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Technical details about Candesartan Cilexetil, learn more about the structure, uses, toxicity, action, side effects and more

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2D Structure
Also known as: 145040-37-5, Atacand, Tcv-116, Amias, Parapres, Kenzen
Molecular Formula
C33H34N6O6
Molecular Weight
610.7  g/mol
InChI Key
GHOSNRCGJFBJIB-UHFFFAOYSA-N
FDA UNII
R85M2X0D68

Candesartan Cilexetil is a synthetic, benzimidazole-derived angiotensin II receptor antagonist prodrug with antihypertensive activity. After hydrolysis of candesartan cilexetil to candesartan during gastrointestinal absorption, candesartan selectively competes with angiotensin II for the binding of the angiotensin II receptor subtype 1 (AT1) in vascular smooth muscle, blocking angiotensin II-mediated vasoconstriction and inducing vasodilatation. In addition, antagonism of AT1 in the adrenal gland inhibits angiotensin II-stimulated aldosterone synthesis and secretion by the adrenal cortex; sodium and water excretion increase, followed by a reduction in plasma volume and blood pressure.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
1-cyclohexyloxycarbonyloxyethyl 2-ethoxy-3-[[4-[2-(2H-tetrazol-5-yl)phenyl]phenyl]methyl]benzimidazole-4-carboxylate
2.1.2 InChI
InChI=1S/C33H34N6O6/c1-3-42-32-34-28-15-9-14-27(31(40)43-21(2)44-33(41)45-24-10-5-4-6-11-24)29(28)39(32)20-22-16-18-23(19-17-22)25-12-7-8-13-26(25)30-35-37-38-36-30/h7-9,12-19,21,24H,3-6,10-11,20H2,1-2H3,(H,35,36,37,38)
2.1.3 InChI Key
GHOSNRCGJFBJIB-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CCOC1=NC2=CC=CC(=C2N1CC3=CC=C(C=C3)C4=CC=CC=C4C5=NNN=N5)C(=O)OC(C)OC(=O)OC6CCCCC6
2.2 Other Identifiers
2.2.1 UNII
R85M2X0D68
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 1-(cyclohexylocarbonyloxy)ethyl-2-ethoxy-1-(2'-(1h-tetrazol-5-yl)biphenyl-4-yl)-1h-benzimidazole-7-carboxylate

2. 1h-benzimidazolium, 7-carboxy-1-(2-((cyclohexylcarbonyl)oxy)ethyl)-2-ethoxy-1-(2'-(1h-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)-, Hydroxide, Inner Salt, (+-)-

3. Amias

4. Atacand

5. Blopress

6. Kenzen

7. Parapres

8. Tcv 116

9. Tcv-116

2.3.2 Depositor-Supplied Synonyms

1. 145040-37-5

2. Atacand

3. Tcv-116

4. Amias

5. Parapres

6. Kenzen

7. Candesartan Cilextil

8. Tcv 116

9. Candesartancilexetil

10. Candesartan Cilexetil [usan]

11. Nsc-758697

12. Chembl1014

13. Chebi:3348

14. 1-(((cyclohexyloxy)carbonyl)oxy)ethyl 1-((2'-(2h-tetrazol-5-yl)-[1,1'-biphenyl]-4-yl)methyl)-2-ethoxy-1h-benzo[d]imidazole-7-carboxylate

15. R85m2x0d68

16. 1-(cyclohexyloxycarbonyloxy)ethyl 1-((2'-(1h-tetrazol-5-yl)biphenyl-4-yl)methyl)-2-ethoxy-1h-benzo[d]imidazole-7-carboxylate

17. 1-cyclohexyloxycarbonyloxyethyl 2-ethoxy-3-[[4-[2-(2h-tetrazol-5-yl)phenyl]phenyl]methyl]benzimidazole-4-carboxylate

18. 1-(((cyclohexyloxy)carbonyl)oxy)ethyl 1-((2'-(1h-tetrazol-5-yl)-[1,1'-biphenyl]-4-yl)methyl)-2-ethoxy-1h-benzo[d]imidazole-7-carboxylate

