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Fexinidazole

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637:(gHAT) Recently, a study of the safety and efficacy of oral fexinidazole in children with gambiense human African trypanosomiasis was accomplished and concluded that orally administered fexinidazole showed high efficacy across all stages of gambiense human African trypanosomiasis infection in children aged 6 years and older and weighing more than 20 kg. The benefit-to-risk ratio of fexinidazole for treating children with gambiense human African trypanosomiasis, regardless of disease stage, is positive. Current interventions for diagnosing, staging, and treating gambiense human African trypanosomiasis require resources, trained personnel, equipment, and hospital infrastructure. These potentially costly procedures are therefore difficult to implement in remote areas or in those that might be mired in conflict, which could prevent the goal of eliminating gambiense human African trypanosomiasis by 2030. 794: 379: 356: 31: 2385: 1715: 655:
FEX-SEDDS had a size of 97±1 and 106±9 nm, respectively. The FEX retention in droplets after SEDDS dilution in simulated gastrointestinal media was almost 100%. Antileishmanial efficacy studies showed that FEX-SEDDS was the only treatment able to significantly (p < 0.05) reduce the parasite burden in the liver and spleen of animals experimentally infected with
644:(currently in clinical trials) that can cure both disease stages of gambiense human African trypanosomiasis and circumvent the need for systematic disease staging with lumbar puncture (a procedure associated with complications and anxiety, particularly in children28) would benefit both patients and health-care professionals Furthermore, Damasio 632:
demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the
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oral efficacy of self-emulsifying drug delivery systems (SEDDS) containing fexinidazole in the experimental treatment of visceral leishmaniasis (VL). The developed FEX-SEDDS formulation presented as a clear, yellowish liquid without precipitate. In the simulated gastric and intestinal media, the
628:. In the mouse model, fexinidazole cures both the first, hemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the 1519:
Damasio DS, Antunes PA, Lages EB, Morais-Teixeira E, Vital KD, Cardoso VN, et al. (January 2023). "A new oral self-emulsifying drug delivery system improves the antileishmania efficacy of fexinidazole in vivo".
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human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC) in December 2018. Fexinidazole was included in the 'role of honour' in Préscrire magazine's 2020 prize list.
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McInturff EL, France SP, Leverett CA, Flick AC, Lindsey EA, Berritt S, et al. (August 2023). "Synthetic Approaches to the New Drugs Approved During 2021".
2430: 104: 1787: 1472:"Safety and efficacy of oral fexinidazole in children with gambiense human African trypanosomiasis: a multicentre, single-arm, open-label, phase 2-3 trial" 1394: 906:"A Phase 2, Randomized, Multicenter, Placebo-Controlled, Proof-of-Concept Trial of Oral Fexinidazole in Adults With Chronic Indeterminate Chagas Disease" 1907: 1196:"Oral fexinidazole for late-stage African Trypanosoma brucei gambiense trypanosomiasis: a pivotal multicentre, randomised, non-inferiority trial" 451: 1984: 1058: 2202: 465: 1019: 874: 1732: 820: 2132: 717: 576: 1423:
Kennedy PG (February 2013). "Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness)".
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Kande Betu Kumesu V, Mutombo Kalonji W, Bardonneau C, Valverde Mordt O, Ngolo Tete D, Blesson S, et al. (November 2022).
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family of medications. It is believed to work by turning on certain enzymes within the parasites that result in their death.
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A trial in Africa found fexinidazole to be 91% effective at treating sleeping sickness. Though less effective than
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Torreele E, Bourdin Trunz B, Tweats D, Kaiser M, Brun R, MazuĂ© G, et al. (December 2010). Boelaert M (ed.).
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Fexinidazole is the first drug candidate for the treatment of advanced-stage sleeping sickness in thirty years.
