Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C33H34N6O6 |
| Molecular Weight | 610.6597 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
CCOC1=NC2=C(N1CC3=CC=C(C=C3)C4=CC=CC=C4C5=NN=NN5)C(=CC=C2)C(=O)OC(C)OC(=O)OC6CCCCC6
InChI
InChIKey=GHOSNRCGJFBJIB-UHFFFAOYSA-N
InChI=1S/C33H34N6O6/c1-3-42-32-34-28-15-9-14-27(31(40)43-21(2)44-33(41)45-24-10-5-4-6-11-24)29(28)39(32)20-22-16-18-23(19-17-22)25-12-7-8-13-26(25)30-35-37-38-36-30/h7-9,12-19,21,24H,3-6,10-11,20H2,1-2H3,(H,35,36,37,38)
DescriptionCurator's Comment: description was created based on several sources, including
http://www.japsonline.com/admin/php/uploads/290_pdf.pdf
Curator's Comment: description was created based on several sources, including
http://www.japsonline.com/admin/php/uploads/290_pdf.pdf
Candesartan is classified as an angiotensin II receptor type 1 antagonist. Candesartan is an orally active lipophilic drug and possesses rapid oral absorption. It causes a reduction in blood pressure and is used in the treatment of hypertension. It is also used in the treatment of congestive heart failure and given as prophylaxis to reduce the severity and duration of migraine. Candesartan cilexetil, a prodrug of Candesartan, is available in the market under the trade names Atacand, Amias. Candesartan cilexetil is rapidly converted to candesartan, its active metabolite, during absorption from the gastrointestinal tract. Candesartan confers blood pressure lowering effects by antagonizing the hypertensive effects of angiotensin II via the RAAS (renin–angiotensin–aldosterone system). RAAS is a homeostatic mechanism for regulating hemodynamics, water, and electrolyte balance. During sympathetic stimulation or when renal blood pressure or blood flow is reduced, renin is released from granular cells of the juxtaglomerular apparatus in the kidneys. Renin cleaves circulating angiotensinogen to angiotensin I, which is cleaved by angiotensin converting enzyme (ACE) to angiotensin II. Angiotensin II increases blood pressure by increasing total peripheral resistance, increasing sodium and water reabsorption in the kidneys via aldosterone secretion, and altering the cardiovascular structure. Angiotensin II binds to two receptors: type-1 angiotensin II receptor (AT1) and type-2 angiotensin II receptor (AT2). Candesartan selectively blocks the binding of angiotensin II to AT1 in many tissues including vascular smooth muscle and the adrenal glands. This inhibits the AT1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin II and results in an overall decrease in blood pressure. Candesartan is greater than 10,000 times more selective for AT1 than AT2.
Originator
Sources: https://www.ncbi.nlm.nih.gov/pubmed/8205603
Curator's Comment: TCV-116 # Takeda, Osaka, Japan
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL227 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | ATACAND Approved UseCandesartan Cilexetil Tablets are an angiotensin II receptor blocker (ARB) indicated for: •Treatment of hypertension in adults and children 1 to < 17 years of age (1.1). •Treatment of heart failure (NYHA class II-IV); candesartan cilexetil tablets reduces cardiovascular death and heart failure hospitalization (1.2). 1.1 Hypertension Candesartan cilexetil tablets are indicated for the treatment of hypertension in adults and children 1 to < 17 years of age. It may be used alone or in combination with other antihypertensive agents. 1.2 Heart Failure Candesartan cilexetil tablets is indicated for the treatment of heart failure (NYHA class II-IV) in adults with left ventricular systolic dysfunction (ejection fraction ≤ 40%) to reduce cardiovascular death and to reduce heart failure hospitalizations [see CLINICAL STUDIES (14.2) Launch Date1998 |
