Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C22H26N2O4S.C4H4O4 |
Molecular Weight | 530.59 |
Optical Activity | ( + ) |
Defined Stereocenters | 2 / 2 |
E/Z Centers | 1 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
OC(=O)\C=C/C(O)=O.COC1=CC=C(C=C1)[C@@H]2SC3=CC=CC=C3N(CCN(C)C)C(=O)[C@@H]2OC(C)=O
InChI
InChIKey=WHBXLOWLFLTDMD-WECFPGDBSA-N
InChI=1S/C22H26N2O4S.C4H4O4/c1-15(25)28-20-21(16-9-11-17(27-4)12-10-16)29-19-8-6-5-7-18(19)24(22(20)26)14-13-23(2)3;5-3(6)1-2-4(7)8/h5-12,20-21H,13-14H2,1-4H3;1-2H,(H,5,6)(H,7,8)/b;2-1-/t20-,21+;/m1./s1
Molecular Formula | C4H4O4 |
Molecular Weight | 116.0722 |
Charge | 0 |
Count |
|
Stereochemistry | ACHIRAL |
Additional Stereochemistry | No |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 1 |
Optical Activity | NONE |
Molecular Formula | C22H26N2O4S |
Molecular Weight | 414.518 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 2 / 2 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
Diltiazem is a nondihydropyridines calcium channel blocker used in the treatment of hypertension, angina pectoris, and some types of arrhythmia. Diltiazem produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance.
CNS Activity
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2095229 |
21.0 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | CARDIZEM Approved UseDiltiazem produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance. The magnitude of blood pressure reduction is related to the degree of hypertension; thus hypertensive individuals experience an antihypertensive effect, whereas there is only a modest fall in blood pressure in normotensives. Launch Date1982 |
|||
Primary | CARDIZEM Approved UseDiltiazem has been shown to produce increases in exercise tolerance, probably due to its ability to reduce myocardial oxygen demand. This is accomplished via reductions in heart rate and systemic blood pressure at submaximal and maximal work loads. Diltiazem has been shown to be a potent dilator of coronary arteries, both epicardial and subendocardial. Spontaneous and ergonovine-induced coronary artery spasm are inhibited by diltiazem. Launch Date1982 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
166.4 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/11329099 |
240 mg 1 times / day steady-state, oral dose: 240 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DILTIAZEM plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2410 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/11329099 |
240 mg 1 times / day steady-state, oral dose: 240 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DILTIAZEM plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
7.5 h |
360 mg single, oral dose: 360 mg route of administration: Oral experiment type: SINGLE co-administered: |
DILTIAZEM plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
25% |
360 mg single, oral dose: 360 mg route of administration: Oral experiment type: SINGLE co-administered: |
DILTIAZEM plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
weak | ||||
yes [IC50 0.6 uM] | ||||
yes [IC50 11 uM] | ||||
yes [IC50 120 uM] | yes (co-administration study) Comment: Diltiazem is an inhibitor of CYP3A4 and has been shown to increase significantly the AUC of some statins. |
|||
yes [Ki 117 uM] | ||||
yes [Ki 12.5 uM] | ||||
yes [Ki 77.7 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
major | ||||
no | no (pharmacogenomic study) Comment: results suggest that CYP3A5*3 has only a minor effect on the pharmacokinetics and metabolism of diltiazem Sources: https://pubmed.ncbi.nlm.nih.gov/16024008/ |
|||
yes | ||||
yes | ||||
yes | weak (pharmacogenomic study) Comment: Two of the most frequent alleles, CYP3A5 3 and CYP2D6 10, among Chinese do not have major impacts on the disposition of diltiazem and N-desmethyl diltiazem. However, the desacetyl diltiazem showed 2-fold accumulation in individuals with CYP2D6 10/10 genotype |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
PubMed
Title | Date | PubMed |
---|---|---|
Calcium-channel blocker withdrawal in a pregnant woman. | 1999 Jan |
|
Statins and peripheral neuropathy. | 1999 Jan |
|
Cyclosporine-induced encephalopathy predisposed by diltiazem in a patient with aplastic anemia. | 1999 Jun |
|
Rapid reversal of life-threatening diltiazem-induced tetany with calcium chloride. | 1999 Nov |
|
Diltiazem causes open channel block of recombinant 5-HT3 receptors. | 1999 Sep 15 |
|
Oral amiodarone increases the efficacy of direct-current cardioversion in restoration of sinus rhythm in patients with chronic atrial fibrillation. | 2000 Jan |
|
Diltiazem-mediated inhibition of sildenafil metabolism may promote nitrate-induced hypotension. | 2000 Oct |
|
Nitroglycerin is preferable to diltiazem for prevention of coronary bypass conduit spasm. | 2000 Sep |
|
Calcium channel blockers for neuroleptic-induced tardive dyskinesia. | 2001 |
|
Influence of diltiazem on the pharmacokinetics of amlodipine in elderly hypertensive patients. | 2001 Apr |
|
Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease. | 2001 Apr |
|
Ionic mechanisms of aglycemic axon injury in mammalian central white matter. | 2001 Apr |
|
