Diethylstilbestrol dipalmitate

Last updated
Diethylstilbestrol dipalmitate
Diethylstilbestrol dipalmitate.svg
Clinical data
Trade names Palmestril, Stilpalmitate
Other namesStilpalmitate
Routes of
administration
Intramuscular injection
Identifiers
  • [4-[(E)-4-(4-Hexadecanoyloxyphenyl)hex-3-en-3-yl]phenyl] hexadecanoate
CAS Number
PubChem CID
ChemSpider
UNII
CompTox Dashboard (EPA)
Chemical and physical data
Formula C50H80O4
Molar mass 745.186 g·mol−1
3D model (JSmol)
  • CCCCCCCCCCCCCCCC(=O)OC1=CC=C(C=C1)/C(=C(\CC)/C2=CC=C(C=C2)OC(=O)CCCCCCCCCCCCCCC)/CC
  • InChI=1S/C50H80O4/c1-5-9-11-13-15-17-19-21-23-25-27-29-31-33-49(51)53-45-39-35-43(36-40-45)47(7-3)48(8-4)44-37-41-46(42-38-44)54-50(52)34-32-30-28-26-24-22-20-18-16-14-12-10-6-2/h35-42H,5-34H2,1-4H3/b48-47+
  • Key:JUHYOIKJCUMOSQ-QJGAVIKSSA-N

Diethylstilbestrol dipalmitate (brand names Palmestril, Stilpalmitate), also known as stilpalmitate, is a synthetic, nonsteroidal estrogen of the stilbestrol group and an ester of diethylstilbestrol (DES) that was formerly marketed but is now no longer available. [1] [2] Its actions and uses are essentially the same as those of DES, but it is absorbed more slowly and for this reason has a much longer duration of action and improved tolerability in comparison. [3] A single 5 mg intramuscular injection of DES dipalmitate in oil solution has been found to have an average duration of action of 8 to 10 weeks [4] in terms of relief of menopausal symptoms, with a duration of as long as 15 to 16 weeks occurring in some women. [5] [6] [7] A single 15 or 20 mg intramuscular injection of DES dipalmitate in oil solution will control menopausal symptoms for 3 months or longer. [8] DES dipalmitate in aqueous suspension by intramuscular injection has been studied as well. [9]

See also

Related Research Articles

<span class="mw-page-title-main">Estradiol valerate</span> Chemical compound

Estradiol valerate (EV), sold for use by mouth under the brand name Progynova and for use by injection under the brand names Delestrogen and Progynon Depot among others, is an estrogen medication. It is used in hormone therapy for menopausal symptoms and low estrogen levels, hormone therapy for transgender people, and in hormonal birth control. It is also used in the treatment of prostate cancer. The medication is taken by mouth or by injection into muscle or fat once every 1 to 4 weeks.

<span class="mw-page-title-main">Polyestradiol phosphate</span> Chemical compound

Polyestradiol phosphate (PEP), sold under the brand name Estradurin, is an estrogen medication which is used primarily in the treatment of prostate cancer in men. It is also used in women to treat breast cancer, as a component of hormone therapy to treat low estrogen levels and menopausal symptoms, and as a component of feminizing hormone therapy for transgender women. It is given by injection into muscle once every four weeks.

<span class="mw-page-title-main">Estradiol benzoate</span> Chemical compound

Estradiol benzoate (EB), sold under the brand name Progynon-B among others, is an estrogen medication which is used in hormone therapy for menopausal symptoms and low estrogen levels in women, in hormone therapy for transgender women, and in the treatment of gynecological disorders. It is also used in the treatment of prostate cancer in men. Estradiol benzoate is used in veterinary medicine as well. When used clinically, the medication is given by injection into muscle usually two to three times per week.

<span class="mw-page-title-main">Estradiol cypionate</span> Chemical compound

Estradiol cypionate (EC), sold under the brand name Depo-Estradiol among others, is an estrogen medication which is used in hormone therapy for menopausal symptoms and low estrogen levels in women, in hormone therapy for trans women, and in hormonal birth control for women. It is given by injection into muscle once every 1 to 4 weeks.

<span class="mw-page-title-main">Estradiol enantate</span> Chemical compound

Estradiol enantate, also spelled estradiol enanthate and sold under the brand names Perlutal and Topasel among others, is an estrogen medication which is used in hormonal birth control for women. It is formulated in combination with dihydroxyprogesterone acetophenide, a progestin, and is used specifically as a combined injectable contraceptive. Estradiol enantate is not available for medical use alone. The medication, in combination with DHPA, is given by injection into muscle once a month.

<span class="mw-page-title-main">Estriol succinate</span> Chemical compound

Estriol succinate, sold under the brand name Synapause among others, is an estrogen medication which is used in the treatment of menopausal symptoms. It is taken by mouth, in through the vagina, and by injection.