19. Candesartan 1-(((cyclohexyloxy)carbonyl)oxy)ethyl Ester

20. Candesartan 1-[[(cyclohexyloxy)carbonyl]oxy]ethyl Ester

21. Racanda

22. Unii-r85m2x0d68

23. Tcy 116

24. Candesartan Hexetil

25. 1-cyclohexyloxycarbonyloxyethyl 2-ethoxy-3-[[4-[2-(1h-tetrazol-5-yl)phenyl]phenyl]methyl]benzimidazole-4-carboxylate

26. Atacand (tn)

27. Candesartan Cilexitil

28. Mfcd00871371

29. Spectrum_001707

30. Candesartan (cilexetil)

31. Dsstox_cid_239

32. Spectrum2_000485

33. Spectrum3_000996

34. Spectrum4_001124

35. Spectrum5_001462

36. Candesartan Celexetil Ester

37. Dsstox_rid_85567

38. Dsstox_gsid_20239

39. Schembl40831

40. Bspbio_002691

41. Candesartan Cilexetil- Bio-x

42. Kbiogr_001607

43. Kbioss_002187

44. 1h-benzimidazolium, 7-carboxy-1-(2-((cyclohexylcarbonyl)oxy)ethyl)-2-ethoxy-1-(2'-(1h-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)-, Hydroxide, Inner Salt, (+-)-

45. Candesartan Cilexetil-[d11]

46. Mls004774127

47. Candesartan Cilexetil , 97%

48. Spectrum1504261

49. Spbio_000349

50. Gtpl8352

51. Candesartan Cilexetil (atacand)

52. Dtxsid5020239

53. Kbio2_002187

54. Kbio2_004755

55. Kbio2_007323

56. Kbio3_001911

57. Hms1922j09

58. Hms2093e20

59. Hms3651i08

60. Pharmakon1600-01504261

61. Candesartan Cilexetil (jp17/usp)

62. Candesartan Cilexetil [jan]

63. Bcp22050

64. Tox21_302202

65. Ac-204

66. Bdbm50318907

67. Candesartan Cilexetil [vandf]

68. Ccg-39530

69. Nsc758697

70. S2037

71. Stl451065

72. Candesartan Cilexetil [mart.]

73. Akos015894954

74. Akos015920180

75. Candesartan Cilexetil [usp-rs]

76. Candesartan Cilexetil [who-dd]

77. Ab07617

78. Am90293

79. Bcp9000480

80. Ccg-222334

81. Db00796

82. Ds-1302

83. Ks-1147

84. Nsc 758697

85. Candesartan Cilexetil, >=98% (hplc)

86. Ncgc00095123-01

87. Ncgc00095123-02

88. Ncgc00095123-03

89. Ncgc00095123-05

90. Ncgc00095123-10

91. Ncgc00095123-16

92. Ncgc00255218-01

93. (+-)-1-hydroxyethyl 2-ethoxy-1-(p-(o-1h-tetrazol-5-ylphenyl)benzyl)-7-benzimidazolecarboxylate, Cyclohexyl Carbonate (ester)

94. 1-[[(cyclohexyloxy)carbonyl]oxy]ethyl 2-ethoxy-1-[[2'-(1h-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1h-benzimidazole-7-carboxylate

95. 1-{[(cyclohexyloxy)carbonyl]oxy}ethyl 2-(ethyloxy)-1-{[2'-(1h-tetrazol-5-yl)biphenyl-4-yl]methyl}-1h-benzimidazole-7-carboxylate

96. 1h-benzimidazole-7-carboxylic Acid, 2-ethoxy-1-((2'-(1h-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, 1-(((cyclohexyloxy)carbonyl)oxy)ethyl Ester, (+-)-

97. 2-ethoxy-1-[[2'-(2h-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1h-benzimidazole-7-carboxylic Acid 1-[[(cyclohexyloxy)carbonyl]oxy]ethyl Ester

