manidipine
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Indications
- essential mild-to-moderate hypertension[3]
* potential to be repurposed as COVID-19 therapy[6]
Dosage
Pharmacokinetics
- 99% protein-bound
- metabolized by cytochrome P450 enzymes to pyridine derivatives (4-7%) & diphenylmethane derivatives (22-24%)
- 63% is eliminated in the feces & 31% in the urine as metabolites
- 1/2 life dose-dependent: with 5 mg 3.94 h, 10 mg 5.02 h, 20 mg 7.95 h
Adverse effects
- peripheral edema (6%)*, headache (3.8%), palpitation (2.7%), flushing (2.2%), dizziness (1.6%), rash (0.5%), fatigue (0.5%)[2]
* peripheral edema allegedly lower than with amlodipine[3]
- drug adverse effects of calcium channel blockers
- drug adverse effects of renin-angiotensin-aldosterone system inhibitors (RAAS inhibitors)
- drug adverse effects of antihypertensive agents
Drug interactions
- potentially many
- drug interaction(s) of calcium channel blockers with ARBs
- drug interaction(s) of calcium channel blockers with ACE inhibitors
- drug interaction(s) of calcium channel blockers with diuretics
- drug interaction(s) of calcium channel blockers with erythromycin
- drug interaction(s) of calcium channel blockers with clarithromycin
- drug interaction(s) of renin-angiotensin-aldosterone inhibitors with trimethoprim-sulfamethoxazole
- drug interaction(s) of beta-adrenergic receptor antagonists with calcium channel blockers
- drug interaction(s) of NSAIDs & antihypertensives
Mechanism of action
- lipophilic dihydropyridine calcium channel blocker
- vasodilator with negligible cardiodepression
- binds to voltage-dependent L-type calcium channels & voltage-dependent L-type calcium channels on smooth muscle cells
- produces renal vasodilation & an increase in natriuresis
- dilates both efferent & afferent renal arterioles[3]
- does not significantly affect norepinephrine levels[3]
- may improve insulin sensitivity[3][4]
- may reduce microalbuminuria relative to amlodipine in patients with diabetes mellitus[5]
More general terms
References
- ↑ Wikipedia: Mandipine https://en.wikipedia.org/wiki/Manidipine
- ↑ 2.0 2.1 DRUGBANK Online https://go.drugbank.com/drugs/DB09238
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 McKeage K, Scott LJ. Manidipine: a review of its use in the management of hypertension. Drugs. 2004;64(17):1923-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15329044
- ↑ 4.0 4.1 Martinez-Martin FJ, Macias-Batista A, Comi-Diaz C Effects of manidipine and its combination with an ACE inhibitor on insulin sensitivity and metabolic, inflammatory and prothrombotic markers in hypertensive patients with metabolic syndrome: the MARCADOR study. Clin Drug Investig. 2011;31(3):201-12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21155616
- ↑ 5.0 5.1 Saiz-Satjes M, Martinez-Martin FJ, Roca-Cusachs A. Factors associated with the reduction of albumin excretion in diabetic hypertensive patients: differential effect of manidipine versus amlodipine. Future Cardiol. 2017 Mar;13(2):143-151. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27885840
- ↑ 6.0 6.1 The Scripps Research Institute Extensive study identifies over a dozen existing drugs as potential COVID-19 therapies. MedicalXpress 2021. June 3 https://medicalxpress.com/news/2021-06-extensive-dozen-drugs-potential-covid-.html