<span class="mw-page-title-main">Estradiol undecylate</span> Chemical compound

Estradiol undecylate, also known as estradiol undecanoate and formerly sold under the brand names Delestrec and Progynon Depot 100 among others, is an estrogen medication which has been used in the treatment of prostate cancer in men. It has also been used as a part of hormone therapy for transgender women. Although estradiol undecylate has been used in the past, it was discontinued. The medication has been given by injection into muscle usually once a month.

<span class="mw-page-title-main">Estradiol dipropionate</span> Chemical compound

Estradiol dipropionate (EDP), sold under the brand names Agofollin, Di-Ovocylin, and Progynon DP among others, is an estrogen medication which has been used in hormone therapy for menopausal symptoms and low estrogen levels in women and in the treatment of gynecological disorders. It has also been used in feminizing hormone therapy for transgender women and in the treatment of prostate cancer in men. Although widely used in the past, estradiol dipropionate has largely been discontinued and is mostly no longer available today. It appears to remain in use only in Japan, Macedonia, and Australia. Estradiol dipropionate is given by injection into muscle at intervals ranging from once or twice a week to once every week and a half to two weeks.

An estrogen ester is an ester of an estrogen, most typically of estradiol but also of other estrogens such as estrone, estriol, and even nonsteroidal estrogens like diethylstilbestrol. Esterification renders estradiol into a prodrug of estradiol with increased resistance to first-pass metabolism, slightly improving its oral bioavailability. In addition, estrogen esters have increased lipophilicity, which results in a longer duration when given by intramuscular or subcutaneous injection due to the formation of a long-lasting local depot in muscle and fat. Conversely, this is not the case with intravenous injection or oral administration. Estrogen esters are rapidly hydrolyzed into their parent estrogen by esterases once they have been released from the depot. Because estradiol esters are prodrugs of estradiol, they are considered to be natural and bioidentical forms of estrogen.

<span class="mw-page-title-main">Hexestrol</span> Chemical compound

Hexestrol, sold under the brand name Synestrol among others, is a nonsteroidal estrogen which was previously used for estrogen replacement therapy and in the treatment of certain hormone-dependent cancers as well as gynecological disorders but is mostly no longer marketed. It has also been used in the form of esters such as hexestrol diacetate and hexestrol dipropionate. Hexestrol and its esters are taken by mouth, held under the tongue, or via injection into muscle.

<span class="mw-page-title-main">Estradiol hexahydrobenzoate</span> Chemical compound

Estradiol hexahydrobenzoate (EHHB), sold under a number of brand names including Benzo-Ginoestril A.P., BenzoGynoestryl Retard, Ginestryl-15-Depot, Menodin, and Tardoginestryl, is an estrogen medication which was previously used for indications such as menopausal hormone therapy and gynecological disorders. EHHB is given by injection into muscle at regular intervals, for instance once every few weeks.

<span class="mw-page-title-main">Dimestrol</span> Chemical compound

Dimestrol, also known as dianisylhexene, 4,4'-dimethoxy-α,α'-diethylstilbene, diethylstilbestrol dimethyl ether, and dimethoxydiethylstilbestrol, is a synthetic nonsteroidal estrogen of the stilbestrol group which is related to diethylstilbestrol. It has been used clinically as a hormonal therapy in cases of delayed female puberty, hypogonadism, menopausal, and postmenopausal symptoms. It is known to induce the development of female secondary sexual characteristics in the case of female delayed puberty or hypogonadism. The drug has also been used as a growth promoter in livestock.

<span class="mw-page-title-main">Estradiol dienantate</span> Chemical compound

Estradiol dienanthate (EDE), sold under the brand names Climacteron among others, is a long-acting estrogen medication which was previously used in menopausal hormone therapy for women and to suppress lactation in women. It was formulated in combination with estradiol benzoate (EB), a short-acting estrogen, and testosterone enanthate benzilic acid hydrazone (TEBH), a long-acting androgen/anabolic steroid. EDE has not been made available for medical use alone. The medication, in combination with EB and TEBH, was given by injection into muscle once or at regular intervals, for instance once every 6 weeks.

<span class="mw-page-title-main">Estradiol benzoate butyrate</span> Chemical compound

Estradiol benzoate butyrate (EBB), sold under the brand names Neolutin N, Redimen, Soluna, and Unijab and formerly known under the developmental code name Unimens, is an estrogen medication which is used in hormonal birth control for women. It is formulated in combination with dihydroxyprogesterone acetophenide, a progestin, and is used specifically as a combined injectable contraceptive. EBB is not available for medical use alone. The medication, in combination with DHPA, is given by injection into muscle once a month.

<span class="mw-page-title-main">Prasterone enanthate</span> Chemical compound

Prasterone enanthate, also known as dehydroepiandrosterone enanthate (DHEA-E) and sold in combination with estradiol valerate under the brand name Gynodian Depot among others, is a weak androgen, estrogen, and neurosteroid medication which is used as a component of menopausal hormone therapy to treat menopausal symptoms in women. It is available only as an injectable preparation in combination with estradiol valerate. The medication is given by injection into muscle typically once every 4 weeks.