98. 2-ethoxy-3-[2'-(1h-tetrazol-5-yl)-biphenyl-4-ylmethyl]-3h-benzoimidazole-4-carboxylic Acid 1-cyclohexyloxycarbonyloxy-ethyl Ester

99. Bc164274

100. Hy-17505

101. Smr003500784

102. Candesartan Cilexetil [orange Book]

103. Sbi-0206767.p001

104. Candesartan Cilexetil [ep Monograph]

105. Candesartan Cilexetil [usp Monograph]

106. Cas-145040-37-5

107. Ft-0602914

108. Sw220041-1

109. C07709

110. D00626

111. Ab01274805-01

112. Ab01274805_02

113. Ab01274805_03

114. 040c375

115. H212/91

116. L006257

117. Sr-05000001976

118. Camptothecine, Antibiotic For Culture Media Use Only

119. Q-200786

120. Sr-05000001976-1

121. Brd-a65671304-001-02-6

122. Brd-a65671304-001-03-4

123. Q27075664

124. Candesartan 1-(((cyclohexyloxy)carbonyl)oxy)ethyl Ester [mi]

125. Candesartan Cilexetil, European Pharmacopoeia (ep) Reference Standard

126. Candesartan Cilexetil, United States Pharmacopeia (usp) Reference Standard

127. Candesartan Cilexetil For Peak Identification, European Pharmacopoeia (ep) Reference Standard

128. Candesartan Cilexetil For System Suitability, European Pharmacopoeia (ep) Reference Standard

129. Candesartan Cilexetil, Pharmaceutical Secondary Standard; Certified Reference Material

130. (+/-)-1-(cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-[2'-(1h-tetrazol-5-yl) Biphenyl-4-yl]methylbenzimidazole-7-carboxylate

131. (+/-)-1-(cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-[2'-(1h-tetrazol-5-yl)biphenyl-4-yl]methylbenzimidazole-7-carboxylate

132. (+/-)1-hydroxyethyl 2-ethoxy-1-(p-(o-1h-tetrazol-5-ylphenyl)benzyl)-7-benzimidazolecarboxylate, Cyclohexyl Carbonate (ester)

133. 1-(((cyclohexyloxy)carbonyl)oxy)ethyl1-((2'-(2h-tetrazol-5-yl)-[1,1'-biphenyl]-4-yl)methyl)-2-ethoxy-1h-benzo[d]imidazole-7-carboxylate

134. 1-(cyclohexyloxycarbonyloxy)ethyl-2-ethoxy-1-[[2'-(1h-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazol-7-carboxylate

135. 1-{[(cyclohexyloxy)carbonyl]oxy}ethyl 2-ethoxy-1-{[2'-(1h-tetrazol-5-yl)biphenyl-4-yl]methyl}-1h-benzimidazole-7-carboxylate

136. 1-cyclohexyloxycarbonyloxyethyl 2-ethoxy-3-[[4-[2-(2h-tetrazol-5-yl)phenyl]phenyl] Methyl]benzimidazole-4-carboxylate

137. 1-cyclohexyloxycarbonyloxyethyl 2-ethoxy-3-[[4-[2-(2h-tetrazol-5-yl)phenyl]phenyl]methyl]benzimidazole-4-carboxylate.

138. 1h-benzimidazole-7-carboxylic Acid, 2-ethoxy-1-((2'-(1h-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, 1-(((cyclohexyloxy)carbonyl)oxy)ethyl Ester, (+/-)-

139. 1h-benzimidazole-7-carboxylic Acid, 2-ethoxy-1-[[2'-(2h-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-, 1-[[(cyclohexyloxy)carbonyl]oxy]ethyl Ester

140. 2-ethoxy-1-[2'-(1h-tetrazole-5-yl)-4-biphenylylmethyl]-1h-benzimidazole-7-carboxylic Acid 1-(cyclohexyloxycarbonyloxy)ethyl Ester

