TO

tooluniverse-drug-repurposing

Uses target-based and bioactivity analysis to find new medical uses for existing drugs. Strategizes based on pathway and target overlap.

Install

mkdir -p .claude/skills/tooluniverse-drug-repurposing && curl -L -o skill.zip "https://agentskills.codes/api/skills/download/3103" && unzip -o skill.zip -d .claude/skills/tooluniverse-drug-repurposing && rm skill.zip

Installs to .claude/skills/tooluniverse-drug-repurposing

Activation

This is the description your AI agent reads to decide when to run this skill — the better it matches your request, the more reliably it fires.

Identify drug repurposing candidates via target-based, compound-based, and disease-based strategies. Combines drug-target-disease network reasoning with mechanism rationale, clinical-trial precedent, and patent/regulatory feasibility. Use for hypothesis-generating repurposing for orphan diseases, finding existing drugs for new indications, and prioritizing candidates by evidence and feasibility.
398 chars✓ has a “when” triggerlonger than Claude Code's old 250-char listing cap (fine on current versions)
Advanced

Key capabilities

  • Evaluate target-based drug hypotheses
  • Analyze drug-target-disease networks
  • Cross-reference clinical trial data
  • Compare molecular pathway overlaps

How it works

It maps input compounds against target/pathway databases to filter for high-confidence therapeutic overlaps before validating against regulatory feasibility.

Inputs & outputs

You give it
Drug name or disease target
You get back
Ranked list of repurposing candidates with evidentiary rationale

When to use tooluniverse-drug-repurposing

  • Finding existing drugs for a new disease
  • Identifying shared pathways for repurposing
  • Analyzing drug targets for secondary indications

About this skill

Drug Repurposing with ToolUniverse

Systematically identify and evaluate drug repurposing candidates using multiple computational strategies.

IMPORTANT: Always use English terms in tool calls. Respond in the user's language.


Reasoning Before Searching

Start by asking: WHY might this drug work for a new disease? Three strategies:

  • (a) Same target: The drug's primary target is also involved in the new disease. This is the strongest hypothesis — use OpenTargets to check if the target has genetic evidence in both diseases before any other search.
  • (b) Off-target activity: The drug has secondary targets or off-target effects that are relevant to the new disease. Check ChEMBL bioactivity data for all known targets of the drug, not just its primary one.
  • (c) Shared pathways: The original indication and new disease share molecular pathways, even if the target itself is not genetically linked. Use Reactome and STRING to compare pathway overlap between diseases.

Each strategy uses different tools and has different evidentiary weight. Identify which strategy applies FIRST, then choose the corresponding workflow below. Do not run all three strategies blindly — reason about which is most plausible given the drug's mechanism.

LOOK UP DON'T GUESS: Never assume a drug hits a target, never assume a target is disease-relevant, never assume pathway overlap. Verify each link with tool calls.

Core Strategies

  1. Target-Based: Disease targets -> Find drugs that modulate those targets
  2. Compound-Based: Approved drugs -> Find new disease indications
  3. Disease-Driven: Disease -> Targets -> Match to existing drugs

Workflow Overview

Phase 1: Disease & Target Analysis
  Get disease info (OpenTargets), find associated targets, get target details

Phase 2: Drug Discovery
  Search DrugBank, DGIdb, ChEMBL for drugs targeting disease-associated genes
  Get drug details, indications, pharmacology

Phase 3: Safety & Feasibility Assessment
  FDA warnings, FAERS adverse events, drug interactions, ADMET predictions

Phase 4: Literature Evidence
  PubMed, Europe PMC, clinical trials for existing evidence

Phase 5: Scoring & Ranking
  Composite score: target association + safety + literature + drug properties

See: PROCEDURES.md for detailed step-by-step procedures and code patterns.


Quick Start

from tooluniverse import ToolUniverse
tu = ToolUniverse()
tu.load_tools()

# Step 1: Get disease targets
disease_info = tu.tools.OpenTargets_get_disease_id_description_by_name(diseaseName="rheumatoid arthritis")
# Response nests ID at data.search.hits[0].id
disease_id = disease_info['data']['search']['hits'][0]['id']
targets = tu.tools.OpenTargets_get_associated_targets_by_disease_efoId(efoId=disease_id, limit=10)

# Step 2: Find drugs for each target
# Response nests targets at data.disease.associatedTargets.rows
rows = targets['data']['disease']['associatedTargets']['rows']
for target in rows[:5]:
    gene = target['target']['approvedSymbol']
    drugs = tu.tools.DGIdb_get_drug_gene_interactions(genes=[gene])

Key ToolUniverse Tools

Disease & Target:

  • OpenTargets_get_disease_id_description_by_name - Disease lookup
  • OpenTargets_get_associated_targets_by_disease_efoId - Disease targets
  • UniProt_get_entry_by_accession - Protein details

Drug Discovery:

  • drugbank_get_drug_name_and_description_by_target_name - Drugs by target. Param: query= (NOT target_name=)
  • drugbank_get_drug_name_and_description_by_indication - Drugs by indication. Param: query= (NOT indication=)
  • DGIdb_get_drug_gene_interactions - Drug-gene interactions. Response path: data.data.genes.nodes[0].interactions
  • ChEMBL_search_drugs / ChEMBL_get_drug_mechanisms - Drug search and MOA

Drug Information (ALL DrugBank tools use query= as the search parameter, plus case_sensitive=False, exact_match=False, limit=N):

  • drugbank_get_drug_basic_info_by_drug_name_or_id - Basic info. Param: query="drug_name"
  • drugbank_get_indications_by_drug_name_or_drugbank_id - Approved indications. Param: query="drug_name"
  • drugbank_get_pharmacology_by_drug_name_or_drugbank_id - Pharmacology. Param: query="drug_name"
  • drugbank_get_targets_by_drug_name_or_drugbank_id - Drug targets. Param: query="drug_name"