<span class="mw-page-title-main">Estrone (medication)</span> Estrogen medication

Estrone (E1), sold under the brand names Estragyn, Kestrin, and Theelin among many others, is an estrogen medication and naturally occurring steroid hormone which has been used in menopausal hormone therapy and for other indications. It has been provided as an aqueous suspension or oil solution given by injection into muscle and as a vaginal cream applied inside of the vagina. It can also be taken by mouth as estradiol/estrone/estriol and in the form of prodrugs like estropipate and conjugated estrogens.

<span class="mw-page-title-main">Pharmacokinetics of estradiol</span>

The pharmacology of estradiol, an estrogen medication and naturally occurring steroid hormone, concerns its pharmacodynamics, pharmacokinetics, and various routes of administration.

<span class="mw-page-title-main">Polyestriol phosphate</span> Chemical compound

Polyestriol phosphate, sold under the brand names Gynäsan, Klimadurin, and Triodurin, is an estrogen medication which was previously used in menopausal hormone therapy and is no longer available.

<span class="mw-page-title-main">Estradiol valerate/prasterone enanthate</span> Combination drug

Estradiol valerate/prasterone enanthate (EV/DHEA-E), sold under the brand name Gynodian Depot among others, is an injectable combination medication of estradiol valerate (EV), an estrogen, and prasterone enanthate (DHEA-E), an androgen, estrogen, and neurosteroid, which is used in menopausal hormone therapy for women. It is provided in the form of 1 mL ampoules containing 4 mg estradiol valerate and 200 mg prasterone enanthate in an oil solution and is administered by intramuscular injection once every 4 to 6 weeks. EV/DHEA-E reportedly has a duration of about 21 days.

References

  1. Elks J (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. p. 397. ISBN   978-1-4757-2085-3.
  2. Hammes B, Laitman CJ (2003). "Diethylstilbestrol (DES) update: recommendations for the identification and management of DES-exposed individuals". Journal of Midwifery & Women's Health. 48 (1): 19–29. doi:10.1016/s1526-9523(02)00370-7. PMID   12589302.
  3. N.A.R.D. Journal ...: The Official Organ of the National Association of Retail Druggists. National Association of Retail Druggists. 1948. p. 62.
  4. Correll CU, Kim E, Sliwa JK, Hamm W, Gopal S, Mathews M, et al. (January 2021). "Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview". CNS Drugs. 35 (1): 39–59. doi:10.1007/s40263-020-00779-5. PMC   7873121 . PMID   33507525.
  5. James DW (Summer 1998). "Management of the Menopause" (PDF). The Permanente Journal. 2 (3): 25–29. doi:10.7812/TPP/98.930. S2CID   248135901. A similar response is obtained with diethylstilbestrol. The free compound is less effective than diethylstilbestrol dipropionate which in turn is less effective than diethylstilbestrol dipalmitate. This is dramatically shown by our results which we have already reported, namely, that injections of diethylstilbestrol in dosages of 5 mg. once weekly for three weeks will give relief in the menopausal patient for an average of three weeks following cessation of treatment. A similar dosage of the dipropionate will induce a therapeutic effect for approximately five weeks under similar conditions while the dipalmitate has an effect lasting on the average of nine weeks and not uncommonly as long as 15 to 16 weeks.2
  6. Freed SC (May 1943). "Estrogens and Androgens". The American Journal of the Medical Sciences. 205 (5): 735–753. doi:10.1097/00000441-194305000-00016. ISSN   0002-9629. There is a possibility that some of the estrogens may be improved further so that even pellets may not be considered to possess advantages. In this regard, Freed and associates have introduced diethylstilbestrol dipalmitate.26 This combination of estrogen with a relative high fatty acid was injected in dosages containing 5 mg. of the active compound 3 times at weekly intervals. The period of relief from symptoms following cessation of therapy averaged 8 to 9 weeks. In some unpublished work the author has found that one injection of a 5 mg. dose in about 200 instances produced relief, on the average, for 5 weeks. It is obvious that compounds developed along these lines with, for instance, even higher fatty acid esters may be even more effective, or than an injection of 10 or 15 mg. will produce results equivalent to that of pellets.
  7. Freed SC (1942). "The Therapeutic Efficiency of Diethylstilbestrol Esters". JAMA: The Journal of the American Medical Association. 119 (17): 1412. doi:10.1001/jama.1942.02830340024007. ISSN   0098-7484.
  8. McCullagh EP (July 1946). "Climacteric, male and female". Cleveland Clinic Quarterly. 13 (3): 166–176. doi:10.3949/ccjm.13.3.166. PMID   20987362. Stilbestrol dipalmitate in oil is a soap-like material which can be liquified by heat and injected intramuscularly. A single injection containing 15 or 20 mg. of stilbestrol may control climacteric symptoms for three months or more at a time.
  9. Freed SC (June 1947). "Diethylstilbestrol dipalmitate in aqueous suspension". The Journal of Clinical Endocrinology and Metabolism. 7 (6): 448. PMID   20344099.