Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C20H24N2O6 |
| Molecular Weight | 388.4144 |
| 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=CC=C2[N+]([O-])=O)C(=O)OCC(C)C
InChI
InChIKey=VKQFCGNPDRICFG-UHFFFAOYSA-N
InChI=1S/C20H24N2O6/c1-11(2)10-28-20(24)17-13(4)21-12(3)16(19(23)27-5)18(17)14-8-6-7-9-15(14)22(25)26/h6-9,11,18,21H,10H2,1-5H3
| Molecular Formula | C20H24N2O6 |
| Molecular Weight | 388.4144 |
| Charge | 0 |
| Count |
|
| Stereochemistry | RACEMIC |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Optical Activity | ( + / - ) |
DescriptionCurator's Comment: Description was created based on several sources, including:
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bcdeafac-f4ef-4dda-bdb7-1f819c33bb76
Pharmaceutical Innovation: Revolutionizing Human Health/ Editors. R. Landau, B. Achilladelis, A. Scriabine Chemical Heritage Foundation, 1999 -P. 408 ISBN 0-941901-21-1
Curator's Comment: Description was created based on several sources, including:
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bcdeafac-f4ef-4dda-bdb7-1f819c33bb76
Pharmaceutical Innovation: Revolutionizing Human Health/ Editors. R. Landau, B. Achilladelis, A. Scriabine Chemical Heritage Foundation, 1999 -P. 408 ISBN 0-941901-21-1
Nisoldipine is a 1,4-dihydropyridine derivative with an outstanding vascular selectivity. As a specific calcium antagonist, it shortens the action potential and causes electromechanical uncoupling in ventricular myocardium. However, this effect, resulting in a negative inotropic action, appears at 100–1000 times higher concentrations of nisoldipine in comparison with its inhibition of calcium-dependent vascular contractions. Detailed analyses of pharmacological effects revealed additional properties such as enhancement of sodium excretion, an interaction with the reninangiotensin-aldosterone system and a protective effect against acute renal ischaemia, that may contribute to its therapeutic efficacy. Nisoldipine was developed at Bayer then licensed to Zeneca and marketed in the United States as SULAR. SULAR is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents. The mechanism of the therapeutic effect of nisoldipine is complex. It involves a decrease of the total peripheral vascular resistance (reduction of afterload) and an increase in coronary blood flow. Moreover, nisoldipine obviously normalises the impaired volume homoeostasis by improving renal function and thus reduces the need for activation of the ANP system. In the advanced stages of hypertension, nisoldipine prevents deleterious calcium overload and the resulting tissue damage.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/8270166
Curator's Comment: Nisoldipine was active in rat brain toward monoamines and metabolites.
In human nisoldipine does not have any cognition enhancing properties but, unlike some calcium antagonists, it does not markedly impair CNS activity.
https://www.ncbi.nlm.nih.gov/pubmed/12404341
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL2095229 Sources: https://www.ncbi.nlm.nih.gov/pubmed/3154674 |
0.04 nM [Kd] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | SULAR Approved UseNisoldipine extended-release tablets are indicated for the treatment of hypertension. They may be used alone or in combination with other antihypertensive agents. Launch Date1995 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
3.4 ng/mL |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
1.44 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1634646/ |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
2.26 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1634646/ |
20 mg 1 times / day multiple, oral dose: 20 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
54 mg × h/mL/(mg dose/kg) |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
19.06 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1634646/ |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
29.42 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1634646/ |
20 mg 1 times / day multiple, oral dose: 20 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
9.7 h |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
12.61 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/1634646/ |
20 mg 1 times / day multiple, oral dose: 20 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
0.27% |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
NISOLDIPINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
40 mg 1 times / day multiple, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: multiple Dose: 40 mg, 1 times / day Sources: |
unhealthy, adult |
Disc. AE: Ischemia, Myocardial infarction... AEs leading to discontinuation/dose reduction: Ischemia (13.6%) Sources: Myocardial infarction (grade 5, 2 patients) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Ischemia | 13.6% Disc. AE |
40 mg 1 times / day multiple, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: multiple Dose: 40 mg, 1 times / day Sources: |
unhealthy, adult |
| Myocardial infarction | grade 5, 2 patients Disc. AE |
