Imeglimin

Chemical compound

A10BX15 (WHO)

Legal statusLegal status

Rx-only in Japan

Identifiers

IUPAC name

(2S)-N⁶,N⁶,2-Trimethyl-1,2-dihydro-1,3,5-triazine-4,6-diamine

CAS Number

775351-65-0

PubChem CID

24812808

ChemSpider

26232690

UNII

UU226QGU97

CompTox Dashboard (EPA)

DTXSID50228237

Chemical and physical dataFormulaC₆H₁₃N₅Molar mass155.205 g·mol⁻¹3D model (JSmol)

Interactive image

SMILES

C[C@H]1NC(=NC(=N1)N)N(C)C

InChI

InChI=1S/C6H13N5/c1-4-8-5(7)10-6(9-4)11(2)3/h4H,1-3H3,(H3,7,8,9,10)/t4-/m1/s1
Key:GFICWFZTBXUVIG-SCSAIBSYSA-N

Imeglimin (EMD- 387008,PXL- 008,RVT-1501, brand name Twymeeg) is an oral anti-diabetic medication.^[1]^[2] It was approved for use in Japan in June 2021.^[3]

It is an oxidative phosphorylation blocker that acts to inhibit hepatic gluconeogenesis, increase muscle glucose uptake, and restore normal insulin secretion. It is the first approved drug of this class of anti-diabetic medication.

References

^ Vuylsteke V, Chastain LM, Maggu GA, Brown C (September 2015). "Imeglimin: A Potential New Multi-Target Drug for Type 2 Diabetes". Drugs in R&D. 15 (3): 227–32. doi:10.1007/s40268-015-0099-3. PMC 4561051. PMID 26254210.
^ Dubourg J, Fouqueray P, Thang C, Grouin JM, Ueki K (April 2021). "Efficacy and Safety of Imeglimin Monotherapy Versus Placebo in Japanese Patients With Type 2 Diabetes (TIMES 1): A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group, Multicenter Phase 3 Trial". Diabetes Care. 44 (4): 952–959. doi:10.2337/dc20-0763. PMID 33574125.
^ Poxel SA (June 23, 2021). "Poxel and Sumitomo Dainippon Pharma Announce the Approval of TWYMEEG® (Imeglimin hydrochloride) for the Treatment of Type 2 Diabetes in Japan" (Press release).

Oral diabetes medication, insulins and insulin analogs, and other drugs used in diabetes (A10)

Insulins/insulin analogs

fast-acting	Insulin aspart Insulin glulisine Insulin lispro
short-acting	Regular insulin^#
long-acting	Insulin detemir^# Insulin glargine^# (+lixisenatide) NPH insulin Lente insulin^‡ Ultralente insulin^‡
ultra-long-acting	Insulin degludec^# (+insulin aspart, +liraglutide) Insulin icodec^† (+semaglutide)
inhalable	Exubera^‡ Afrezza

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

Non-insulins

Insulin sensitizers

Biguanides	Buformin^‡ Metformin^# Phenformin^‡
TZDs/"glitazones" (PPAR)	Ciglitazone^§ Darglitazone^§ Englitazone^§ Lobeglitazone Netoglitazone^§ Pioglitazone Rivoglitazone^† Rosiglitazone Troglitazone^‡
Dual PPAR agonists	Aleglitazar^† Muraglitazar^§ Saroglitazar Tesaglitazar^§
Amylin analogs and DACRAs	Cagrilintide^§ Pramlintide

Secretagogues

K⁺_ATP

Sulfonylureas	1st generation: Acetohexamide Carbutamide Chlorpropamide Glycyclamide Metahexamide Tolazamide Tolbutamide 2nd generation: Glibenclamide (glyburide) Glibornuride Glicaramide Gliclazide^# Glimepiride Glipizide Gliquidone Glisoxepide Glyclopyramide
Meglitinides/"glinides"	Mitiglinide Nateglinide Repaglinide

GLP-1 receptor agonists

GLP1 poly-agonist peptides	Mazdutide (GLP-1/GCGR) Retatrutide^§ (GLP-1/GIP/GCGR) Tirzepatide (GLP-1/GIP)

DPP-4 inhibitors/"gliptins"

Other

Aldose reductase inhibitors	Epalrestat Fidarestat^§ Ranirestat^† Tolrestat^‡ Zenarestat^§
Alpha-glucosidase inhibitors	Acarbose Miglitol Voglibose
SGLT2 inhibitors/"gliflozins"	Canagliflozin Dapagliflozin Empagliflozin^# Ertugliflozin Ipragliflozin Luseogliflozin Remogliflozin^§ Sergliflozin^§ Sotagliflozin Tofogliflozin^† Velagliflozin
Other	Benfluorex^‡ Bromocriptine Imeglimin