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| Primary | ATACAND Approved UseCandesartan Cilexetil Tablets are an angiotensin II receptor blocker (ARB) indicated for: •Treatment of hypertension in adults and children 1 to < 17 years of age (1.1). •Treatment of heart failure (NYHA class II-IV); candesartan cilexetil tablets reduces cardiovascular death and heart failure hospitalization (1.2). 1.1 Hypertension Candesartan cilexetil tablets are indicated for the treatment of hypertension in adults and children 1 to < 17 years of age. It may be used alone or in combination with other antihypertensive agents. 1.2 Heart Failure Candesartan cilexetil tablets is indicated for the treatment of heart failure (NYHA class II-IV) in adults with left ventricular systolic dysfunction (ejection fraction ≤ 40%) to reduce cardiovascular death and to reduce heart failure hospitalizations [see CLINICAL STUDIES (14.2) Launch Date1998 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
55 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
79 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
61 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
92 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
485 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1359 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
509 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1152 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
6.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
12 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
7.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
15.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10192757 |
8 mg 1 times / day multiple, oral dose: 8 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CANDESARTAN CILEXETIL serum | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
1% |
unknown, unknown |
CANDESARTAN CILEXETIL plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
16 mg 1 times / day steady, oral Recommended Dose: 16 mg, 1 times / day Route: oral Route: steady Dose: 16 mg, 1 times / day Sources: |
unhealthy, 41 years |
Disc. AE: Hepatitis... AEs leading to discontinuation/dose reduction: Hepatitis (acute, 1 patient) Sources: |
32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, 59 years |
|
23 mg 1 times / day steady, oral Recommended Dose: 23 mg, 1 times / day Route: oral Route: steady Dose: 23 mg, 1 times / day Sources: |
unhealthy, 67 years Health Status: unhealthy Age Group: 67 years Sex: M+F Sources: |
Disc. AE: Hypotension, Hyperkalemia... AEs leading to discontinuation/dose reduction: Hypotension (4.1%) Sources: Hyperkalemia (2.4%) |
16 mg 1 times / day steady, oral Recommended Dose: 16 mg, 1 times / day Route: oral Route: steady Dose: 16 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Other AEs: Disorder fetal... Other AEs: Disorder fetal Sources: |
2 mg 1 times / day steady, oral Dose: 2 mg, 1 times / day Route: oral Route: steady Dose: 2 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Disc. AE: Headache, Dizziness... AEs leading to discontinuation/dose reduction: Headache (0.6%) Sources: Dizziness (0.3%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Hepatitis | acute, 1 patient Disc. AE |
16 mg 1 times / day steady, oral Recommended Dose: 16 mg, 1 times / day Route: oral Route: steady Dose: 16 mg, 1 times / day Sources: |
unhealthy, 41 years |
| Hyperkalemia | 2.4% Disc. AE |
23 mg 1 times / day steady, oral Recommended Dose: 23 mg, 1 times / day Route: oral Route: steady Dose: 23 mg, 1 times / day Sources: |
unhealthy, 67 years Health Status: unhealthy Age Group: 67 years Sex: M+F Sources: |
| Hypotension | 4.1% Disc. AE |
23 mg 1 times / day steady, oral Recommended Dose: 23 mg, 1 times / day Route: oral Route: steady Dose: 23 mg, 1 times / day Sources: |
unhealthy, 67 years Health Status: unhealthy Age Group: 67 years Sex: M+F Sources: |
| Disorder fetal | 16 mg 1 times / day steady, oral Recommended Dose: 16 mg, 1 times / day Route: oral Route: steady Dose: 16 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
|
| Dizziness | 0.3% Disc. AE |
2 mg 1 times / day steady, oral Dose: 2 mg, 1 times / day Route: oral Route: steady Dose: 2 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
| Headache | 0.6% Disc. AE |
