Details
Stereochemistry | RACEMIC |
Molecular Formula | C19H21N3O5 |
Molecular Weight | 371.3871 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
COC(=O)C1=C(C)NC(C)=C(C1C2=CC=CC3=NON=C23)C(=O)OC(C)C
InChI
InChIKey=HMJIYCCIJYRONP-UHFFFAOYSA-N
InChI=1S/C19H21N3O5/c1-9(2)26-19(24)15-11(4)20-10(3)14(18(23)25-5)16(15)12-7-6-8-13-17(12)22-27-21-13/h6-9,16,20H,1-5H3
Isradipine (tradenames DynaCirc, Prescal) is a calcium channel blocker of the dihydropyridine class. It is usually prescribed for the treatment of high blood pressure in order to reduce the risk of stroke and heart attack. Except for diuretic activity, the mechanism of which is not clearly understood, the pharmacodynamics effects of isradipine observed in whole animals can also be explained by calcium channel blocking activity, especially dilating effects in arterioles, which reduce systemic resistance and lower blood pressure, with a small increase in resting heart rate. Isradipine binds to calcium channels with high affinity and specificity and inhibits calcium flux into cardiac and arterial smooth muscle cells. It exhibits greater selectivity towards arterial smooth muscle cells owing to alternative splicing of the alpha-1 subunit of the channel and increased prevalence of inactive channels in smooth muscle cells. Although like other dihydropyridine calcium channel blockers, isradipine has negative inotropic effects in vitro; studies conducted in intact anesthetized animals have shown that the vasodilating effect occurs at doses lower than those do which affect contractility. In patients with normal ventricular function, isradipine's afterload reducing properties lead to some increase in cardiac output. Effects in patients with impaired ventricular function have not been fully studied. Most adverse reactions were mild and related to the vasodilatory effects of isradipine (dizziness, edema, palpitations, flushing, tachycardia), and many were transient. About 5% of isradipine patients left studies prematurely because of adverse reactions (vs. 3% of placebo patients and 6% of active control patients), principally due to headache, edema, dizziness, palpitations, and gastrointestinal disturbances.
CNS Activity
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2095229 Sources: https://www.ncbi.nlm.nih.gov/pubmed/10766758 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | ISRADIPINE Approved UseIsradipine capsules are indicated in the management of hypertension. It may be used alone or concurrently with thiazide-type diuretics. Launch Date1.44858245E12 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
11.44 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
29.84 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
5.89 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
2.5 mg single, oral dose: 2.5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
14.52 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
31.01 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
7.31 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
2.5 mg single, oral dose: 2.5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2.85 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
2.68 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
2.93 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/2965165/ |
2.5 mg single, oral dose: 2.5 mg route of administration: Oral experiment type: SINGLE co-administered: |
ISRADIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
30 mg single, oral Highest studied dose |
healthy, 27 - 44 n = 8 Health Status: healthy Age Group: 27 - 44 Sex: M Population Size: 8 Sources: |
|
0.015 mg/kg single, intravenous Highest studied dose Dose: 0.015 mg/kg Route: intravenous Route: single Dose: 0.015 mg/kg Sources: Page: p.1103 |
unhealthy, 58+/-8 n = 8 Health Status: unhealthy Condition: Chest pain| stable angina Age Group: 58+/-8 Sex: M Population Size: 8 Sources: Page: p.1103 |
|
10 mg 1 times / day multiple, oral MTD Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: Page: p.1823, 1826, 1827 |
unhealthy, 58.5 n = 26 Health Status: unhealthy Condition: Parkinson's disease Age Group: 58.5 Sex: M+F Population Size: 26 Sources: Page: p.1823, 1826, 1827 |
Disc. AE: Drop of blood pressure, Leg edema... AEs leading to discontinuation/dose reduction: Drop of blood pressure Sources: Page: p.1823, 1826, 1827Leg edema Dizziness |
100 mg single, oral (max) Overdose Dose: 100 mg Route: oral Route: single Dose: 100 mg Sources: |
healthy Health Status: healthy Sources: |
Other AEs: Lethargy, Sinus tachycardia... Other AEs: Lethargy Sources: Sinus tachycardia Hypotension |
200 mg single, oral Overdose Dose: 200 mg Route: oral Route: single Dose: 200 mg Co-administed with:: ethanol Sources: |
healthy Health Status: healthy Sources: |
Other AEs: Flushing, Tachycardia... Other AEs: Flushing Sources: Tachycardia Electrocardiogram ST segment depression Hypotension |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Dizziness | Disc. AE | 10 mg 1 times / day multiple, oral MTD Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: Page: p.1823, 1826, 1827 |
unhealthy, 58.5 n = 26 Health Status: unhealthy Condition: Parkinson's disease Age Group: 58.5 Sex: M+F Population Size: 26 Sources: Page: p.1823, 1826, 1827 |
Drop of blood pressure | Disc. AE | 10 mg 1 times / day multiple, oral MTD Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: Page: p.1823, 1826, 1827 |
unhealthy, 58.5 n = 26 Health Status: unhealthy Condition: Parkinson's disease Age Group: 58.5 Sex: M+F Population Size: 26 Sources: Page: p.1823, 1826, 1827 |
Leg edema | Disc. AE | 10 mg 1 times / day multiple, oral MTD Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: Page: p.1823, 1826, 1827 |
unhealthy, 58.5 n = 26 Health Status: unhealthy Condition: Parkinson's disease Age Group: 58.5 Sex: M+F Population Size: 26 Sources: Page: p.1823, 1826, 1827 |
Hypotension | 100 mg single, oral (max) Overdose Dose: 100 mg Route: oral Route: single Dose: 100 mg Sources: |
healthy Health Status: healthy Sources: |
|
Lethargy | 100 mg single, oral (max) Overdose Dose: 100 mg Route: oral Route: single Dose: 100 mg Sources: |
healthy Health Status: healthy Sources: |
|
Sinus tachycardia | 100 mg single, oral (max) Overdose Dose: 100 mg Route: oral Route: single Dose: 100 mg Sources: |
