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This repository is under review for potential modification in compliance with Administration directives.

Details

Stereochemistry ABSOLUTE
Molecular Formula C26H30NO4S2
Molecular Weight 484.651
Optical Activity UNSPECIFIED
Defined Stereocenters 1 / 2
E/Z Centers 0
Charge 1

SHOW SMILES / InChI
Structure of ACLIDINIUM

SMILES

OC(C(=O)O[C@H]1C[N+]3(CCCOC2=CC=CC=C2)CCC1CC3)(C4=CC=CS4)C5=CC=CS5

InChI

InChIKey=ASMXXROZKSBQIH-VITNCHFBSA-N
InChI=1S/C26H30NO4S2/c28-25(26(29,23-9-4-17-32-23)24-10-5-18-33-24)31-22-19-27(14-11-20(22)12-15-27)13-6-16-30-21-7-2-1-3-8-21/h1-5,7-10,17-18,20,22,29H,6,11-16,19H2/q+1/t20?,22-,27?/m0/s1

HIDE SMILES / InChI
Molecular Formula C26H29NO4S2
Molecular Weight 483.643
Charge 0
Count
Stereochemistry EPIMERIC
Additional Stereochemistry No
Defined Stereocenters 1 / 2
E/Z Centers 0
Optical Activity UNSPECIFIED

Description
Curator's Comment: description was created based on several sources, including: | http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_report/human/002706/WC500132734.pdf | http://www.ncbi.nlm.nih.gov/pubmed/?term=24587893 | https://www.ncbi.nlm.nih.gov/pubmed/19710368

Aclidinium is a long-acting, competitive, and reversible anticholinergic drug that is specific for the acetylcholine muscarinic receptors. It binds to all 5 muscarinic receptor subtypes to a similar affinity. It has a much higher propensity to bind to muscarinic receptors than nicotinic receptors. FDA approved on July 24, 2012. Aclidinium's effects on the airways are mediated through the M3 receptor at the smooth muscle to cause bronchodilation. Prevention of acetylcholine-induced bronchoconstriction effects was dose-dependent and lasted longer than 24 hours.

CNS Activity

CNS Non-penetrant
1040
Curator's Comment: The polar nature of aclidinium bromide makes it unlikely to cross the blood brain barrier

Originator

Actavis
2
Curator's Comment: In 2015 AstraZeneca acquired the development and commercial rights in the US and Canada to Tudorza Pressair (aclidinium bromide inhalation powder).

Approval Year

2012
608
Targets

Targets

Primary TargetPharmacologyConditionPotency
Antagonist
2849
 0.14 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Secondary
Approved
8583
TUDORZA PRESSAIR

Approved Use

Indicated for the long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema

Launch Date

2012
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
240.5 pg/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg 2 times / day steady-state, oral
dose: 400 μg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
194.2 pg/mL
DRUG LABEL
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg single, oral
dose: 400 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
468.4 pg × h/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg 2 times / day steady-state, oral
dose: 400 μg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
386.7 pg × h/mL
DRUG LABEL
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg single, oral
dose: 400 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
17 h
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg 2 times / day steady-state, oral
dose: 400 μg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
5.9 h
DRUG LABEL
https://pubmed.ncbi.nlm.nih.gov/22366196/
400 μg single, oral
dose: 400 μg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACLIDINIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
400 ug single, intravenous
Dose: 400 ug
Route: intravenous
Route: single
Dose: 400 ug
Sources:
https://pubmed.ncbi.nlm.nih.gov/21628603
healthy, 30 years (range: 24-43 years)
Health Status: healthy
Age Group: 30 years (range: 24-43 years)
Sex: M
Sources:
https://pubmed.ncbi.nlm.nih.gov/21628603
Sources:
https://pubmed.ncbi.nlm.nih.gov/21628603
800 ug 2 times / day steady, respiratory
Highest studied dose
Dose: 800 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 800 ug, 2 times / day
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
healthy, 39.3 years (range: 18-45 years)
Health Status: healthy
Age Group: 39.3 years (range: 18-45 years)
Sex: M+F
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
Other AEs: Muscle spasm, Dysgeusia...
Other AEs:
Muscle spasm (12.5%)
Dysgeusia (12.5%)
Somnolence (12.5%)
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
6000 ug single, respiratory
Highest studied dose
Dose: 6000 ug
Route: respiratory
Route: single
Dose: 6000 ug
Sources:
https://pubmed.ncbi.nlm.nih.gov/19640353/
healthy
Health Status: healthy
Sources:
https://pubmed.ncbi.nlm.nih.gov/19640353/
Sources:
https://pubmed.ncbi.nlm.nih.gov/19640353/
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Disc. AE: Non-cardiac chest pain, Headache...
AEs leading to
discontinuation/dose reduction:
Non-cardiac chest pain (0.3%)
Headache (0.2%)
Dyspnea (0.2%)
COPD (2%)
Pruritus (0.2%)
Syncope (0.2%)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Disc. AE: Fatigue, Non-cardiac chest pain...
AEs leading to
discontinuation/dose reduction:
Fatigue (0.4%)
Non-cardiac chest pain (0.2%)
Dizziness (0.4%)
Dyspnea (0.2%)
COPD (2.9%)
Pruritus (0.2%)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
AEs