2 mg 1 times / day steady, oral Dose: 2 mg, 1 times / day Route: oral Route: steady Dose: 2 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Effects of angiotensin II type 1 receptor antagonist (candesartan) in preventing fatal ventricular arrhythmias in dogs during acute myocardial ischemia and reperfusion. | 2001-11 |
|
| Effects of all-trans retinoic acid on renin-angiotensin system in rats with experimental nephritis. | 2001-11 |
|
| ERK and p38 MAPK, but not NF-kappaB, are critically involved in reactive oxygen species-mediated induction of IL-6 by angiotensin II in cardiac fibroblasts. | 2001-10-12 |
|
| Angiotensin II induces circadian gene expression of clock genes in cultured vascular smooth muscle cells. | 2001-10-09 |
|
| Do vascular compartments differ in the development of chronic rejection? AT(1) blocker candesartan versus Ace blocker enalapril in an experimental heart transplant model. | 2001-10 |
|
| Ventricular production of natriuretic peptides and ventricular structural remodeling in hypertensive heart failure. | 2001-10 |
|
| Role of AT1 and AT2 receptor subtypes in salt-sensitive hypertension induced by sensory nerve degeneration. | 2001-10 |
|
| Angiotensin-II type 1 receptor interaction is a major regulator for liver fibrosis development in rats. | 2001-10 |
|
| TCV-116 stimulates eNOS and caveolin-1 expression and improves coronary microvascular remodeling in normotensive and angiotensin II-induced hypertensive rats. | 2001-10 |
|
| Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure. | 2001-10 |
|
| Autoregulated glomerular filtration rate during candesartan treatment in hypertensive type 2 diabetic patients. | 2001-10 |
|
| pK(a) determination of angiotensin II receptor antagonists (ARA II) by spectrofluorimetry. | 2001-10 |
|
| Mechanism of action of angiotensin II in human isolated subcutaneous resistance arteries. | 2001-09 |
|
| Peripheral administration of an angiotensin II AT(1) receptor antagonist decreases the hypothalamic-pituitary-adrenal response to isolation Stress. | 2001-09 |
|
| Functional role of endogenous endothelin-1 in congestive heart failure treated with angiotensin II receptor antagonist. | 2001-08 |
|
| Persistent cardiovascular effects of chronic renin-angiotensin system inhibition following withdrawal in adult spontaneously hypertensive rats. | 2001-08 |
|
| Role of nNOS in regulation of renal function in angiotensin II-induced hypertension. | 2001-08 |
|
| [Angiotensin II receptor antagonists: different or equivalent?]. | 2001-07-27 |
|
| Effects of candesartan on cough and bronchial hyperresponsiveness in mildly to moderately hypertensive patients with symptomatic asthma. | 2001-07-17 |
|
| Cardioprotection with angiotensin converting enzyme inhibitor and angiotensin II type 1 receptor antagonist is not abolished by nitric oxide synthase inhibitor in ischemia-reperfused rabbit hearts. | 2001-07 |
|
| The angiotensin II receptor antagonist candesartan cilexetil (TCV-116) ameliorates retinal disorders in rats. | 2001-07 |
|
| A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II. | 2001-07 |
|
| Activation of angiotensin II subtype 2 receptor induces catecholamine release in an extracellular Ca(2+)-dependent manner through a decrease of cyclic guanosine 3',5'-monophosphate production in cultured porcine adrenal medullary chromaffin Cells. | 2001-07 |
|
| Angiotensin receptor blockers for chronic heart failure and acute myocardial infarction. | 2001-07 |
|
| Angiotensin II activates the GFAT promoter in mesangial cells. | 2001-07 |
|
| Antihypertensive efficacy of candesartan in comparison to losartan: the CLAIM study. | 2001-06-21 |
|
| Case of adrenocorticotropic hormone-independent macronodular adrenal hyperplasia with possible adrenal hypersensitivity to angiotensin II. | 2001-06 |
|
| Possible roles of cardiac chymase after myocardial infarction in hamster hearts. | 2001-06 |
|
| In vitro and in vivo pharmacology of olmesartan medoxomil, an angiotensin II type AT1 receptor antagonist. | 2001-06 |
|