141. 2-ethoxy-3-[2''-(1h-tetrazol-5-yl)-biphenyl-4-ylmethyl]-3h-benzoimidazole-4-carboxylic Acid 1-cyclohexyloxycarbonyloxy-ethyl Ester

142. 2-ethoxy-3-[2''-(2h-tetrazol-5-yl)-biphenyl-4-ylmethyl]-3h-benzoimidazole-4-carboxylic Acid 1-cyclohexyloxycarbonyloxy-ethyl Ester

143. 2-ethoxy-3-[2'-(1h-tetrazol-5-yl)-biphenyl-4-ylmethyl]-3h-benzoimidazole-4-carboxylic Acid 1-cyclohe

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 610.7 g/mol
Molecular Formula C33H34N6O6
XLogP37
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count10
Rotatable Bond Count13
Exact Mass610.25398283 g/mol
Monoisotopic Mass610.25398283 g/mol
Topological Polar Surface Area143 Ų
Heavy Atom Count45
Formal Charge0
Complexity962
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count1
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 6  
Drug NameAtacand
PubMed HealthCandesartan (By mouth)
Drug ClassesAngiotensin II Receptor Antagonist/Thiazide Combination
Drug LabelATACAND (candesartan cilexetil), a prodrug, is hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist.Candesartan cilexetil, a nonpeptide, is chemically d...
Active IngredientCandesartan cilexetil
Dosage FormTablet
RouteOral
Strength32mg; 4mg; 16mg; 8mg
Market StatusPrescription
CompanyAstrazeneca

2 of 6  
Drug NameAtacand hct
PubMed HealthCandesartan/Hydrochlorothiazide (By mouth)
Active Ingredienthydrochlorothiazide; Candesartan cilexetil
Dosage FormTablet
RouteOral
Strength32mg; 25mg; 16mg; 12.5mg
Market StatusPrescription
CompanyAstrazeneca

3 of 6  
Drug NameCandesartan cilexetil
Drug LabelCandesartan cilexetil, a prodrug, is hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist.Candesartan cilexetil, a nonpeptide, is chemically described a...
Active IngredientCandesartan cilexetil
Dosage FormTablet
Routeoral; Oral
Strength32mg; 4mg; 16mg; 8mg
Market StatusTentative Approval; Prescription
CompanyMatrix Labs; Apotex; Sandoz

4 of 6  
Drug NameAtacand
PubMed HealthCandesartan (By mouth)
Drug ClassesAngiotensin II Receptor Antagonist/Thiazide Combination
Drug LabelATACAND (candesartan cilexetil), a prodrug, is hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist.Candesartan cilexetil, a nonpeptide, is chemically d...
Active IngredientCandesartan cilexetil
Dosage FormTablet
RouteOral
Strength32mg; 4mg; 16mg; 8mg
Market StatusPrescription
CompanyAstrazeneca

5 of 6  
Drug NameAtacand hct
PubMed HealthCandesartan/Hydrochlorothiazide (By mouth)
Active Ingredienthydrochlorothiazide; Candesartan cilexetil
Dosage FormTablet
RouteOral
Strength32mg; 25mg; 16mg; 12.5mg
Market StatusPrescription
CompanyAstrazeneca

6 of 6  
Drug NameCandesartan cilexetil
Drug LabelCandesartan cilexetil, a prodrug, is hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist.Candesartan cilexetil, a nonpeptide, is chemically described a...
Active IngredientCandesartan cilexetil
Dosage FormTablet
Routeoral; Oral
Strength32mg; 4mg; 16mg; 8mg
Market StatusTentative Approval; Prescription
CompanyMatrix Labs; Apotex; Sandoz

4.2 Drug Indication

May be used as a first line agent to treat uncomplicated hypertension, isolated systolic hypertension and left ventricular hypertrophy. May be used as a first line agent to delay progression of diabetic nephropathy. Candesartan may be also used as a second line agent in the treatment of congestive heart failure, systolic dysfunction, myocardial infarction and coronary artery disease in those intolerant of ACE inhibitors.