40 mg 1 times / day multiple, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: multiple Dose: 40 mg, 1 times / day Sources: |
unhealthy, adult |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/10805063/ Page: - |
yes [Ki 1.97 uM] | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/20599790/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/28756727/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/28756727/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/28756727/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/28756727/ Page: - |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/20599790/ Page: - |
yes |
Drug as victim
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/19399628/ Page: - |
PubMed
| Title | Date | PubMed |
|---|---|---|
| FDA-approved drugs and other compounds tested as inhibitors of human glutathione transferase P1-1. | 2013-09-05 |
|
| Calcium channel blocker-associated small bowel angioedema. | 2009-04 |
|
| Pharmacokinetics of oral doses of telmisartan and nisoldipine, given alone and in combination, in patients with essential hypertension. | 2007-03 |
|
| Prediction of genotoxicity of chemical compounds by statistical learning methods. | 2005-06 |
|
| The effect of beta-carotene on the photostability of nisoldipine. | 2005-04 |
|
| Ca(V)1.2 calcium channel dysfunction causes a multisystem disorder including arrhythmia and autism. | 2004-10-01 |
|
| Block of cardiac delayed-rectifier and inward-rectifier K+ currents by nisoldipine. | 2003-11 |
|
| Enhanced expression of L-type Cav1.3 calcium channels in murine embryonic hearts from Cav1.2-deficient mice. | 2003-10-17 |
|
| Comparative efficacy and safety of nisoldipine extended-release (ER) and amlodipine (CESNA-III study) in African American patients with hypertension. | 2003-09 |
|
| Intensive blood pressure control reduces the risk of cardiovascular events in patients with peripheral arterial disease and type 2 diabetes. | 2003-02-11 |
|
| Interaction of digoxin with antihypertensive drugs via MDR1. | 2002-02-15 |
|
| Rapid-release and coat-core formulations of nisoldipine in treatment of hypertension, angina, and heart failure. | 2001-11-27 |
|
| Functional embryonic cardiomyocytes after disruption of the L-type alpha1C (Cav1.2) calcium channel gene in the mouse. | 2000-12-15 |
|
| Inhibition of human cytochrome P450 enzymes by 1,4-dihydropyridine calcium antagonists: prediction of in vivo drug-drug interactions. | 2000-05-11 |
|
| Differential effects of morning and evening dosing of nisoldipine ER on circadian blood pressure and heart rate. | 1999-08 |
|
| Nisoldipine selectively induces coronary vasodilation and improves mild myocardial ischemia in dogs: a potential role of cellular acidosis. | 1998-12 |
|
| A comparison of nisoldipine coat-core and felodipine in the treatment of mild-to-moderate hypertension. | 1998-06 |
|
| New evidence on the prevention of cardiovascular events in hypertensive patients with type 2 diabetes. | 1998 |
|
| Protective effect of nisoldipine on dipyridamole-induced myocardial ischemia: correlation with exercise electrocardiography. | 1998 |
|
| Nisoldipine CC and lisinopril alone or in combination for treatment of mild to moderate systemic hypertension. Canadian Nisoldipine CC Hypertension Trial Group. | 1997-09 |
|
| Effects of nisoldipine on cytosolic calcium, platelet aggregation, and coagulation/fibrinolysis in patients with coronary artery disease. | 1997-06 |
|
| Effects of nisoldipine and/or enalapril on left ventricular function and exercise capacity in patients with recent anterior myocardial infarction and mild cardiac dysfunction. | 1997-03 |
|
| Efficacy and tolerability of nisoldipine coat-core formulation in the treatment of essential hypertension: The South African Multicenter ANCHOR Study. Ambulatory Nisoldipine Coat-Core Hypertension Outpatient Response (ANCHOR) Investigators. | 1997-03 |
|
| Nisoldipine CC: clinical experience in hypertension. | 1997 |
|
| Plasma endothelin-1 concentrations in patients with coronary artery disease during stress test before and after nisoldipine administration. | 1996 |
|
| The effects of nisoldipine on carotid artery stiffness and left ventricular functions. | 1995-09 |
|
| Nisoldipine improves ventricular function in rats with ischemic heart failure. | 1995-09 |
|
| Acute effects of intravenous nisoldipine on left ventricular function after acute myocardial infarction. | 1994-05 |
|
| Cardiovascular effects of nisoldipine in essential hypertension. | 1994-02 |
|
| The acute effects of intravenous nisoldipine on left ventricular function within 24 h after acute myocardial infarction. | 1992-12 |
|
| Improved diastolic function with the calcium antagonist nisoldipine (coat-core) in patients post myocardial infarction: results of the DEFIANT study. Doppler Flow and Echocardiography in Functional cardiac Insufficiency: Assessment of Nisoldipine Therapy. | 1992-11 |
|
| Usefulness of oral nisoldipine for stable angina pectoris. The Nisoldipine Multicenter Angina Study Group. | 1991-10-15 |
|
