The Identification of a Nitrosated Prodrug of the PDE-5 Inhibitor Aildenafil in a Dietary Supplement: a Viagra with A

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The Identification of a Nitrosated Prodrug of the PDE-5 Inhibitor Aildenafil in a Dietary Supplement: a Viagra with A Journal of Pharmaceutical and Biomedical Analysis 54 (2011) 735–741 Contents lists available at ScienceDirect Journal of Pharmaceutical and Biomedical Analysis journal homepage: www.elsevier.com/locate/jpba The identification of a nitrosated prodrug of the PDE-5 inhibitor aildenafil in a dietary supplement: A Viagra with a pop B.J. Venhuis a,∗, G. Zomer b, M. Hamzink b, H.D. Meiring b, Y. Aubin c, D. de Kaste a a National Institute for Public Health and the Environment, Postbox 1, 3721 MA, Bilthoven, The Netherlands b Netherlands Vaccine Institute, Postbox 457, 3720 AL, Bilthoven, The Netherlands c Biologics and Genetic Therapies Directorate, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada K1A 0K9 article info abstract Article history: A new unapproved analogue of sildenafil was detected in capsules of a herbal dietary supplement pro- Received 13 August 2010 moted as a libido enhancing product. Using LC–DAD–MS, MS–MS, HRMS, IR and NMR the analogue Received in revised form was shown to be a derivative of the PDE-5 inhibitor aildenafil with a nitrosamine moiety. A hydroly- 11 November 2010 sis experiment showed that the new analogue was a prodrug of aildenafil and was therefore named Accepted 13 November 2010 nitroso-prodenafil. A capsule contained 108 mg of nitroso-prodenafil which is equivalent to 84 mg of Available online 21 November 2010 aildenafil and 5.1 mg of nitrogen monoxide (NO). Although it is unknown how much NO can be usefully generated there is 3-fold more NO present than in a 10 mg isorbide nitrate tablet. Keywords: Sildenafil analogue Both PDE-5 inhibitors and nitrosamines cause vasodilatation by increasing levels of NO. To their coinci- Nitroso-prodenafil dental use is warned against because it may cause a fatal drop in blood pressure. In addition, nitrosamines Aildenafil prodrug are known carcinogens. This is the first time a PDE-5 inhibitor and a potential NO donor were identified Liquid chromatography–mass in one molecule. The findings indicate the dangerous level of advancement in medicinal chemistry by spectrometry (LC–MS) producers of unapproved drugs. Nuclear magnetic resonance (NMR) © 2010 Elsevier B.V. All rights reserved. 1. Introduction drugs is illustrated by the identification of many unapproved PDE- 5 inhibitors [8]. Most of the unapproved PDE-5 inhibitors identified The erectile dysfunction (ED) drug Viagra (sildenafil citrate) are structural varieties (analogues) of the approved ED-drugs silde- or other PDE-5 inhibitors are not to be used coincidentally with nafil, vardenafil and tadalafil. Although many of these analogues are NO-donors [1–3]. NO-donating drugs are used in the treatment of disclosed in Pfizer, Bayer, or Lilly patents as PDE-5 inhibitors they angina pectoris (e.g. glyceryltrinitrate, isorbide nitrate) and act by were never selected for clinical development. As patent literature causing coronary vasodilatation. Originally, sildenafil was devel- is publicly accessible it can easily be misused. oped as an alternative treatment for angina pectoris because it The analogue identified in the current study is a cleverly raised NO-levels through PDE-5 inhibition. However, in clinical tri- designed nitrosated prodrug of aildenafil (Fig. 1). An N-methyl-N- als the vasodilatation caused in the corpus cavernosum of the penis nitroso-1,3-thiazole-5-amine moiety is linked to aildenafil through was more effective. Though the efficacy of sildenafil in inducing a hydrolyzable bond. The finding described in this article shows coronary vasodilatation was limited, coincidental use of drugs that that the producers of these pharmaceuticals evidently invest give off NO may cause a dangerous drop in blood pressure [4,5].ED time, resources and knowledge in the development of novel ana- patients using PDE-5 inhibitors are warned against the concomitant logues and are concomitantly prepared to take large health risks. use of NO-donating medicine and ‘poppers’ which are NO-releasing Nitrosamines may generate NO and enhance the vasodilating effect recreational (sex) drugs [6]. of a PDE-5 inhibitor with the risk of a dangerous drop in blood It has been estimated that for every two legitimate prescriptions pressure [9,10]. The potentially toxic nature of nitrosamines is illus- of an ED drug in Europe one third is purchased from illegal sources trated by the slimming drug nitroso-fenfluramine causing liver [7]. This ratio is expected to increase when adulterated dietary sup- failure on a large scale [11]. plements are also considered. The booming market for illegal ED 