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Common side effects include nausea, vomiting, headache, and trouble sleeping. Other side effects may include
1788:"Fexinidazole, the first all-oral treatment for sleeping sickness, approved in Democratic Republic of Congo" 1395:"Fexinidazole, the first all-oral treatment for sleeping sickness, approved in Democratic Republic of Congo" 1954: 1694: 697: 521: 374: 275: 324: 530: 335: 2410: 2375: 1885: 1345:"Fexinidazole for Human African Trypanosomiasis, the Fruit of a Successful Public-Private Partnership" 1140: 1112: 721: 568: 351: 2415: 525:. It is effective against both first and second stage disease. Also a potential new treatment for 2344: 1665: 1614:"Cross-resistance to nitro drugs and implications for treatment of human African trypanosomiasis" 1563:
Wyllie S, Patterson S, Stojanovski L, Simeons FR, Norval S, Kime R, et al. (February 2012).
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Mesu VK, Kalonji WM, Bardonneau C, Mordt OV, Blesson S, Simon F, et al. (January 2018).
1084: 545: 1874: 1565:"The anti-trypanosome drug fexinidazole shows potential for treating visceral leishmaniasis" 2270: 2000: 284: 264: 199: 493:
InChI=1S/C12H13N3O3S/c1-14-11(13-7-12(14)15(16)17)8-18-9-3-5-10(19-2)6-4-9/h3-7H,8H2,1-2H3
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Torrico F, GascĂłn J, Ortiz L, Pinto J, Rojas G, Palacios A, et al. (February 2023).
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Simplified oral treatments such as fexinidazole or single-dose oral treatments such as
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new therapy for first-stage and non-severe second-stage sleeping sickness caused by
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Synthetic pathway of fexinidzaole, adapted from Scheme 3 of McInturff et al. 2023.
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Fexinidazole was first described in 1978. It was given a positive opinion by the
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Kaiser M, Bray MA, Cal M, Bourdin Trunz B, Torreele E, Brun R (December 2011).
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in 2018, for use in non-European markets. It was approved for the treatment of
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in severe disease, fexinidazole has the benefit that it can be taken by mouth.
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Sokolova AY, Wyllie S, Patterson S, Oza SL, Read KD, Fairlamb AH (July 2010).
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World Health Organization model list of essential medicines: 22nd list (2021)
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World Health Organization model list of essential medicines: 21st list 2019
977: 939: 765: 601: 112: 921: 2320: 2310: 2287: 2251: 2194: 2111: 2101: 2097: 1994: 1990: 1980: 1629: 1311: 701: 641: 1814:"Fexinidazole Winthrop° (fexinidazole) : au Tableau d'Honneur 2020" 1153: 1125: 1085:"Antileishmanial Drug Discovery: Past, Present, and Future Perspectives" 244: 2259: 2228: 2212: 2184: 2048: 2044: 1915: 690: 597: 512: 427: 255: 2159: 1972: 1962: 674: 549: 541: 210: 1686:
Advancing Health Through Innovation: New Drug Therapy Approvals 2021
2316: 2117: 1923: 1920: 1432: 769: 693:, but its development as a pharmaceutical was halted in the 1980s. 304: 235: 74: 1518: 764:. They also found no toxicity in any of them, including a lack of 450: 2004: 1718:
This article incorporates text from this source, which is in the
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Deeks ED (February 2019). "Fexinidazole: First Global Approval".
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Fexinidazole was discovered by the German pharmaceutical company
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that affects millions of people worldwide. It is taken by mouth.
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Bernhard S, Kaiser M, Burri C, Mäser P (October 2022).
