Trandolapril

Trandolapril

Systematic (IUPAC) name
(2S,3aR,7aS)-1-[(2S)-2-{[(2S)-1-ethoxy-1-oxo-4-phenylbutan-2-yl]amino}propanoyl]-octahydro-1H-indole-2-carboxylic acid
Clinical data
Trade names	Mavik
AHFS/Drugs.com	monograph
MedlinePlus	a697010
Pregnancy cat.	D(US)
Legal status	℞ Prescription only
Routes	Oral
Pharmacokinetic data
Protein binding	Trandolapril 80% (independent of concentration) Trandolaprilat 65 to 94% (concentration-dependent)
Metabolism	Hepatic
Half-life	6 hours (trandolapril) 10 hours (trandolaprilat)
Excretion	Fecal and renal
Identifiers
CAS number	87679-37-6^Y
ATC code	C09AA10
PubChem	CID 5484727
DrugBank	APRD01269
ChemSpider	4588590^Y
UNII	1T0N3G9CRC^Y
KEGG	D00383^N
ChEMBL	CHEMBL1519^Y
Chemical data
Formula	C₂₄H₃₄N₂O₅
Mol. mass	430.537 g/mol
SMILES	eMolecules & PubChem
InChI InChI=1S/C24H34N2O5/c1-3-31-24(30)19(14-13-17-9-5-4-6-10-17)25-16(2)22(27)26-20-12-8-7-11-18(20)15-21(26)23(28)29/h4-6,9-10,16,18-21,25H,3,7-8,11-15H2,1-2H3,(H,28,29)/t16-,18+,19-,20-,21-/m0/s1^Y Key:VXFJYXUZANRPDJ-WTNASJBWSA-N^Y
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Trandolapril is an ACE inhibitor used to treat high blood pressure, it may also be used to treat other conditions. It is marketed by Abbott Laboratories with the brand name Mavik.

1 Pharmacology
2 Mode of action
3 Side effects
4 Possible drug interactions
5 Contraindications and precautions
6 Pregnancy and lactation
7 Additional effects
8 References
9 External links
10 References

Pharmacology

Trandolapril is a prodrug that is deesterified to trandolaprilat. It is believed to exert its antihypertensive effect through the renin-angiotensin-aldosterone system. Trandolapril has a half life of about 6 hours, and trandolaprilat has a half life of about 10. Trandolaprilat has about 8 times the activity of its parent drug. Approximately 1/3 of Trandolapril and its metabolites are excreted in the urine, and about 2/3 of trandolapril and its metabolites are excreted in the feces. Serum protein binding of trandolapril is about 80%.

Mode of action

Main article: ACE inhibitor

Trandolapril acts by competitive inhibition of Angiotensin Converting Enzyme (ACE), a key enzyme in the renin-angiotensin system (RAS pathway) which plays an important role in regulating blood pressure.

Side effects

Side effects reported for trandolapril include nausea, vomiting, or diarrhea; headache; dry cough; dizziness or lightheadedness when sitting up or standing; hypotension or fatigue.

Possible drug interactions

Patients also on diuretics may experience an excessive reduction of blood pressure after initiation of therapy with trandolapril. Trandolapril can reduce potassium loss caused by thiazide diuretics, and increase serum potassium when used alone. Therefore hyperkalemia is a possible risk. Increased serum lithum levels can occur in patients who are also on lithium.

Contraindications and precautions

Main article: ACE inhibitor#Contraindications and precautions

Pregnancy and lactation

Trandolapril is teratogenic (US: pregnancy category D) and can cause birth defects and even death of the developing fetus. The highest risk to the fetus is during the second and third trimester. When pregnancy is detected, trandolapril should be discontinued as soon as possible.

Trandolapril should not be administed to nursing mothers.

Additional effects

Combination therapy with paricalcitol and trandolapril has been found to reduce fibrosis in obstructive uropathy.^[1]

References

^ Tan, X; He, W; Liu, Y (2009). "Combination therapy with paricalcitol and trandolapril reduces renal fibrosis in obstructive nephropathy". Kidney international 76 (12): 1248–57. doi:10.1038/ki.2009.346. PMID 19759524.