healthy Health Status: healthy Sources: |
|
Electrocardiogram ST segment depression | 200 mg single, oral Overdose Dose: 200 mg Route: oral Route: single Dose: 200 mg Co-administed with:: ethanol Sources: |
healthy Health Status: healthy Sources: |
|
Flushing | 200 mg single, oral Overdose Dose: 200 mg Route: oral Route: single Dose: 200 mg Co-administed with:: ethanol Sources: |
healthy Health Status: healthy Sources: |
|
Hypotension | 200 mg single, oral Overdose Dose: 200 mg Route: oral Route: single Dose: 200 mg Co-administed with:: ethanol Sources: |
healthy Health Status: healthy Sources: |
|
Tachycardia | 200 mg single, oral Overdose Dose: 200 mg Route: oral Route: single Dose: 200 mg Co-administed with:: ethanol Sources: |
healthy Health Status: healthy Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/11560876/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/11560876/ Page: - |
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/11487504/ Page: - |
||||
Sources: https://pubmed.ncbi.nlm.nih.gov/12007180/ Page: 1.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Acute calcium entry blockade inhibits the blood pressure but not the hormonal responses to angiotensin II. | 1989 |
|
Multicenter study with isradipine and diuretics against atherosclerosis. US MIDAS Research Group. | 1990 |
|
Antiischemic and hemodynamic effects of intravenous isradipine, a new calcium antagonist, in coronary heart disease: a comparative double-blind cross-over study with nifedipine. | 1990 Nov |
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Low-dose isradipine once daily effectively controls 24-h blood pressure in essential hypertension. | 1991 Feb |
|
MIDAS: hypertension and atherosclerosis. A trial of the effects of antihypertensive drug treatment on atherosclerosis. MIDAS Research Group. | 1992 |
|
A randomized comparative study of the electrophysiological and electrocardiographic effects of isradipine vs verapamil. | 1993 |
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MIDAS: rationale, design and descriptive data of trial patients. The MIDAS Research Group. | 1994 |
|
Isradipine. An update of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the treatment of mild to moderate hypertension. | 1995 Apr |
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The antiatherosclerotic effect of calcium antagonists in man--what did MIDAS actually show? Multicenter Isradipine Diuretic Atherosclerosis Study. | 1995 May |
|
How to study the role of hypertension in atherosclerosis. Lessons from MIDAS. Multicentre Isradipine Diuretic Atherosclerosis Study. | 1996 |
|
[Effects of calcium antagonists on atherosclerosis progression and intima media thickness]. | 2000 |
|
Functional expression and characterization of a voltage-gated CaV1.3 (alpha1D) calcium channel subunit from an insulin-secreting cell line. | 2001 Jul |
|
alpha 1D (Cav1.3) subunits can form l-type Ca2+ channels activating at negative voltages. | 2001 Jun 22 |
|
Isoform-specific regulation of mood behavior and pancreatic beta cell and cardiovascular function by L-type Ca 2+ channels. | 2004 May |
|
Calcium antagonist isradipine-induced calcium influx through nonselective cation channels in human gingival fibroblasts. | 2006 Mar 27 |
Sample Use Guides
The recommended initial dose of isradipine is 2.5 mg b.i.d. alone or in combination with a thiazide diuretic. An antihypertensive response usually occurs within 2-3 hours. Maximal response may require 2-4 weeks. If a satisfactory reduction in blood pressure does not occur after this period, the dose may be adjusted in increments of 5 mg/day at 2-4 week intervals up to a maximum of 20 mg/day. Most patients, however, show no additional response to doses above 10 mg/day, and adverse effects are increased in frequency above 10 mg/day.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/1285938
Curator's Comment: Cytosolic Ca2+ concentration ([Ca2+]i) was investigated in erythrocytes from spontaneously hypertensive rats (SHR) and their normotensive controls (WKY), after an acute treatment with the Ca2+ antagonist isradipine. In vitro, isradipine dose-dependently decreased [Ca2+]i only in SHR (P = .006). The reduction by isradipine of the elevated [Ca2+]i in SHR suggests the presence of a greater dihydropyridine-sensitive Ca2+ influx in the SHR erythrocyte.
Unknown
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NDF-RT |
N0000007556
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NCI_THESAURUS |
C333
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WHO-ATC |
C08CA03
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NDF-RT |
N0000000069
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WHO-VATC |
QC08CA03
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LIVERTOX |
NBK548193
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NDF-RT |
N0000175421
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DB00270
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100000091633
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SUB08346MIG
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33910
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YO1UK1S598
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D017275
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1511
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Isradipine
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Z-3
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C47577
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3784
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m6557
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CHEMBL1648
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4488
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75695-93-1
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5724
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ISRADIPINE
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YO1UK1S598
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759892
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1354207
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DTXSID4023179
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ACTIVE MOIETY