U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C30H24N4O8
Molecular Weight 568.5336
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of AZILSARTAN MEDOXOMIL

SMILES

CCOC1=NC2=C(N1CC3=CC=C(C=C3)C4=CC=CC=C4C5=NOC(=O)N5)C(=CC=C2)C(=O)OCC6=C(C)OC(=O)O6

InChI

InChIKey=QJFSABGVXDWMIW-UHFFFAOYSA-N
InChI=1S/C30H24N4O8/c1-3-38-28-31-23-10-6-9-22(27(35)39-16-24-17(2)40-30(37)41-24)25(23)34(28)15-18-11-13-19(14-12-18)20-7-4-5-8-21(20)26-32-29(36)42-33-26/h4-14H,3,15-16H2,1-2H3,(H,32,33,36)

HIDE SMILES / InChI

Molecular Formula C30H24N4O8
Molecular Weight 568.5336
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Description
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/23487168

TAK-536 (generic name: azilsartan) is an angiotensin II type 1 receptor blocker, discovered by Takeda and its mechanism of action is to lower blood pressure by inhibiting action of a vasopressor hormone Angiotensin II. Angiotensin II type 1 receptor antagonists have become an important drug class in the treatment of hypertension and heart failure. TAK-536 is in phase III clinical trial for treatment hypertension. This drug also known as active metabolite of the prodrug azilsartan medoxomil (also known as azilsartan kamedoxomil), but in some countries azilsartan rather than its prodrug is used for oral treatment.

CNS Activity

Curator's Comment: In rats, minimal azilsartan-associated radioactivity crossed the blood-brain barrier.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Target ID: P30556
Gene ID: 185.0
Gene Symbol: AGTR1
Target Organism: Homo sapiens (Human)
0.62 nM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
EDARBI

Approved Use

Indicated for the treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. Edarbi may be used either alone or in combination with other antihypertensive agents.

Launch Date

2011
Primary
Unknown

Approved Use

Unknown
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
5355.71 ng/mL
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered: Chlorthalidone
AZILSARTAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
141.3 ng/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-I plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
191.3 ng/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-I plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
227.7 ng/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-II plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
179.3 ng/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-II plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
888.3 ng/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
831.3 ng/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
46688.2 ng × h/mL
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered: Chlorthalidone
AZILSARTAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1420.5 ng*h/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-I plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
1592.7 ng*h/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-I plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
1986.5 ng*h/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-II plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
3526 ng*h/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN METABOLITE M-II plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
6350.3 ng*h/mL
5 mg single, oral
dose: 5 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
6871.7 ng*h/mL
10 mg single, oral
dose: 10 mg
route of administration: oral
experiment type: single
co-administered:
AZILSARTAN plasma
Homo sapiens
population: unhealthy
age: Children
sex:
food status: Fed
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
12.1 h
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered: Chlorthalidone
AZILSARTAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
1%
80 mg 1 times / day unknown, oral
dose: 80 mg
route of administration: Oral
experiment type: UNKNOWN
co-administered:
AZILSARTAN plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
80 mg 1 times / day multiple, oral (max)
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources: Page: p.187
unhealthy, 50.4+/-10.2
n = 179
Health Status: unhealthy
Condition: Hypertension
Age Group: 50.4+/-10.2
Sex: M+F
Population Size: 179
Sources: Page: p.187
Disc. AE: Dizziness, Fatigue...
AEs leading to
discontinuation/dose reduction:
Dizziness (3.35%)
Fatigue (2.79%)
Sources: Page: p.187
320 mg 1 times / day multiple, oral
Overdose
Dose: 320 mg, 1 times / day
Route: oral
Route: multiple
Dose: 320 mg, 1 times / day
Sources: Page: p.6
healthy
80 mg 1 times / day multiple, oral (max)
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources: Page: p.4
unhealthy
n = 2146
Health Status: unhealthy
Condition: Hypertension
Population Size: 2146
Sources: Page: p.4
Disc. AE: Hypotension orthostatic...
AEs leading to
discontinuation/dose reduction:
Hypotension orthostatic (0.4%)
Sources: Page: p.4
AEs