AEs

AESignificanceDosePopulation
Dysgeusia 12.5%
800 ug 2 times / day steady, respiratory
Highest studied dose
Dose: 800 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 800 ug, 2 times / day
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
healthy, 39.3 years (range: 18-45 years)
Health Status: healthy
Age Group: 39.3 years (range: 18-45 years)
Sex: M+F
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
Muscle spasm 12.5%
800 ug 2 times / day steady, respiratory
Highest studied dose
Dose: 800 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 800 ug, 2 times / day
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
healthy, 39.3 years (range: 18-45 years)
Health Status: healthy
Age Group: 39.3 years (range: 18-45 years)
Sex: M+F
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
Somnolence 12.5%
800 ug 2 times / day steady, respiratory
Highest studied dose
Dose: 800 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 800 ug, 2 times / day
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
healthy, 39.3 years (range: 18-45 years)
Health Status: healthy
Age Group: 39.3 years (range: 18-45 years)
Sex: M+F
Sources:
https://pubmed.ncbi.nlm.nih.gov/22366196
Dyspnea 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Headache 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Pruritus 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Syncope 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Non-cardiac chest pain 0.3%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
COPD 2%
Disc. AE
200 ug 2 times / day steady, respiratory
Recommended
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Dyspnea 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Non-cardiac chest pain 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Pruritus 0.2%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Dizziness 0.4%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Fatigue 0.4%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
COPD 2.9%
Disc. AE
200 ug 2 times / day steady, respiratory
Dose: 200 ug, 2 times / day
Route: respiratory
Route: steady
Dose: 200 ug, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
unhealthy
Health Status: unhealthy
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/202450Orig1s000MedR.pdf
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG
inhibitor
2438

inducer
440
inhibitor
2507

inducer
109
inhibitor
2217

OverviewOther

Other InhibitorOther SubstrateOther Inducer
CYP1A2
2153

CYP2A6
879

CYP2B6
926

CYP2C8
1057

CYP2C19
2057

CYP2E1
1060

CYP3A4/5
296

CYP4A9/11
35

P-gp
1741
CYP450
59

P-gp
2052
CYP1A2
832

CYP2A6
86

CYP2B6
669

CYP2C8
198

CYP2C19
329

CYP2E1
131

CYP3A4/5
133

CYP4A9/11
2
Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
CYP3A4/5
357
 no [IC50 90 uM]
CYP1A2
2333
 no
CYP1A2
2333
 no
CYP2A6
911
 no
CYP2A6
911
 no
CYP2B6
1160
 no
CYP2B6
1160
 no
CYP2C19
2141
 no
CYP2C19
2141
 no
CYP2C8
1117
 no
CYP2C8
1117
 no
CYP2C9
2497
 no
CYP2C9
2497
 no
CYP2D6
2546
 no
CYP2E1
1146
 no
CYP2E1
1146
 no
CYP3A4/5
357
 no
CYP4A9/11
35
 no
CYP4A9/11
35
 no
P-gp
1932
 no
CYP2D6
2546
 yes [IC50 2.4 uM]
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
P-gp
2052
 no
CYP450
59
 unlikely
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
hERG
2263
Sourcing