FDA Label


Diabetic retinopathy, Essential hypertension, Heart Failure


Diabetic retinopathy, Essential hypertension, Heart Failure


5 Pharmacology and Biochemistry
5.1 Pharmacology

Candesartan cilexetil is an ARB prodrug that is rapidly converted to candesartan, its active metabolite, during absorption from the gastrointestinal tract. Candesartan confers blood pressure lowering effects by antagonizing the hypertensive effects of angiotensin II via the RAAS. RAAS is a homeostatic mechanism for regulating hemodynamics, water and electrolyte balance. During sympathetic stimulation or when renal blood pressure or blood flow is reduced, renin is released from granular cells of the juxtaglomerular apparatus in the kidneys. Renin cleaves circulating angiotensinogen to angiotensin I, which is cleaved by angiotensin converting enzyme (ACE) to angiotensin II. Angiotensin II increases blood pressure by increasing total peripheral resistance, increasing sodium and water reabsorption in the kidneys via aldosterone secretion, and altering cardiovascular structure. Angiotensin II binds to two receptors: type-1 angiotensin II receptor (AT1) and type-2 angiotensin II receptor (AT2). AT1 is a G-protein coupled receptor (GPCR) that mediates the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Studies performed in recent years suggest that AT2 antagonizes AT1-mediated effects and directly affects long-term blood pressure control by inducing vasorelaxation and increasing urinary sodium excretion. Angiotensin receptor blockers (ARBs) are non-peptide competitive inhibitors of AT1. ARBs block the ability of angiotensin II to stimulate pressor and cell proliferative effects. Unlike ACE inhibitors, ARBs do not affect bradykinin-induced vasodilation. The overall effect of ARBs is a decrease in blood pressure.


5.2 MeSH Pharmacological Classification

Antihypertensive Agents

Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. (See all compounds classified as Antihypertensive Agents.)


Angiotensin II Type 1 Receptor Blockers

Agents that antagonize ANGIOTENSIN II TYPE 1 RECEPTOR. Included are ANGIOTENSIN II analogs such as SARALASIN and biphenylimidazoles such as LOSARTAN. Some are used as ANTIHYPERTENSIVE AGENTS. (See all compounds classified as Angiotensin II Type 1 Receptor Blockers.)


5.3 FDA Pharmacological Classification
5.3.1 Pharmacological Classes
Angiotensin 2 Receptor Blocker [EPC]; Angiotensin 2 Receptor Antagonists [MoA]
5.4 Absorption, Distribution and Excretion

Absorption

Following administration of the candesartan cilexetil prodrug, the absolute bioavailability of candesartan was estimated to be 15%. Food with a high fat content has no effect on the bioavailability of candesartan from candesartan cilexetil.


Route of Elimination

When candesartan is administered orally, about 26% of the dose is excreted unchanged in urine. Candesartan is mainly excreted unchanged in urine and feces (via bile).


Volume of Distribution

0.13 L/kg


Clearance

0.37 mL/min/kg


5.5 Metabolism/Metabolites

The prodrug candesartan cilexetil undergoes rapid and complete ester hydrolysis in the intestinal wall to form the active drug, candesartan. Elimination of candesartan is primarily as unchanged drug in the urine and, by the biliary route, in the feces. Minor hepatic metabolism of candesartan (<20%) occurs by O-deethylation via cytochrome P450 2C9 to form an inactive metabolite. Candesartan undergoes N-glucuronidation in the tetrazole ring by uridine diphosphate glucuronosyltransferase 1A3 (UGT1A3). O-glucuronidation may also occur. 75% of candesartan is excreted as unchanged drug in urine and feces.


5.6 Biological Half-Life

Approximately 9 hours.


5.7 Mechanism of Action

Candesartan selectively blocks the binding of angiotensin II to AT1 in many tissues including vascular smooth muscle and the adrenal glands. This inhibits the AT1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin II and results in an overall decrease in blood pressure. Candesartan is greater than 10,000 times more selective for AT1 than AT2. Inhibition of aldosterone secretion may increase sodium and water excretion while decreasing potassium excretion.


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