Slowing the progression of renal disease in diabetic patients. | 2001 Apr |
|
Pharmacokinetics of cyclosporine in heart transplant recipients receiving metabolic inhibitors. | 2001 Apr |
|
Contribution of amiloride-insensitive pathways to alveolar fluid clearance in adult rats. | 2001 Apr |
|
Susac's syndrome: beneficial effects of corticosteroid therapy in a Japanese case. | 2001 Feb |
|
Mechanical stress stimulates phospholipase C activity and intracellular calcium ion levels in neonatal rat cardiomyocytes. | 2001 Feb |
|
L-type calcium channel blockers and EGTA enhance superoxide production in cardiac fibroblasts. | 2001 Feb |
|
Diltiazem comes in from the cold. | 2001 Feb |
|
Characterization of a novel cationic drug transporter in human retinal pigment epithelial cells. | 2001 Feb |
|
Diltiazem affects human dendritic cell maturation. | 2001 Feb-Mar |
|
Silent ischemic interval on exercise test is a predictor of response to drug therapy: a randomized crossover trial of metoprolol versus diltiazem in stable angina. | 2001 Jan |
|
Pharmacokinetic interaction between single oral doses of diltiazem and sirolimus in healthy volunteers. | 2001 Jan |
|
Rho-kinase inhibitors prevent agonist-induced vasospasm in human internal mammary artery. | 2001 Jan |
|
Calculation of the dimensions of dosage forms with release controlled by diffusion for in vivo use. | 2001 Jan |
|
Calcium channel antagonists enhance retention of passive avoidance and maze learning in mice. | 2001 Jan |
|
Na+ effects on mitochondrial respiration and oxidative phosphorylation in diabetic hearts. | 2001 Jun |
|
Analysis of multicomponent formulations containing phenylpropanolamine hydrochloride, caffeine and diazepam by using LC. | 2001 Jun |
|
Positive and negative contractile effects of somatostatin-14 on rat ventricular cardiomyocytes. | 2001 Mar |
|
Trimetazidine for stable angina pectoris. | 2001 May |
|
Ca2+-dependent exocytosis of L-glutamate by alphaTC6, clonal mouse pancreatic alpha-cells. | 2001 May |
|
Left ventricular diastolic heart failure with normal left ventricular systolic function in older persons. | 2001 May |
|
Calcium-dependent effects of melatonin inhibition of glutamatergic response in rat striatum. | 2001 May |
|
[Attempted suicide with sustained release diltiazem]. | 2001 May 12 |
|
Characterization of drug release from diltiazem-loaded polylactide microspheres prepared using sodium caseinate and whey protein as emulsifying agents. | 2001 May-Jun |
|
Study of processing parameters influencing the properties of diltiazem hydrochloride microspheres. | 2001 May-Jun |
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/pro/dilt-cd.html
When used as monotherapy, reasonable starting doses are 180 to 240 mg once daily, although some patients may respond to lower doses. Maximum antihypertensive effect is usually observed by 14 days of chronic therapy; therefore, dosage adjustments should be scheduled accordingly. The usual dosage range studied in clinical trials was 240 to 360 mg once daily. Individual patients may respond to higher doses of up to 480 mg once daily. Dosages for the treatment of angina should be adjusted to each patient's needs, starting with a dose of 120 or 180 mg once daily. Individual patients may respond to higher doses of up to 480 mg once daily. When necessary, titration may be carried out over a 7- to 14-day period.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/7473567
Tissue homogenate of cerebral cortext and heart containing calcium channel receptors was used in a radioligand-binding assays. Cerebral cortices of male SD rats were homogenized. Hearts were also removed, perfused through aorta with ice-cold saline solution, and homogenized. Subsequently, the cardiac homogenates were filtered through four layers of cloth. Both cortical and cardiac homogenates were washed 5 times by centrifugation for 10 min at 48000 g. The final pelle was resuspended to a conc. of 50 mg of original wet tissue wt/mL of buffer and stored at -70°C. Tissue homogenate (200 uL) was incubated for 90 min in a dark room at 0°C with 100 uL of [3H]nitreddipine (3x10^-10M, 87 Ci/mmol) and 100 uL of the test compound dissolved in DMSO in 50 mM of Na-Hepes buffer, pH 7.4. The incubations were stopped by adding 4 mL of cold buffer followed by rapid filtratoin through glass fiber filter disks. The samples were subsequently washed 3 times with 4.5 mL of the same buffer and placed into scintill. vials. Diltiazem inhibited binding of [3H]nitrendipine with Ki of 21 nM.
Substance Class |
Chemical
Created
by
admin
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Edited
Fri Dec 15 19:00:55 GMT 2023
by
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on
Fri Dec 15 19:00:55 GMT 2023
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Record UNII |
896626Q8XW
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Record Status |
Validated (UNII)
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Record Version |
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DBSALT002322
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PARENT -> SALT/SOLVATE |
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