2. Materials and methods ∗ Corresponding author at: National Institute for Public Health and the Envi- 2.1. General ronment, Center for Quality of Chemical-Pharmaceutical Products, Anthonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands. Tel.: +31 30 2744228; · · fax: +31 30 2744462. Reference sildenafil citrate, vardenafil HCl 3H2O and tadalafil E-mail address: [email protected] (B.J. Venhuis). were obtained from Pfizer, Bayer and Lilly, respectively. Methanol 0731-7085/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jpba.2010.11.020 736 B.J. Venhuis et al. / Journal of Pharmaceutical and Biomedical Analysis 54 (2011) 735–741 38 33 N O 32 34 N N 36 31 N S 35 37 N N 21 O 10 N N 4 S S 20 9 N 3 + + O 5 N N 2 m/z 112 m/z 124 19 14 18 6 N 8 1 7 30 11 17 16 15 OH 12 N + N + 25 24 S S 26 23 22 HN NOS 13 27 28 m/z 85 m/z 101 O 29 Fig. 1. The proposed structure of the new analogue prodrug and the suggested fragments for ‘Moiety142’. (HPLC supra-gradient; MeOH) was obtained from Biosolve 2.3. High resolution mass spectrometry (HRMS) (Valkenswaard, The Netherlands). Formic acid (p.a.), ammonium hydroxide (p.a.) and 2N NaOH were obtained from Merck (Darm- A small amount of the composite (20 mg) was dissolved in 1 ml stadt, Germany). Other chemicals were obtained from various of CHCl3. The clear supernatant was collected after centrifuga- commercial sources in the highest purity grade available. Water tion and evaporated to dryness. The residue was reconstituted in was demineralised and filtered using a Millipak® 200 0.22-␮m filter 100 ␮l of water/acetonitrile (3:1, v/v) + 0.1% (v/v) formic acid and from Millipore B.V. (Amsterdam, The Netherlands). Acidified water also containing 1 pmol/␮l of the peptide Angiotensin-III as inter- was prepared by addition of 2 ml of formic acid to 1000 ml of water nal lock mass calibrant at the m/z-value of the doubly charged ion and adjusting the pH to 4.0 using NH4OH. @ 466.26106 Da. A 10-␮l aliquot of this mixture was pipetted into One package with two capsules of the herbal dietary supple- a gold-coated borosilicate glass nanospray needle (manufactured ment was brought in for analysis. The product label listed 9 herbal in-house, essentially as described by Wilm and Mann [12]) and ingredients and a content of 560 mg per capsule. However, a cap- positioned in a static nanoelectrospray ion source (built in-house) sule contained, on average, 386 mg of a white powder. A composite that was mounted onto an LTQ Orbitrap XL mass spectrometer was prepared of the two capsules. (Thermo Scientific). The sample was continuously infused into the mass spectrometer operated in positive ion mode, using an electro- ◦ 2.2. LC–DAD–MS spray voltage of 800 V and a heated capillary temperature of 200 C. Automatic gain control was used to control the filling of the mass × 5 A stock solution of the sample was prepared by sonication analyzer at a full MS target of 5 10 ions in the Orbitrap mass of an amount of the composite equivalent to a quarter dosage analyzer (operated at a mass resolution of 100,000 FWHM @ m/z × 4 unit in 25 ml of MeOH. An aliquot of the supernatant liquid was 400 Da) or at a MS/MS target of 1 10 ions in the LTQ ion trap. diluted 100× using MeOH/acidified water (v/v = 50/50), which solu- Full scan MS spectra were acquired from m/z 150–1500 Da with 1 tion was subsequently used for LC–DAD–MSn analysis. All samples microscan and a maximum inject time of 150 ms. For structural elu- and solutions were filtered before use over a 0.45 ␮m Spartan 30 cidation, analyte ions of interest were fragmented in the ion trap filter (Whatman GmbH, Dassel, Germany). For chromatography with collision induced fragmentation (CID) and the resulting prod- and UV detection, a Surveyor instrumentation (Thermo Finnigan, uct ions were mass-analyzed in the Orbitrap analyzer at a mass Breda, The Netherlands) was used under the following condi- resolution of 100,000 FWHM @ m/z 400 Da. ® tions: XTerra MS C18 guard column (20 mm × 2.1 mm, 3.5 mm) ® × and XTerra MS C18 analytical column (100 mm 2.1 mm, 3.5 mm; 2.4. IR spectroscopy Waters Chromatography B.V., Etten-Leur, The Netherlands); elu- tion using solvent A—MeOH and solvent B—acidified water/MeOH The unknown compound was coated on KBr for IR analysis by (v/v = 50/50): 0–15 min isocratic (B = 100), 15–17 min gradient to mixing 20 mg KBr with 2 ml of the stock solution prepared under A/B = 60/40, 17–28 min isocratic A/B = 60/40, 28–33 min: isocratic Section 2.2. After evaporation of the MeOH under a stream of N a −1 ◦ 2 B = 100; flow rate at 0.25 ml min ; column temperature 25 C; sample of the dry powder was used for IR analysis (KBr) in a Bruker ␮ injection volume 20 l; ultraviolet light detection from 200 to IFS55 FT-IR spectrometer with a DTGS detector and OPUS software 450 nm.
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