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World Health Organization's List of Essential Medicines
575:. Development for sleeping sickness was funded by the 2373: 838: 1835:(15). American Chemical Society (ACS): 10150–10201. 1666:"Jump-Start on Slow Trek to Treatment for a Disease" 1306:(12). American Society for Microbiology: 5602–5608. 815: 813: 1733:"CHMP Summary of Opinion - Fexinidazole Winthrop" 720:(DNDi), received a positive endorsement from the 2397: 223: 1418: 1416: 810: 198: 1792:Drugs for Neglected Diseases Initiative (DNDi) 1399:Drugs for Neglected Diseases Initiative (DNDi) 2431:World Health Organization essential medicines 1901: 869: 867: 669:The biologically relevant active metabolites 1413: 1003: 1001: 999: 997: 995: 78: 1908: 1894: 1091:. Royal Society of Chemistry. p. 30. 864: 744:. found the drug to be effective against 377: 354: 263: 29: 1755: 1660: 1637: 1588: 1495: 1370: 1360: 1319: 1270: 1260: 1211: 1152: 1124: 992: 951: 949: 929: 700:granted the application for fexinidazole 283: 1605: 1042: 1040: 1422: 1161: 1133: 1082: 718:Drugs for Neglected Diseases Initiative 577:Drugs for Neglected Diseases initiative 350: 243: 2398: 1556: 1522:International Journal of Pharmaceutics 1105: 1009:"Fexinidazole Winthrop (fexinidazole)" 946: 707: 664: 610: 368: 1889: 1618:Antimicrobial Agents and Chemotherapy 1300:Antimicrobial Agents and Chemotherapy 1147:. Geneva: World Health Organization. 1119:. Geneva: World Health Organization. 1037: 955: 615:In cell culture, fexinidazole has an 323: 143: 69: 1881:. U.S. National Library of Medicine. 1703:from the original on 6 December 2022 716:-Aventis product developed with the 591: 116: 852:. U.S. National Library of Medicine 303: 214: 13: 821:"Fexinidazole: FDA-Approved Drugs" 792: 14: 2447: 1867: 881:. 22 January 2019. Archived from 825:U.S. Food and Drug Administration 731: 2383: 1713: 1249:PLOS Neglected Tropical Diseases 1089:Drug Discovery for Leishmaniasis 875:"Fexinidazole Winthrop H-W-2320" 630:Democratic Republic of the Congo 556:is safe. Fexinidazole is in the 408: 402: 16:Oral anti-parasitic medical drug 1806: 1780: 1749: 1725: 1654: 1512: 1463: 1387: 1336: 1236: 1187: 498:Key:MIWWSGDADVMLTG-UHFFFAOYSA-N 1829:Journal of Medicinal Chemistry 1569:Science Translational Medicine 1076: 897: 738:African animal trypanosomiasis 586: 548:. It is unclear if use during 519:(sleeping sickness) caused by 420: 414: 396: 1: 1534:10.1016/j.ijpharm.2022.122505 1488:10.1016/S2214-109X(22)00338-2 1441:10.1016/s1474-4422(12)70296-x 1213:10.1016/s0140-6736(17)32758-7 803: 736:Fexinidazole is promising in 1841:10.1021/acs.jmedchem.3c00501 1695:Food and Drug Administration 1581:10.1126/scitranslmed.3003326 1262:10.1371/journal.pntd.0000923 1087:. In Gil C, Rivas L (eds.). 