司美匹韦

司美匹韦
临床资料
读音	/sɪˈmɛprəvɪər/; si-MEP-rə-veer
商品名（英语：Drug nomenclature）	Olysio, Sovriad, Galexos, others
其他名称	TMC435; TMC435350
AHFS/Drugs.com	Monograph
MedlinePlus	a614013
核准状况	欧 EMA: yes;
给药途径	经口（胶囊剂）
ATC码	J05AP05 (WHO) ;
法律规范状态
法律规范	美：处方药（℞-only）; 处方药（℞-only）;
药物动力学数据
生物利用度	62% (under fed conditions)
血浆蛋白结合率	>99.9%
药物代谢	Hepatic (CYP3A, CYP2C8, CYP2C19)
生物半衰期	10–13小时（HCV-uninfected subjects），41小时（HCV-infected subjects）
排泄途径	粪便（91%），尿液（<1%）
识别信息
	IUPAC命名法 (2R,3aR,10Z,11aS,12aR,14aR)-N-(Cyclopropylsulfonyl)-2[2-(4-isopropyl-1,3-thiazol-2-yl)-7-methoxy-8-methyl-4-quinolinyl]oxy5-methyl-4,14-dioxo-2,3,3a,4,5,6,7,8,9,11a,12,13,14,14a-tetradecahydrocyclopenta[c]cyclopropa[g][1,6]diazacyclotetradecine-12a(1H)-carboxamide; ;
CAS号	923604-59-5
PubChem CID	24873435;
IUPHAR/BPS	7367;
DrugBank	DB06290;
ChemSpider	23331536;
UNII	9WS5RD66HZ;
KEGG	D10081;
ChEMBL	ChEMBL501849;
NIAID ChemDB	489101;
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)	DTXSID20919221 ;
ECHA InfoCard	100.215.933
化学信息
化学式	C38H47N5O7S2
摩尔质量	749.94 g·mol−1
	SMILES Cc1c(ccc2c1nc(cc2O[C@@H]3C[C@@H]4[C@@H](C3)C(=O)N(CCCC/C=C\[C@@H]5C[C@]5(NC4=O)C(=O)NS(=O)(=O)C6CC6)C)c7nc(cs7)C(C)C)OC;
	InChI InChI=1S/C38H47N5O7S2/c1-21(2)30-20-51-35(40-30)29-18-32(26-13-14-31(49-5)22(3)33(26)39-29)50-24-16-27-28(17-24)36(45)43(4)15-9-7-6-8-10-23-19-38(23,41-34(27)44)37(46)42-52(47,48)25-11-12-25/h8,10,13-14,18,20-21,23-25,27-28H,6-7,9,11-12,15-17,19H2,1-5H3,(H,41,44)(H,42,46)/b10-8-/t23-,24-,27-,28-,38-/m1/s1; Key:JTZZSQYMACOLNN-VDWJNHBNSA-N;

司美匹韦（英语：Simeprevir），是一种抗病毒药物，常与其他药物并用治疗丙型肝炎^[1]^[2]。本品主要用于治疗丙型肝炎第一及四型基因型^[1]，常见的市售药名为奥利西奥（英语：Olysio）。可联合使用的药物有索非布韦、利巴韦林及聚乙二醇干扰素-α（英语：peginterferon-alfa）^[1]。此药治疗丙型肝炎的治愈率高达八至九成^[3]^[4]^[5]，同时罹有艾滋病的患者也可以使用^[1]。通常的疗程为每天口服一次，持续12周^[1]。

常见的副作用为有疲倦感、头痛、起红疹、搔痒及畏光^[1]。若患者有乙型肝炎病史，亦可能会使相关潜伏疾病复发^[1]。肝脏功能严重不佳者不建议使用^[1]，怀孕的患者如果并用利巴韦林可能影响胎儿；与索非布韦并用是否安全，则尚无定论^[1]^[2]。本品属于丙型肝炎病毒蛋白酶抑制剂（HCV protease inhibitor）^[1]，可透过抑制病毒的蛋白酶活性以阻止病毒复制增生。

司美匹韦系由Medivir AB（英语：Medivir AB）和杨森制药研发^[6]，2013 年在美国通过核准使用^[7]，2019 年已从世界卫生组织基本药物标准清单除名^[8]。截至2015年，仍无通用名药物在市面上流通^[2]；同年在英国，一套疗程包含利巴韦林、长效型干扰素α 需花费约 29,700 英镑^[9]，而在美国，一套疗程包含索非布韦则须花费超过 17.1 万美元，包含司美匹韦成分则需花费 66,360 美元^[10]。

