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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
Structure of DILTIAZEM MALEATE

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

HIDE SMILES / InChI

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.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
21.0 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
CARDIZEM

Approved Use

Diltiazem 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 Date

1982
Primary
CARDIZEM

Approved Use

Diltiazem 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 Date

1982
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
166.4 ng/mL
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

AUC

ValueDoseCo-administeredAnalytePopulation
2410 ng × h/mL
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

T1/2

ValueDoseCo-administeredAnalytePopulation
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

Funbound

ValueDoseCo-administeredAnalytePopulation
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

OverviewOther

Other InhibitorOther SubstrateOther Inducer






Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical 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

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
major
no
no (pharmacogenomic study)
Comment: results suggest that CYP3A5*3 has only a minor effect on the pharmacokinetics and metabolism of diltiazem
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

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
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
Patents

Sample Use Guides

In Vivo Use Guide
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
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
on Fri Dec 15 19:00:55 GMT 2023
Edited
by admin
on Fri Dec 15 19:00:55 GMT 2023
Record UNII
896626Q8XW
Record Status Validated (UNII)
Record Version
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Name Type Language
DILTIAZEM MALEATE
VANDF  
Common Name English
DILTIAZEM MALEATE [VANDF]
Common Name English
1,5-BENZOTHIAZEPIN-4(5H)-ONE, 3-(ACETYLOXY)-5-(2-(DIMETHYLAMINO)ETHYL)-2,3-DIHYDRO-2-(4-METHOXYPHENYL)-, (2S,3S)-, (2Z)-2-BUTENEDIOATE (1:1)
Systematic Name English
Code System Code Type Description
PUBCHEM
67938926
Created by admin on Fri Dec 15 19:00:55 GMT 2023 , Edited by admin on Fri Dec 15 19:00:55 GMT 2023
PRIMARY
CAS
139492-78-7
Created by admin on Fri Dec 15 19:00:55 GMT 2023 , Edited by admin on Fri Dec 15 19:00:55 GMT 2023
PRIMARY
DRUG BANK
DBSALT002322
Created by admin on Fri Dec 15 19:00:55 GMT 2023 , Edited by admin on Fri Dec 15 19:00:55 GMT 2023
PRIMARY
FDA UNII
896626Q8XW
Created by admin on Fri Dec 15 19:00:55 GMT 2023 , Edited by admin on Fri Dec 15 19:00:55 GMT 2023
PRIMARY
RXCUI
314592
Created by admin on Fri Dec 15 19:00:55 GMT 2023 , Edited by admin on Fri Dec 15 19:00:55 GMT 2023
PRIMARY RxNorm
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ACTIVE MOIETY