Trandolapril
{{Drugbox | Watchedfields = changed | verifiedrevid = 470612121 | 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 | image = Trandolapril structure.svg | width2 = 222
| tradename = Mavik | Drugs.com = Monograph | MedlinePlus = a697010 | pregnancy_US = D | legal_status = Rx-only | routes_of_administration = Oral
| bioavailability =
| protein_bound = Trandolapril 80%
(independent of concentration)
Trandolaprilat 65 to 94%
(concentration-dependent)
| metabolism = Hepatic
| elimination_half-life = 6 hours (trandolapril)
10 hours (trandolaprilat)
| excretion = Fecal and renal
| IUPHAR_ligand = 6453
| CAS_number_Ref = 
| CAS_number = 87679-37-6
| ATC_prefix = C09
| ATC_suffix = AA10
| PubChem = 5484727
| DrugBank_Ref =
| DrugBank = DB00519
| ChemSpiderID_Ref =
| ChemSpiderID = 4588590
| UNII_Ref =
| UNII = 1T0N3G9CRC
| KEGG_Ref =
| KEGG = D00383
| ChEMBL_Ref =
| ChEMBL = 1519
| C=24 | H=34 | N=2 | O=5
| molecular_weight = 430.537 g/mol
| smiles = O=C(OCC)[C@@H](N[C@H](C(=O)N1[C@H](C(=O)O)C[C@H]2CCCC[C@H]12)C)CCc3ccccc3
| StdInChI_Ref =
| StdInChI = 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
| StdInChIKey_Ref =
| StdInChIKey = VXFJYXUZANRPDJ-WTNASJBWSA-N
| melting_point = 119
| melting_high = 123
}}
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 under the brand name Mavik.
Pharmacology
Trandolapril is a prodrug that is de-esterified 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 h. Trandolaprilat has about eight times the activity of its parent drug. About one-third of trandolapril and its metabolites are excreted in the urine, and about two-thirds of trandolapril and its metabolites are excreted in the feces. Serum protein binding of trandolapril is about 80%.
Mode of action
Trandolapril acts by competitive inhibition of angiotensin converting enzyme (ACE), a key enzyme in the renin-angiotensin system which plays an important role in regulating blood pressure.
Side effects
Side effects reported for trandolapril include nausea, vomiting, 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. It 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
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 trimesters. 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.
External links
- Mavik (PDF from manufacturer's website)
- Tarka (PDF from manufacturer's website)
- Trandolapril Information - rxlist.com (Rxlist.com, The Internet Drug Index)