910:Clinical Infectious Diseases 775: 726:Trypanosoma brucei gambiense 698:Food and Drug Administration 635:Trypanosoma brucei gambiense 522:Trypanosoma brucei gambiense 473:(=O)c1cnc(n1C)COc2ccc(SC)cc2 7: 10: 2452: 1157:. WHO/MHP/HPS/EML/2021.02. 684: 531:neglected tropical disease 386:Chemical and physical data 2334: 2269: 2238: 2167: 2158: 2131: 2062: 2025: 1953: 1944: 1935: 1476:The Lancet. Global Health 1141:World Health Organization 1113:World Health Organization 970:10.1007/s40265-019-1051-6 879:European Medicines Agency 722:European Medicines Agency 712:Fexinidazole Winthrop, a 622:of around 1–4 ÎĽM against 569:European Medicines Agency 481: 461: 439: 426: 390: 385: 366: 334: 314: 294: 274: 254: 234: 209: 189: 163: 158: 133: 128: 103: 89: 59: 42: 37: 28: 1362:10.3390/diseases10040090 2083:Pentavalent antimonials 1955:African trypanosomiasis 1879:Drug Information Portal 1699:(Report). 13 May 2022. 1048:"Fexinidazole Winthrop" 517:African trypanosomiasis 798: 784:in several steps from 579:in collaboration with 571:in 2018. It is on the 2091:Sodium stibogluconate 2087:Meglumine antimoniate 1425:The Lancet. Neurology 1169:"Fexinidazole – DNDi" 846:"Fexinidazole tablet" 796: 546:low white blood cells 49:Fexinidazole Winthrop 2406:Antiparasitic agents 2001:naphthalenesulfonate 1759:(16 November 2018). 1630:10.1128/AAC.00332-10 1312:10.1128/aac.00246-11 780:Fexinidazole can be 1482:(11): e1665–e1674. 1083:Mowbray CE (2017). 1064:on 12 November 2019 922:10.1093/cid/ciac579 708:Society and culture 665:Mechanism of action 658:Leishmania infantum 611:Efficacy and safety 25: 2361:Never to phase III 1766:The New York Times 1671:The New York Times 1664:(8 January 2008). 1206:(10116): 144–154. 1175:. 31 December 2004 916:(3): e1186–e1194. 885:on 18 January 2021 799: 625:Trypanosoma brucei 21: 2411:German inventions 2371: 2370: 2330: 2329: 2154: 2153: 2108:phosphorylcholine 2058: 2057: 1794:. 29 January 2019 1401:. 29 January 2019 1025:on 2 January 2021 592:Sleeping sickness 506: 505: 452:Interactive image 336:CompTox Dashboard 177:methyl}-5-nitro-1 147: 72: 2443: 2388: 2387: 2386: 2379: 2165: 2164: 1951: 1950: 1942: 1941: 1910: 1903: 1896: 1887: 1886: 1882: 1861: 1860: 1824: 1818: 1817: 1810: 1804: 1803: 1801: 1799: 1784: 1778: 1777: 1775: 1773: 1753: 1747: 1746: 1744: 1742: 1737: 1729: 1723: 1717: 1716: 1712: 1710: 1708: 1690: 1682: 1676: 1675: 1658: 1652: 1651: 1641: 1624:(7): 2893–2900. 1609: 1603: 1602: 1592: 1560: 1554: 1553: 1516: 1510: 1509: 1499: 1467: 1461: 1460: 1420: 1411: 1410: 1408: 1406: 1391: 1385: 1384: 1374: 1364: 1340: 1334: 1333: 1323: 1291: 1285: 1284: 1274: 1264: 1240: 1234: 1233: 1215: 1191: 1185: 1184: 1182: 1180: 1165: 1159: 1158: 1156: 1137: 1131: 1130: 1128: 1109: 1103: 1102: 1080: 1074: 1073: 1071: 1069: 1063: 1057:. Archived from 1052: 1044: 1035: 1034: 1032: 1030: 1024: 1018:. 