AEs

AESignificanceDosePopulation
Fatigue 2.79%
Disc. AE
80 mg 1 times / day multiple, oral (max)
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources: Page: p.187
unhealthy, 50.4+/-10.2
n = 179
Health Status: unhealthy
Condition: Hypertension
Age Group: 50.4+/-10.2
Sex: M+F
Population Size: 179
Sources: Page: p.187
Dizziness 3.35%
Disc. AE
80 mg 1 times / day multiple, oral (max)
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources: Page: p.187
unhealthy, 50.4+/-10.2
n = 179
Health Status: unhealthy
Condition: Hypertension
Age Group: 50.4+/-10.2
Sex: M+F
Population Size: 179
Sources: Page: p.187
Hypotension orthostatic 0.4%
Disc. AE
80 mg 1 times / day multiple, oral (max)
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: multiple
Dose: 80 mg, 1 times / day
Sources: Page: p.4
unhealthy
n = 2146
Health Status: unhealthy
Condition: Hypertension
Population Size: 2146
Sources: Page: p.4
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no (co-administration study)
Comment: Human liver microsomes (Phenacetin O-deethylation), Maximum inhibition = 5.1%; Coadministration of Azilsartan medoxomil (80 mg QD for 6 days) did not significantly affect Caffeine (200 mg QD on Day 6, CYP1A2 substrate) AUC and Cmax.
Page: 9, 46-47, (ClinPharm) 15, 17-18, 58-59
no [IC50 >100 uM]
no (co-administration study)
Comment: Human liver microsomes (Paclitaxel 6a-hydroxylation), Maximum inhibition = 10.1%; Pioglitazone does not affect systemic exposure to Azilzartan, and systemic exposure to pioglitazone is not affected by Azilzartan.
Page: 9, 46-47, (ClinPharm) 15, 17-18, 77-78
no [IC50 >100 uM]
no (co-administration study)
Comment: Human liver microsomes (Diclofenac 4'-hydroxylation), Inhibited CYP2C9 activities at 30 (14.4%) and 100 mcM (37.9%); Human CYP expressing microsomes derived from B-lymphoblastoid cells (tolbutamide hydroxylation); Coadministration of Azilsartan medoxomil (80 mg QD for 6 days) did not significantly affect Tolbutamide (500 mg QD on Day 6, CYP2C9 substrate) AUC and Cmax.; Azilzartan dose not affect the pharmacokinetics and pharmacodynamics of warfarin and is not expected to significantly affect systemic exposure to other CYP 2C9 substartes.
Page: 9, 46-47, (ClinPharm) 15, 17-18, 58-59, 66-68
no [IC50 >100 uM]
no (co-administration study)
Comment: Human liver microsomes (Bufuralol 1'-hydroxylation), Maximum inhibition = 5.1%; Coadministration of Azilsartan medoxomil (80 mg QD for 6 days) did not significantly affect Dextromethorphan (30 mg QD on Day 6, CYP2D6 substrate) AUC and Cmax.
Page: 9, 46-47, (ClinPharm) 15, 17-18, 58-59
no [IC50 >100 uM]
no (co-administration study)
Comment: Human liver microsomes (Midazolam 17-hydroxylation, Testosterone 6b-hydroxylation), Maximum inhibition = /<0%; Coadministration of Azilsartan medoxomil(80 mg QD for 6 days) did not significantly affect Midazolam (4 mg QD on Day 6, CYP3A4 substrate) AUC and Cmax.; Amlodipine does not affect systemic exposure to Azilzartan, and systemic exposure to amlodipine is not affected by Azilzartan.
Page: 9, 46-47, (ClinPharm) 15, 17-18, 58-59, 73-74
unlikely
unlikely
weak (co-administration study)
Comment: Caco-2 cells (After incubation at 37°C for 2 hours with Azilzartan (at 0, 20, 100, and 500 μmol/L), efflux ratios of digoxin were 6.4, 7.0, 6.6, and 7.23. These results show that Azilsartan had no inhibitory effect on P-gp-mediated efflux activity.; Coadministration of Azilsartan medoxomil (80 mg QD for 6 days) did not significantly affect Fexofenadine (60 mg QD on Day 6, P-gp substrate) AUC and Cmax.; Coadminitration of Azilzartan (80 mg QD for 10 days) increased Digoxin (200 mcg QD for 10 days) AUC0-tau by 2.87% and decreased Cmax by 5.71%.
Page: 35, (ClinPharm) 22-23, 58-59, 62-63
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
inconclusive
major
yes (co-administration study)
Comment: O-dealkylation to form Azilsartan M-II primarily by CYP2C9, Incubation of 14C-AZILSARTAN with microsomes from baculovirus-infected insect cellsexpressuing human CYP isoforms (elimination and formation (M-1 & M-II) rate); Human liver microsomes (16 donors); Clearance of Azilzartan (40 mg QD on Days 1 & 10) is reduced when co-administered with fluconazole (200 mg QD on Days 4-10), a CYP 2C9 inhibitor. This is evident from the ~ 40% increase in AUC, but only ~ 14% increase in Cmax. However, this is not of clinical significance given the flat D-R relationship for Azilzartan and the absence of serious adverse events.; Systemic exposure to glyburide (5 mg QD on DAy 8) is not affected by Azilzartan (40 mg QD for 8 days).
Page: 9, 45, (ClinPharm) 14, 64-65, 69-70
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes (co-administration study)
Comment: Incubation of 14C-AZILSARTAN with microsomes from baculovirus-infected insect cellsexpressuing human CYP isoforms (elimination and formation (M-1 & M-II) rate); Human liver microsomes (16 donors); When co-administered with ketoconazole (400 mg QD on Days 4-10), Cmax of Azilzartan (40 mg QD on Day 1 & 10) decreased by ~ 30% and AUC by ~ 20%. However, the reason for this is not apparent.
Page: 9, 45, (ClinPharm) 14, 64-65
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
TAK-536, a new AT1 receptor blocker, improves glucose intolerance and adipocyte differentiation.
2007 May
Differential pharmacology and benefit/risk of azilsartan compared to other sartans.
2012
A systematic comparison of the properties of clinically used angiotensin II type 1 receptor antagonists.
2013 Apr
Azilsartan, aliskiren, and combination antihypertensives utilizing renin-angiotensin-aldosterone system antagonists.
2014 Sep-Oct
Patents