| Efficacy of candesartan cilexetil as add-on therapy in hypertensive patients uncontrolled on background therapy: a clinical experience trial. ACTION Study Investigators. | 2001-06 |
|
| Coronary hemodynamic and ventricular responses to angiotensin type 1 receptor inhibition in SHR: interaction with angiotensin type 2 receptors. | 2001-06 |
|
| Mildly oxidized low-density lipoprotein acts synergistically with angiotensin II in inducing vascular smooth muscle cell proliferation. | 2001-06 |
|
| Effects of TCV-116 on expression of NOS and adrenomedullin in failing heart of Dahl salt-sensitive rats. | 2001-06 |
|
| Dose-dependent blockade of the angiotensin II type 1 receptor with losartan in normal volunteers. | 2001-06 |
|
| Endogenous angiotensin II in the NTS contributes to sympathetic activation in rats with aortocaval shunt. | 2001-06 |
|
| Significance of exaggerated natriuresis after angiotensin AT1 receptor blockade or angiotensin- converting enzyme inhibition in obese Zucker rats. | 2001-05-31 |
|
| Angiotensin-II-receptor inhibitors in pregnancy. | 2001-05-19 |
|
| Reversible renal impairment induced by treatment with the angiotensin II receptor antagonist candesartan in a patient with bilateral renal artery stenosis. | 2001-05-17 |
|
| [Change from ACE inhibitor, Ca-antagonist or beta-blocker to candesartan cilexetil: better efficacy and tolerance. SWITCH study (German study segment)]. | 2001-05-11 |
|
| An angiotensin II type 1 receptor blocker, candesartan, increases myocardial apoptosis in rats with acute ischemia-reperfusion. | 2001-05 |
|
| Angiotensin II and its metabolites stimulate PAI-1 protein release from human adipocytes in primary culture. | 2001-05 |
|
| Angiotensin type 1 receptor antagonism and ACE inhibition produce similar renoprotection in N(omega)-nitro-L>-arginine methyl ester/spontaneously hypertensive rats. | 2001-05 |
|
| A candesartan cilexetil/hydrochlorothiazide combination tablet provides effective blood pressure control in hypertensive patients inadequately controlled on monotherapy. | 2001-05 |
|
| Protective effect of agiotensin II type I receptor antagonist, CV-11974, on ischemia and reperfusion injury of the liver. | 2001-04-27 |
|
| Involvement of angiotensin II in progression of renal injury in rats with genetic non-insulin-dependent diabetes mellitus (Wistar fatty rats). | 2001-04 |
|
| Pharmacological differences among angiotensin II receptor antagonists. | 2001 |
|
| [Angiotensin II type-1 receptor antagonists and diabetes mellitus]. | 2001 |
|
| [Angiotensin I receptor blockers for heart failure]. | 2001 |
|
| [Angiotensin receptor blockers--significance for the therapy of hypertension]. | 2001 |
|
| Angiotensin II AT(1) receptor antagonists and platelet activation. | 2001 |
Patents
Sample Use Guides
Adult Hypertension:
2 DOSAGE AND ADMINISTRATION
2.1 Adult Hypertension
The usual recommended starting dose of ATACAND (candesartan cilexetil) is 16 mg once daily when it is used as monotherapy in patients who are not volume depleted. ATACAND can be administered once or twice daily with total daily doses ranging from 8 mg to 32 mg.
Pediatric Hypertension 1 to < 17 Years of Age:
Children 1 to < 6 years of age: The dose range is 0.05 to 0.4 mg/kg per day. The recommended starting dose is 0.20 mg/kg (oral suspension).
Children 6 to < 17 years of age: For those less than 50 kg, the dose range is 2 to 16 mg per day. The recommended starting dose is 4 to 8 mg.
For those greater than 50 kg, the dose range is 4 to 32 mg per day. The recommended starting dose is 8 to 16 mg.
Adult Heart Failure:
The recommended initial dose for treating heart failure is 4 mg once daily. The target dose is 32 mg once daily, which is achieved by doubling the dose at approximately 2-week intervals, as tolerated by the patient.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/25420481
Primary cultures of human retinal endothelial cells (EC) were candesartan treatment (1μg/ml).
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NCI_THESAURUS |
C66930
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ACTIVE MOIETY
SUBSTANCE RECORD