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Retrieved 1791: 1782: 1770:. Retrieved 1764: 1751: 1739:. Retrieved 1727: 1705:. Retrieved 1692: 1680: 1669: 1656: 1621: 1617: 1607: 1572: 1568: 1558: 1525: 1521: 1514: 1479: 1475: 1465: 1428: 1424: 1403:. Retrieved 1398: 1389: 1352: 1348: 1338: 1303: 1299: 1289: 1255:(12): e923. 1252: 1248: 1238: 1203: 1199: 1189: 1177:. Retrieved 1173:www.dndi.org 1172: 1163: 1154:10665/345533 1144: 1135: 1126:10665/325771 1116: 1107: 1088: 1078: 1066:. Retrieved 1059:the original 1054: 1027:. Retrieved 1020:the original 1015: 961: 957: 913: 909: 899: 887:. Retrieved 883:the original 878: 854:. Retrieved 849: 840: 828:. Retrieved 824: 779: 766:mutagenicity 745: 741: 735: 725: 711: 695: 688: 670: 668: 656: 649: 645: 639: 634: 623: 614: 606: 602:eflornithine 595: 566: 535: 520: 509:Fexinidazole 508: 507: 178: 175:1-Methyl-2-{ 135:Legal status 129:Legal status 80:Fexinidazole 61:License data 23:Fexinidazole 18: 2347:from market 2321:Paromomycin 2311:Doxycycline 2288:Secnidazole 2252:Carnidazole 2195:Albendazole 2122:Paromomycin 2112:Miltefosine 2102:Pentamidine 2098:benzamidine 1995:Pentamidine 1991:benzamidine 1981:Melarsoprol 1772:20 November 1757:McNeil Jr D 1741:19 November 1662:McNeil Jr D 1435:: 186–194. 1179:12 November 1068:12 November 1029:12 November 889:12 November 782:synthesized 740:. Torreele 702:orphan drug 642:acoziborole 587:Medical use 435: g·mol 375:100.207.619 159:Identifiers 43:Other names 2426:Thioethers 2400:Categories 2301:Iodoquinol 2260:Tinidazole 2229:Quinacrine 2213:nitrofuran 2203:thiazolide 2185:Tinidazole 2169:Giardiasis 2049:Nifurtimox 2045:nitrofuran 1707:22 January 1528:: 122505. 804:References 691:Hoechst AG 598:nifurtimox 513:medication 440:3D model ( 428:Molar mass 285:306ERL82IR 256:ChemSpider 200:59729-37-2 191:CAS Number 181:-imidazole 168:IUPAC name 2357:Phase III 2345:Withdrawn 2317:neomycin 2160:Trichozoa 1973:arsenical 1963:ornithine 1924:parasites 1857:260377572 1550:254917177 1355:(4): 90. 856:20 August 776:Synthesis 675:sulfoxide 550:pregnancy 542:psychosis 91:Routes of 2390:Medicine 2118:neomycin 1921:excavata 1849:37528515 1701:Archived 1648:20439607 1599:22301556 1542:36549405 1506:36179736 1449:23260189 1433:Elsevier 1381:36278589 1349:Diseases 1330:21911566 1281:21200426 1230:46781585 1222:29113731 1143:(2021). 1115:(2019). 986:57772417 978:30635838 940:35925555 850:DailyMed 770:in vitro 768:despite 673:are the 560:and the 236:DrugBank 105:ATC code 98:By mouth 75:DailyMed 2141:polyene 2072:polyene 2005:Suramin 1639:2897277 1590:3457684 1497:9554014 1457:8688394 1372:9589988 1321:3232772 1272:3006138 931:9907522 830:16 July 762:beagles 758:rabbits 696:The US 685:History 679:sulfone 671:in vivo 651:in vivo 392:Formula 245:DB12265 211:PubChem 121:) 115: ( 113:P01CA03 77::  52:HOE 239 2376:Portal 2340:WHO-EM 1977:Atoxyl 1855:  1847:  1798:4 June 1646:  1636:  1597:  1587:  1548:  1540:  1504:  1494:  1455:  1447:  1405:4 June 1379:  1369:  1328:  1318:  1279:  1269:  1228:  1220:  1200:Lancet 1095:  984:  976:  938:  928:  714:Sanofi 581:Sanofi 544:, and 466:SMILES 433:279.31 316:ChEMBL 305:D11252 150:â„ž-only 148: 73:  1853:S2CID 1736:(PDF) 1697:(FDA) 1693:U.S. 1689:(PDF) 1546:S2CID 1453:S2CID 1431:(2). 