The amide functional
group plays a key role in the composition
of biomolecules, including many clinically approved drugs. Bioisosterism
is widely employed in the rational modification of lead compounds,
being used to increase potency, enhance selectivity, improve pharmacokinetic
properties, eliminate toxicity, and acquire novel chemical space to
secure intellectual property. The introduction of a bioisostere leads
to structural changes in molecular size, shape, electronic distribution,
polarity, pK
a, dipole or polarizability,
which can be either favorable or detrimental to biological activity.
This approach has opened up new avenues in drug design and development
resulting in more efficient drug candidates introduced onto the market
as well as in the clinical pipeline. Herein, we review the strategic
decisions in selecting an amide bioisostere (the why), synthetic routes
to each (the how), and success stories of each bioisostere (the implementation)
to provide a comprehensive overview of this important toolbox for
medicinal chemists.