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Pathway Description
Ramipril Metabolism Pathway
Homo sapiens
Drug Metabolism Pathway
Created: 2013-09-11
Last Updated: 2019-08-29
Ramipril (trade name: Altace) belongs to the class of drugs known as angiotensin-converting enzyme (ACE) inhibitors and is used primarily to lower high blood pressure (hypertension). This drug can also be used in the treatment of congestive heart failure and type II diabetes. Ramipril is a prodrug which, following oral administration, undergoes biotransformation in vivo into its active form ramiprilat via cleavage of its ester group by the liver. Angiotensin-converting enzyme (ACE) is a component of the body's renin–angiotensin–aldosterone system (RAAS) and cleaves inactive angiotensin I into the active vasoconstrictor angiotensin II. ACE (or kininase II) also degrades the potent vasodilator bradykinin. Consequently, ACE inhibitors decrease angiotensin II concentrations and increase bradykinin concentrations resulting in blood vessel dilation and thereby lowering blood pressure.
References
Ramipril Pathway References
Altace. (2009). e-CPS (online version of Compendium of Pharmaceuticals and Specialties). Retrieved August 22, 2009.
Bader, M. Renin-angiotensin-aldosterone system. In S. Offermanns, & W. Rosenthal (Eds.). Encyclopedic reference of molecular pharmacology (2004) p.810-814. Berlin, Germany: Springer.
Peters, J. ACE inhibitors. In S. Offermanns, & W. Rosenthal (Eds.). Encyclopedic reference of molecular pharmacology (2004) p. 2-5. Berlin, Germany: Springer.
Stanfield, C.L., & Germann, W.J. Principles of human physiology (3rd ed.) (2008). San Francisco, CA: Pearson Education, Inc.;
Todd PA, Benfield P: Ramipril. A review of its pharmacological properties and therapeutic efficacy in cardiovascular disorders. Drugs. 1990 Jan;39(1):110-35. doi: 10.2165/00003495-199039010-00009.
Pubmed: 2138076
Ehlers MR, Riordan JF: Angiotensin-converting enzyme: zinc- and inhibitor-binding stoichiometries of the somatic and testis isozymes. Biochemistry. 1991 Jul 23;30(29):7118-26. doi: 10.1021/bi00243a012.
Pubmed: 1649623
Woodman ZL, Oppong SY, Cook S, Hooper NM, Schwager SL, Brandt WF, Ehlers MR, Sturrock ED: Shedding of somatic angiotensin-converting enzyme (ACE) is inefficient compared with testis ACE despite cleavage at identical stalk sites. Biochem J. 2000 May 1;347 Pt 3:711-8.
Pubmed: 10769174
Donoghue M, Hsieh F, Baronas E, Godbout K, Gosselin M, Stagliano N, Donovan M, Woolf B, Robison K, Jeyaseelan R, Breitbart RE, Acton S: A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000 Sep 1;87(5):E1-9. doi: 10.1161/01.res.87.5.e1.
Pubmed: 10969042
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