附注

^ ^1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 Simeprevir. The American Society of Health-System Pharmacists. [30 November 2016]. （原始内容存档于2016-12-01）.
^ ^2.0 ^2.1 ^2.2 Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 80. ISBN 9781284057560.
^ Initial treatment of HCV infection. www.hcvguidelines.org. October 2016 [1 December 2016]. （原始内容存档于2016-12-07）.
^ Majumdar, A; Kitson, MT; Roberts, SK. Systematic review: current concepts and challenges for the direct-acting antiviral era in hepatitis C cirrhosis.. Alimentary Pharmacology & Therapeutics. June 2016, 43 (12): 1276–92. PMID 27087015. doi:10.1111/apt.13633.
^ Brochot, E; Helle, F; François, C; Castelain, S; Capron, D; Nguyen-Khac, E; Duverlie, G. Which therapeutic option for hepatitis C virus genotype 1?. Scandinavian Journal of Gastroenterology. April 2015, 50 (4): 470–8. PMID 25396710. doi:10.3109/00365521.2014.978364.
^ Grubbs, Robert H.; O'Leary, Daniel J. Handbook of Metathesis, Volume 2: Applications in Organic Synthesis. John Wiley & Sons. 2015: 699 [2019-09-30]. ISBN 9783527694020. （原始内容存档于2021-08-29）（英语）.
^ DUGUM, M.; O'SHEA, R. Hepatitis C virus: Here comes all-oral treatment. Cleveland Clinic Journal of Medicine. 2014, 81 (3): 159–172. PMID 24591471. doi:10.3949/ccjm.81a.13155.
^ Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines: WHO Headquarters, Geneva, 1-5 April 2019. 2019. hdl:10665/325773.
^ Janssen will cover cost of unsuccessful hepatitis C treatment. PMLive. 16 January 2015 [1 December 2016]. （原始内容存档于2016-12-02）.
^ Smith, Michael. HCV Drugs Costly but Cure Might Not Be. MedPageToday. 28 February 2015 [1 December 2016]. （原始内容存档于2016-12-01）.

[AHFS2016-1] 1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 Simeprevir. The American Society of Health-System Pharmacists. [30 November 2016]. （原始内容存档于2016-12-01）.

[Ric2015-2] 2.0 ^2.1 ^2.2 Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 80. ISBN 9781284057560.

[3] Initial treatment of HCV infection. www.hcvguidelines.org. October 2016 [1 December 2016]. （原始内容存档于2016-12-07）.

[4] Majumdar, A; Kitson, MT; Roberts, SK. Systematic review: current concepts and challenges for the direct-acting antiviral era in hepatitis C cirrhosis.. Alimentary Pharmacology & Therapeutics. June 2016, 43 (12): 1276–92. PMID 27087015. doi:10.1111/apt.13633.

[5] Brochot, E; Helle, F; François, C; Castelain, S; Capron, D; Nguyen-Khac, E; Duverlie, G. Which therapeutic option for hepatitis C virus genotype 1?. Scandinavian Journal of Gastroenterology. April 2015, 50 (4): 470–8. PMID 25396710. doi:10.3109/00365521.2014.978364.

[6] Grubbs, Robert H.; O'Leary, Daniel J. Handbook of Metathesis, Volume 2: Applications in Organic Synthesis. John Wiley & Sons. 2015: 699 [2019-09-30]. ISBN 9783527694020. （原始内容存档于2021-08-29）（英语）.

[Cle2013-7] DUGUM, M.; O'SHEA, R. Hepatitis C virus: Here comes all-oral treatment. Cleveland Clinic Journal of Medicine. 2014, 81 (3): 159–172. PMID 24591471. doi:10.3949/ccjm.81a.13155.

[WHO21st-8] Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines: WHO Headquarters, Geneva, 1-5 April 2019. 2019. hdl:10665/325773.

[9] Janssen will cover cost of unsuccessful hepatitis C treatment. PMLive. 16 January 2015 [1 December 2016]. （原始内容存档于2016-12-02）.

[10] Smith, Michael. HCV Drugs Costly but Cure Might Not Be. MedPageToday. 28 February 2015 [1 December 2016]. （原始内容存档于2016-12-01）.

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