Sourcing

Vendor/AggregatorIDURL
ChEBI
CHEBI:65346
https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:65346
ZINC
ZINC000030691727
http://zinc15.docking.org/substances/ZINC000030691727
PubMed

PubMed

TitleDatePubMed
Patents

Patents

08044205
2
20050209272
3
US2010261877
2
US2010261877
2

Sample Use Guides

In Vivo Use Guide
Curator's Comment: Aclidinium bromide inhalation powder
One inhalation of TUDORZA PRESSAIR 400 mcg twice daily. For oral inhalation only.
Route of Administration: Other
In Vitro Use Guide
Unknown
Substance Class Chemical
Created
by admin
on Mon Mar 31 18:01:37 GMT 2025
Edited
by admin
on Mon Mar 31 18:01:37 GMT 2025
Record UNII
K17VY42F6C
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
ACLIDINIUM
VANDF   WHO-DD  
Common Name English
ACLIDINIUM ION
Preferred Name English
Aclidinium [WHO-DD]
Common Name English
(3R)-3-(2-HYDROXY(DI-2-THIENYL)ACETOXY)-1-(3-PHENOXYPROPYL)-1-AZONIABICYCLO(2.2.2)OCTANE
Systematic Name English
ACLIDINIUM [VANDF]
Common Name English
ACLIDINIUM CATION
Common Name English
1-AZONIABICYCLO(2.2.2)OCTANE, 3-((HYDROXYDI-2-THIENYLACETYL)OXY)-1-(3-PHENOXYPROPYL)-, (3R)-
Systematic Name English
Classification Tree Code System Code
EMA ASSESSMENT REPORTS BRIMICA GENUAIR ( AUTHORIZED: PLUMONARY DISEASE, CRONIC OBSTRUCTIVE)
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
WHO-ATC R03BB05
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
NDF-RT N0000175574
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
NCI_THESAURUS C29704
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
WHO-ATC R03AL05
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
Code System Code Type Description
DAILYMED
K17VY42F6C
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
SMS_ID
100000135703
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
CAS
727649-81-2
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
PUBCHEM
11434515
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
EPA CompTox
DTXSID00223070
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
DRUG BANK
DB08897
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
LACTMED
Aclidinium
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
IUPHAR
7449
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
EVMPD
SUB71686
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
WIKIPEDIA
Aclidinium
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
RXCUI
1303098
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY RxNorm
NCI_THESAURUS
C79894
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
FDA UNII
K17VY42F6C
Created by admin on Mon Mar 31 18:01:37 GMT 2025 , Edited by admin on Mon Mar 31 18:01:37 GMT 2025
PRIMARY
Related Record Type Details
MUSCARINIC ACETYLCHOLINE RECEPTOR M5
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MUSCARINIC ACETYLCHOLINE RECEPTOR M3
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MUSCARINIC ACETYLCHOLINE RECEPTOR M4
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MUSCARINIC ACETYLCHOLINE RECEPTOR M2
TARGET->ANTAGONIST
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Structure of ACLIDINIUM BROMIDE
SALT/SOLVATE -> PARENT
Structure of ACLIDINIUM
EXCRETED UNCHANGED
URINE
MUSCARINIC ACETYLCHOLINE RECEPTOR M1
TARGET -> INHIBITOR
Ki
Related Record Type Details
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METABOLITE -> PARENT
in healthy subjects
MAJOR
FECAL; PLASMA; URINE
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METABOLITE -> PARENT
MAJOR
FECAL; PLASMA
Structure of 2-THIOPHENEGLYOXYLIC ACID
METABOLITE -> PARENT
Structure of 1-AZONIABICYCLO(2.2.2)OCTANE, 3-HYDROXY-1-(3-(4-HYDROXYPHENOXY)PROPYL)-, LABELED WITH CARBON-14, (3R)-
METABOLITE -> PARENT
Related Record Type Details
Structure of ACLIDINIUM
ACTIVE MOIETY
Name Property Type Amount Referenced Substance Defining Parameters References
Biological Half-life PHARMACOKINETIC
Tmax PHARMACOKINETIC
Volume of Distribution PHARMACOKINETIC
NIH
NCATS
PRIVACY ACT
ACCESSIBILITY
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HHS VULNERABILITY DISCLOSURE
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