| Effects of nisoldipine on stress-induced changes in haemodynamics and plasma catecholamines in normotensives and hypertensives. | 1990-12 |
|
| The initial hemodynamic response to newer antihypertensive agents at rest and during exercise: review of visacor, doxazosin, nisoldipine, tiapamil, perindoprilat, pinacidil, dilevalol, and carvedilol. | 1990-08 |
|
| Hemodynamic mechanisms of antianginal action of calcium channel blocker nisoldipine in dynamic exercise-induced angina. | 1990-06 |
|
| [Responses of plasma eicosanoids and hemodynamics to myocardial ischemia and the salutary effect of calcium entry blocker]. | 1990-02 |
|
| The acute effects of intravenous nisoldipine on left ventricular function 24 to 72 hours after uncomplicated acute myocardial infarction. | 1988-12 |
|
| Nisoldipine. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of angina pectoris, hypertension and related cardiovascular disorders. | 1988-12 |
|
| Effects of nisoldipine on left ventricular function during exercise or cold pressor stress. | 1987-11 |
|
| Differential effects of 1,4-dihydropyridine calcium channel blockers: therapeutic implications. | 1987-11 |
|
| Monotherapy with the calcium channel antagonist nisoldipine for systemic hypertension and comparison with diuretic drugs. | 1987-09-15 |
|
| Comparative antianginal effects of nisoldipine and nifedipine in patients with chronic stable angina. | 1987-02 |
|
| Renal effects of 1,4-dihydropyridines in animal models of hypertension and renal failure. | 1987 |
|
| The hypotensive effect of nisoldipine in renovascular hypertensive rats. | 1986-12 |
|
| Alteration of left ventricular diastolic filling in hypertensive patients: effects of nitrendipine and atenolol. | 1986-09 |
Patents
Sample Use Guides
The dosage of SULAR (nisoldipine tablet, film coated, extended release) must be adjusted to each patient's needs. Therapy usually should be initiated with 17 mg orally once daily, then increased by 8.5 mg per week or longer intervals, to attain adequate control of blood pressure. Usual maintenance dosage is 17 to 34 mg once daily. Blood pressure response increases over the 8.5 - 34 mg daily dose range but adverse event rates also increase. Doses beyond 34 mg once daily are not recommended. SULAR has been used safely with diuretics, ACE inhibitors, and beta-blocking agents. Patients over age 65, or patients with impaired liver function are expected to develop higher plasma concentrations of nisoldipine. Their blood pressure should be monitored closely during any dosage adjustment. A starting dose not exceeding 8.5 mg daily is recommended in these patient groups. SULAR tablets should be administered orally once daily. SULAR should be taken on an empty stomach (1 hour before or 2 hours after a meal). Grapefruit products should be avoided before and after dosing. SULAR is an extended release dosage form and tablets should be swallowed whole, not bitten, divided or crushed.
Route of Administration:
Oral
Nisoldipine depressed in a dose dependent manner the spontaneous rhythmic contractions displayed by the human coronary artery preparations and at 1 nM abolished these contractions. Nisoldipine was twenty times more potent than nifedipine as an inhibitor of increase in tone induced by depolarization (100 mM K+). The rhythmic activity induced by serotonin (10μM) was more sensitive to nisoldipine than to nifedipine.
| Substance Class |
Chemical
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4I8HAB65SZ
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QC08CA07
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NBK548364
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| Related Record | Type | Details | ||
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TARGET -> INHIBITOR | |||
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DEGRADENT -> PARENT | |||
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DEGRADENT -> PARENT |
| Related Record | Type | Details | ||
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METABOLITE -> PARENT |
Dehydrogenation step is catalyzed by the cytochrome P450 (CYP) 3A4 enzyme
PLASMA
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METABOLITE -> PARENT |
Dehydrogenation step is catalyzed by the cytochrome P450 (CYP) 3A4 enzyme
PLASMA; URINE
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METABOLITE -> PARENT |
Although M9 showed small pharmacological activity ? qualitatively similar to nisoldipine ? in animal models, it does not contribute significantly to the haemodynamic effects of the drug in humans.
PLASMA
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METABOLITE -> PARENT |
Dehydrogenation step is catalyzed by the cytochrome P450 (CYP) 3A4 enzyme
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METABOLITE -> PARENT |
PLASMA
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METABOLITE -> PARENT |
URINE
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METABOLITE -> PARENT |
Dehydrogenation step is catalysed by the cytochrome P450 (CYP) 3A4 enzyme
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