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CMX-020 is modeled from the natural enzymatic chemistry that takes place in the periaqueductal gray to control pain.

CMX-020 can be delivered both orally (at home) and intravenously (in a hospital setting).


Cmxtwenty is a Milwaukee-based pharmaceutical company focused on development of a non-narcotic treatment for pain using a unique lipid molecule called CMX-020. This molecule is an analog of arachidonic acid with a multi-modal mechanism of action, including CB1, CB2, Melatonin MT1, Adenosine A3, kappa- and delta-opioid, and TRPV1 receptors. Unlike opioid pain therapeutics, CMX-020 does not activate the mu-opioid receptor that produces devastating effects. CMX-020’s physiochemical properties are similar to the active metabolite of acetaminophen (AM404). Like acetaminophen, CMX-020 reduces pain without feeling the effects of the drug itself. The lack of “drug feel” associated with CMX-020 mitigates side effect complications and the risk of addiction to the patient.

CMX-020 can be delivered both orally (at home) and intravenously (in a hospital setting). Analysis from a recently completed Phase 2 proof of concept (POC) study in sciatica suggests that oral CMX-020 has an effectiveness slightly better than Lyrica and a superior safety profile with no observations of Lyrica’s common side effects: dizziness, somnolence, fatigue, or vertigo. The oral formulation of CMX-020 utilizes enteric-coated soft gels. In preclinical studies, the intravenous formulation of CMX-020 using an aqueous formulation is similar to remifentanil in its maximal analgesic strength. With a half-life of 35 minutes, intravenous CMX-020 can be utilized in operative settings without respiratory depression with anesthesia or in post-operative settings with patient-controlled analgesia. Cmxtwenty is currently completing a Phase 1 maximum tolerated dose (MTD) clinical study with intravenous CMX-020 in Australia. This will be followed by a Phase 2 POC study in bunionectomy.

Cmxtwenty maintains international patent filings on CMX-020 through 2029 (excluding extensions).