Sample Use Guides

The recommended dose in adults is 80 mg taken orally once daily. Consider a starting dose of 40 mg for patients who are treated with high doses of diuretics.
Route of Administration: Oral
In Vitro Use Guide
Unknown
Substance Class Chemical
Created
by admin
on Fri Dec 15 16:05:02 GMT 2023
Edited
by admin
on Fri Dec 15 16:05:02 GMT 2023
Record UNII
LL0G25K7I2
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
AZILSARTAN MEDOXOMIL
DASH   INN   MART.   MI   ORANGE BOOK   USAN   VANDF   WHO-DD  
INN   USAN  
Official Name English
(5-METHYL-2-OXO-1,3-DIOXOL-4-YL)METHYL 2-ETHOXY-1-((2'-(5-OXO-2,5-DIHYDRO-1,2,4-OXADIAZOL-3-YL)BIPHENYL-4-YL)METHYL)-1H-BENZIMIDAZOLE-7-CARBOXYLATE
Systematic Name English
AZILSARTAN MEDOXOMIL [VANDF]
Common Name English
AZILSARTAN MEDOXOMIL [MI]
Common Name English
AZILSARTAN MEDOXOMIL [USAN]
Common Name English
EDARBI
Brand Name English
IPREZIV
Brand Name English
TAK 491
Code English
AZILSARTAN MEDOXOMIL [MART.]
Common Name English
TAK-491
Code English
Azilsartan medoxomil [WHO-DD]
Common Name English
AZILSARTAN MEDOXOMIL [ORANGE BOOK]
Common Name English
azilsartan medoxomil [INN]
Common Name English
1H-BENZIMIDAZOLE-7-CARBOXYLIC ACID, 1-((2'-(2,5-DIHYDRO-5-OXO-1,2,4-OXADIAZOL-3-YL)(1,1'-BIPHENYL)-4-YL)METHYL)-2-ETHOXY-, (5-METHYL-2-OXO-1,3-DIOXOL-4-YL)METHYL ESTER
Common Name English
AR-14
Code English
Classification Tree Code System Code
WHO-ATC C09CA09
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
NCI_THESAURUS C66930
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
EMA ASSESSMENT REPORTS EDARBI (AUTHORIZED: HYPERTENSION)
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
WHO-ATC C09DA09
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
EMA ASSESSMENT REPORTS IPREZIV (WITHDRAWN: HYPERTENSION)
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
WHO-VATC QC09CA09
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
Code System Code Type Description
NCI_THESAURUS
C75110
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
MERCK INDEX
m2173
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY Merck Index
RXCUI
1091642
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY RxNorm
EVMPD
SUB31560
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
USAN
UU-32
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
ChEMBL
CHEMBL2028661
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
CHEBI
68847
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
FDA UNII
LL0G25K7I2
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
INN
8874
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
CHEBI
68845
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
CAS
863031-21-4
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
DRUG BANK
DB08822
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
IUPHAR
6900
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
PUBCHEM
135409642
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
SMS_ID
100000124197
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
DRUG CENTRAL
4322
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
EPA CompTox
DTXSID10235482
Created by admin on Fri Dec 15 16:05:02 GMT 2023 , Edited by admin on Fri Dec 15 16:05:02 GMT 2023
PRIMARY
Related Record Type Details
TRANSPORTER -> INHIBITOR
TARGET -> INHIBITOR
TRANSPORTER -> INHIBITOR
SALT/SOLVATE -> PARENT
Related Record Type Details
METABOLITE ACTIVE -> PRODRUG
Related Record Type Details
ACTIVE MOIETY