1226:S2CID 1062:(PDF) 1051:(PDF) 1023:(PDF) 1012:(PDF) 982:S2CID 958:Drugs 742:et al 646:et al 600:with 511:is a 486:InChI 442:JSmol 265:62032 225:68792 1845:PMID 1800:2019 1774:2018 1743:2018 1709:2023 1644:PMID 1595:PMID 1538:PMID 1502:PMID 1445:PMID 1407:2019 1377:PMID 1326:PMID 1277:PMID 1218:PMID 1181:2019 1093:ISBN 1070:2019 1031:2019 974:PMID 936:PMID 891:2019 858:2021 832:2021 760:and 754:rats 750:mice 677:and 529:, a 296:KEGG 276:UNII 2133:PAM 1928:P01 1837:doi 1634:PMC 1626:doi 1585:PMC 1577:doi 1530:doi 1526:631 1492:PMC 1484:doi 1437:doi 1367:PMC 1357:doi 1316:PMC 1308:doi 1267:PMC 1257:doi 1208:doi 1204:391 1149:hdl 1121:hdl 1055:EMA 1016:EMA 966:doi 926:PMC 918:doi 552:or 341:EPA 215:CID 118:WHO 2402:: 2353:: 2258:, 2254:, 2183:, 2093:) 2089:, 1983:, 1979:, 1877:. 1851:. 1843:. 1833:66 1831:. 1790:. 1763:. 1691:. 1668:. 1642:. 1632:. 1622:54 1620:. 1616:. 1593:. 1583:. 1571:. 1567:. 1544:. 1536:. 1524:. 1500:. 1490:. 1480:10 1478:. 1474:. 1451:. 1443:. 1429:12 1427:. 1415:^ 1397:. 1375:. 1365:. 1353:10 1351:. 1347:. 1324:. 1314:. 1304:55 1302:. 1298:. 1275:. 1265:. 1251:. 1247:. 1224:. 1216:. 1202:. 1198:. 1171:. 1053:. 1039:^ 1014:. 994:^ 980:. 972:. 962:79 960:. 948:^ 934:. 924:. 914:76 912:. 908:. 877:. 866:^ 848:. 823:. 812:^ 788:. 756:, 752:, 681:. 661:. 619:50 617:IC 540:, 406:13 400:12 144:US 70:US 2378:: 2323:) 2319:( 2313:) 2309:( 2303:) 2299:( 2290:) 2281:( 2262:) 2250:( 2231:) 2227:( 2219:) 2215:( 2209:) 2205:( 2197:) 2193:( 2187:) 2179:( 2147:) 2143:( 2124:) 2120:( 2114:) 2110:( 2104:) 2100:( 2085:( 2078:) 2074:( 2051:) 2047:( 2041:) 2037:( 2018:) 2014:( 2007:) 2003:( 1997:) 1993:( 1987:) 1975:( 1969:) 1965:( 1930:) 1926:( 1909:e 1902:t 1895:v 1859:. 1839:: 1816:. 1802:. 1776:. 1745:. 1722:. 1711:. 1674:. 1650:. 1628:: 1601:. 1579:: 1573:4 1552:. 1532:: 1508:. 1486:: 1459:. 1439:: 1409:. 1383:. 1359:: 1332:. 1310:: 1283:. 1259:: 1253:4 1232:. 1210:: 1183:. 1151:: 1123:: 1101:. 1072:. 1033:. 988:. 968:: 942:. 920:: 893:. 860:. 834:. 444:) 421:S 418:3 415:O 412:3 409:N 403:H 397:C 343:) 339:( 179:H 146::

Index


License data
DailyMed
Fexinidazole
Routes of
administration

By mouth
ATC code
P01CA03
WHO
Legal status
â„ž-only
IUPAC name
CAS Number
59729-37-2
PubChem
68792
DrugBank
DB12265
ChemSpider
62032
UNII
306ERL82IR
KEGG
D11252
ChEMBL
ChEMBL1631694
CompTox Dashboard
DTXSID00208448
Edit this at Wikidata
ECHA InfoCard

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