Safety:

  • FDA_get_warnings_and_cautions_by_drug_name - FDA warnings
  • FAERS_search_reports_by_drug_and_reaction - Adverse events. Param: medicinalproduct= (NOT drug_name=)
  • FAERS_count_death_related_by_drug - Serious outcomes. Param: medicinalproduct= (NOT drug_name=)
  • drugbank_get_drug_interactions_by_drug_name_or_id - Interactions

Property Prediction:

  • ADMETAI_predict_physicochemical_properties / ADMETAI_predict_toxicity - ADMET and toxicity

Pathway & Network Analysis:

  • ReactomeAnalysis_pathway_enrichment - Pathway enrichment. Param: identifiers="SOD1\nTARDBP\nFUS" (newline-separated string, NOT array)
  • STRING_get_network - Protein interaction networks. Param: identifiers="SOD1\rTARDBP\rFUS" (CR-separated string), species=9606
  • CTD_get_gene_diseases - Curated gene-disease associations. Param: input_terms="gene_symbol" (NOT gene_symbol=)

Literature & Clinical Trials:

  • PubMed_search_articles / EuropePMC_search_articles - Literature search
  • search_clinical_trials - ClinicalTrials.gov search. Use condition for disease name. The intervention filter is strict and may miss trials — use query_term for broader drug-name matching as fallback.

CNS diseases note: For neurological indications (ALS, Alzheimer's, Parkinson's), prioritize BBB-penetrant candidates. Use ChEMBL molecular properties (MW < 500, PSA < 90) as BBB proxy since ADMETAI_predict_BBB_penetrance may require the tooluniverse[ml] extra. Consider route of administration (oral preferred for patients with swallowing difficulty) and sex-specific effects from preclinical models.


Scoring & Decision Framework

Repurposing Viability Score (0-100)

CategoryPointsHow to Score
Target Association0-4040: Target has genetic evidence in disease (GWAS, rare variants); 25: Target is in a disease-associated pathway (Reactome, KEGG); 15: Target is differentially expressed in disease tissue; 5: Target shares a GO term with disease genes
Safety Profile0-3030: FDA-approved drug, no black box warning, established safety record; 20: FDA-approved with manageable warnings; 10: Phase II+ data, acceptable safety; 0: Preclinical only or serious safety signals
Literature Evidence0-2020: Phase II+ trial for the new indication exists; 15: Case reports or retrospective studies show efficacy; 10: Preclinical in-vivo evidence (animal models); 5: In-vitro evidence only; 0: No prior evidence
Drug Properties0-1010: Oral, good bioavailability, IP available; 5: Injectable or narrow therapeutic window; 0: Poor PK or formulation challenges

Classification:

  • 80-100: Strong candidate — proceed to clinical evaluation
  • 60-79: Promising — worth preclinical validation or retrospective study
  • 40-59: Speculative — needs significant additional evidence
  • <40: Weak — likely not worth pursuing without new mechanistic insight

Evidence Grading for Repurposing

GradeDefinitionAction
E1 (Clinical)Existing clinical trial for new indication (any phase)High priority — check trial results
E2 (Epidemiological)Retrospective/observational data showing benefitModerate priority — design prospective study
E3 (Preclinical)Animal model evidence for new indicationStandard priority — validate mechanism
E4 (Computational)Target overlap, network proximity, or molecular similarity onlyLow priority — needs experimental validation

How to Interpret and Combine Results

After running Phases 1-4, synthesize by answering:

  1. Is the target validated for this disease? Check OpenTargets association score (>0.5 = strong). Cross-reference with genetic evidence (GWAS hits, rare variant studies). If target association is only pathway-level, the repurposing hypothesis is speculative.

  2. Does the drug actually hit the target at achievable doses? Check ChEMBL IC50/Ki values. If the drug's affinity for the new target is >10x weaker than for its original target, clinical efficacy is unlikely at safe doses.

  3. What's the safety margin? Compare the dose needed for the new indication to the approved dose. If higher doses are needed, safety data from the original indication may not apply.

  4. Is there prior clinical evidence? A Phase II trial for the new indication (even failed) is more informative than 100 computational predictions. Check search_clinical_trials first.

  5. What's the competitive landscape? If better drugs already exist for the disease, repurposing offers little value. Check DrugBank indications for approved therapies.


Best Practices

  1. Check clinical trials FIRST: search_clinical_trials(condition="[disease]", intervention="[drug]") — if a trial already exists, start there
  2. Validate targets with genetics: Genetic evidence (GWAS, rare variants) is the strongest predictor of successful drug development
  3. Safety first: Prioritize approved drugs with known safety profiles
  4. Dose matters: A drug that hits a disease target at 100x its approved dose is not a repurposing candidate
  5. Mechanism over correlation: Network proximity alone is insufficient — explain WHY the drug should work
  6. Consider IP and formulation: Generic drugs are easier to repurpose but harder to fund trials for

Computational Procedure: Drug-Target Dose Feasibility Check

A drug that hits a new target onl


Content truncated.

When not to use it

  • Direct medical consultation
  • General literature searching without hypothesis

Prerequisites

OpenTargetsChEMBLreactome

Limitations

  • Requires biological validation
  • Incomplete regulatory status data

How it compares

It follows a rigorous hypothesis-first reasoning process instead of performing broad, indiscriminate keyword searches.

Compared to similar skills

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SkillInstallsUpdatedSafetyDifficulty
tooluniverse-drug-repurposing (this skill)12moNo flagsAdvanced
literature-review5592moReviewAdvanced
openalex-database487moReviewIntermediate
scientific-critical-thinking187moReviewAdvanced

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