chemistry

Roxadustat

Roxadustat is a chemistry topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Roxadustat rather than just read about it. In short: Roxadustat, sold under the brand name Evrenzo, is an anti-anemia medication. Roxadustat is a HIF prolyl-hydroxylase inhibitor that increases endogenous production of erythropoietin and stimulates production of hemoglobin and red blood cells.

Key takeaways

Roxadustat belongs to chemistry; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Roxadustat to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Roxadustat from memory before moving on to harder problems.

Reference excerpt

Roxadustat, sold under the brand name Evrenzo, is an anti-anemia medication. Roxadustat is a HIF prolyl-hydroxylase inhibitor that increases endogenous production of erythropoietin and stimulates production of hemoglobin and red blood cells. It was investigated in clinical trials for the treatment of anemia caused by chronic kidney disease. It is taken by mouth. The drug was developed by FibroGen, in partnership with AstraZeneca. The most common side effects include hypertension (high blood pressure), vascular access thrombosis (formation of blood clots in the blood vessels associated with dialysis), diarrhea, peripheral edema (swelling especially of the ankles and feet), hyperkalemia (high blood potassium levels) and nausea (feeling sick). Roxadustat received its first global approval in China in December 2018, for the treatment of anemia caused by chronic kidney disease in people who are dialysis-dependent. It was approved in Japan in 2019, for the treatment of anemia caused by chronic kidney disease in people on dialysis, and in 2020 for people not on dialysis. Roxadustat was approved for medical use in the European Union in August 2021.

Medical uses Roxadustat is indicated for treatment of adults with symptomatic anemia associated with chronic kidney disease.

Adverse effects Roxadustat is reported to increase VEGF, a signal protein that can activate tumor growth and also is considered to cause pulmonary hypertension. In phase 3 trial conducted at 29 sites in China, roxadustat treatment was found to cause hyperkalemia, i.e., increase in serum potassium, and metabolic acidosis in patients.

Society and culture

Legal status In July 2021, the Cardiovascular and Renal Drugs Advisory Committee of the US Food and Drug Administration (FDA) voted against the use of roxadustat in people with anemia in chronic kidney disease, both for those that are non-dialysis-dependent and those that are on dialysis. Significant safety concerns were raised that the panelists believed could not be addressed without further study. Notably, prior to the vote of the FDA committee, FibroGen and AstraZeneca announced that the company had changed parameters used to analyze cardiovascular safety data, which made the drug appear safer than it is.

Usage as a doping product Due to the potential applications of roxadustat in athletic doping, such as raising haemoglobin levels and stimulating the production of red blood cells, it has been incorporated into screens for performance-enhancing drugs, as it has already been detected being used illicitly by athletes. In March 2024, following a lengthy process, former world No. 1 tennis player Simona Halep received a nine month ban for unintentional use of roxadustat that was sourced to a contaminated supplement that she had ingested.

Synthesis A 85-kilogram scale synthesis of roxadustat was recently reported.

A modified Ullman-type coupling converted 5-bromophthalide [64169-34-2] (1) into 5-phenoxyphthalide [57830-14-5] (2). The γ-lactone was opened to furnish an acid chloride intermediate which delivered methyl ester upon treatment with MeOH, methyl 2-(chloromethyl)-4-phenoxybenzoate [1455091-04-9] (3). Substitution of benzyl chloride with p-toluenesulfonylglycine methyl ester [2645-02-5] (4) was conducted under Finkelstein conditions to produce an intermediate [1455091-06-1] (5). This then underwent base-mediated cyclization and subsequent aromatization to produce isoquinoline, methyl 4-hydroxy-7-phenoxyisoquinoline-3-carboxylate [1455091-10-7] (6). Mannich reaction of the isoquinoline with bis(dimethylamino)methane [51-80-9] (7) in acetic acid furnished dimethylaminomethyl intermediate [1509958-19-3] (8). Treatment with acetic anhydride replaced the dimethylamino group with an acetoxy moiety to give methyl 1-(acetoxymethyl)-4-hydroxy-7-phenoxyisoquinoline-3-carboxylate [1509958-20-6] (10). The undesired bis-acetoxy adduct [1537180-08-7] (9) was treated with morpholine to generate additional 10. Catalytic hydrogenation of the acetoxy group yielded methyl 4-hydroxy-1-methyl-7-phenoxyisoquinoline-3-carboxylate [1421312-34-6] (11). Lastly, treatment with glycine (12) and sodium methoxide completed the synthesis of roxadustat (13).

References

Illustrations

Worked examples

Example 1 — a first encounter with Roxadustat

Start with the simplest possible case. Write down what Roxadustat claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In chemistry, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Roxadustat before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Roxadustat ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Roxadustat

In research: Roxadustat appears in chemistry research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Roxadustat in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Roxadustat is common in secondary-school and first-year university syllabi. It links to neighbouring topics Acetic acids, Antianemic preparations, Diaryl ethers, so understanding it makes those chapters shorter.
In everyday life: Look for Roxadustat outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Roxadustat in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Roxadustat means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Roxadustat out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Roxadustat in simple terms?

Why does Roxadustat matter?

Because it connects several chemistry ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Roxadustat?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Roxadustat.