Milvexian Explained

Routes Of Administration:	By mouth
Atc Prefix:	None
Legal Status:	Investigational
Elimination Half-Life:	11.4–18.1 h^[1]
Cas Number:	1802425-99-5
Pubchem:	118277544
Chemspiderid:	76803905
Drugbank:	DB16233
Chembl:	4112929
Kegg:	D11802
Unii:	0W79NDQ608
Synonyms:	BMS-986177, JNJ-70033093
Iupac Name:	(9R,13S)-13--3-(difluoromethyl)-9-methyl-3,4,7,15-tetraazatricyclo[12.3.1.0<sup>2,6</sup>]octadeca-1(18),2(6),4,14,16-pentaen-8-one
C:	28
H:	23
Cl:	2
F:	2
N:	9
O:	2
Smiles:	C[C@@H]1CCC[C@H](n2cnc(-c3cc(Cl)ccc3-n3cc(Cl)nn3)cc2=O)c2cc(ccn2)-c2c(cnn2C(F)F)NC1=O
Stdinchi:	1S/C28H23Cl2F2N9O2/c1-15-3-2-4-23(20-9-16(7-8-33-20)26-21(36-27(15)43)12-35-41(26)28(31)32)39-14-34-19(11-25(39)42)18-10-17(29)5-6-22(18)40-13-24(30)37-38-40/h5-15,23,28H,2-4H2,1H3,(H,36,43)/t15-,23+/m1/s1
Stdinchikey:	FSWFYCYPTDLKON-CMJOXMDJSA-N

Milvexian is a factor XIa inhibitor which acts as an anticoagulant. It is taken by mouth. As of late 2021, it was under study for the prevention of blood clots in patients undergoing surgery.^[2] In 2018–2023, Bristol-Myers Squibb studied milvexian for the prevention of stroke.^[3]

Notes and References

1. Perera V, Wang Z, Luettgen J, Li D, DeSouza M, Cerra M, Seiffert D . First-in-human study of milvexian, an oral, direct, small molecule factor XIa inhibitor . Clinical and Translational Science . September 2021 . 15 . 2 . 330–342 . 34558200 . 10.1111/cts.13148 . 8841437 . 237617815 . free .
2. Weitz JI, Strony J, Ageno W, Gailani D, Hylek EM, Lassen MR, Mahaffey KW, Notani RS, Roberts R, Segers A, Raskob GE . 6 . Milvexian for the Prevention of Venous Thromboembolism . The New England Journal of Medicine . November 2021 . 385 . 23 . 2161–2172 . 34780683 . 10.1056/NEJMoa2113194 . 9540352 . 244132392 . free .
3. Web site: A Study on BMS-986177 for the Prevention of a Stroke in Patients Receiving Aspirin and Clopidogrel (AXIOMATIC-SSP) . ClinicalTrial.gov . . 26 June 2023.