desmetramadol (desmethyltramadol) Diamorphine (heroin) Diacetylnalorphine Difelikefalin Dihydroetorphine Dihydromorphine Dinalbuphine sebacate Diprenorphine Dynorphin A Dynorphin B (rimorphin) Eluxadoline Enadoline Eptazocine Ethylketazocine Etorphine Fedotozine Fentanyl Gemazocine GR-89696 Hemorphin-4 Herkinorin HS665 Hydromorphone HZ-2 Ibogaine ICI-199,441 ICI-204,448 Ketamine Ketazocine Laudanosine Leumorphin (dynorphin B-29) Levallorphan Levomethorphan Levorphanol Lofentanil LPK-26 Lufuradom Matrine Menthol Metazocine Metkefamide Mianserin Mirtazapine Morphine Moxazocine Nalbuphine Nalfurafine Nalmefene Nalodeine (N-allylnorcodeine) Nalorphine Naltriben Niravoline Norbuprenorphine Norbuprenorphine-3-glucuronide Noribogaine Norketamine Oripavine Oxilorphan Oxycodone Pentazocine Pethidine (meperidine) Phenazocine Proxorphan Racemethorphan Racemorphan RB-64 Salvinorin A (salvia) Salvinorin B ethoxymethyl ether Salvinorin B methoxymethyl ether Samidorphan Spiradoline (U-62,066) Thienorphine Tifluadom Tricyclic antidepressants (e.g., amitriptyline, desipramine, imipramine, nortriptyline) U-50488 U-69,593 Xorphanol Antagonists: 4',7-Dihydroxyflavone 5'-GNTI 6'-GNTI 6β-Naltrexol 6β-Naltrexol-d4 β-Chlornaltrexamine Buprenorphine/samidorphan Amentoflavone Apigenin AT-076 Aticaprant Axelopran Binaltorphimine BU09059 Buprenorphine Catechin Catechin gallate CERC-501 (LY-2456302) Clocinnamox Dezocine EGC ECG Epicatechin Hyperoside JDTic LY-255582 LY-2459989 Methylnaltrexone Naloxone Naltrexone Naltrindole Naringenin Norbinaltorphimine Noribogaine Pawhuskin A PF-4455242 RB-64 Quadazocine Taxifolin Zyklophin Unknown/unsorted: Akuammicine Akuammine Coronaridine Cyproterone acetate Ibogamine Tabernanthine
NOP	Agonists: Buprenorphine Cebranopadol Dihydroetorphine Etorphine Levomethorphan Levorphanol MCOPPB NNC 63-0532 Nociceptin (orphanin FQ) Norbuprenorphine Racemethorphan Racemorphan Ro64-6198 SR-16435 Antagonists: AT-076 BTRX-246040 (LY-2940094) J-113,397 JTC-801 SB-612,111 Thienorphine
Unsorted	β-Casomorphins Amidorphin Cytochrophin-4 Gliadorphin (gluteomorphin) Gluten exorphins Hemorphins Kava constituents NEM Neoendorphins Nepetalactone (catnip) Rubiscolins
Others	Enkephalinase inhibitors: Amastatin Candoxatril D -Phenylalanine Ecadotril (sinorphan) Kelatorphan Racecadotril (acetorphan) RB-101 RB-120 RB-3007 Selank Semax Spinorphin Thiorphan Tynorphin Ubenimex (bestatin) Propeptides: β-Lipotropin (proendorphin) Prodynorphin Proenkephalin Proopiomelanocortin (POMC) Others: Kyotorphin (met-enkephalin releaser/degradation stabilizer)