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Pathway Description
Candesartan cilexetil Action Pathway
Homo sapiens
Drug Action Pathway
This drug is administered as the prodrug (candesartan cilexetil), this molecule is quickly converted in candesartan, the active metabolite while it is absorbed in the gastrointestinal tract (ester hydrolosis). Candesartan selectively inhibits the binding of angiotensin II to Type-1 angiotensin II receptors (AT1) in vascular smooth muscle and adrenal glands. In consequence of this interaction, AT1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin II are inhibited (inhibition of the RAAS). The last inhibition may increase sodium and water excretion while decresing the excretion of potassium. During sympathetic stimulation or when renal blood pressure or blood flow is reduced, renin comes in the blood by the granular cells (kidneys). This protein cleaves the angiotensinogen to angiotensin I, which is cleaved by angiotensin converting enzyme (ACE) to angiotensin II. Angiotensin II increases blood pressure by increasing sodium and water reabsorption in the kidneys via aldosterone secretion. Angiotensin II can bind two receptors: type-1 angiotensin II receptor (AT1) and type-2 angiotensin II receptor (AT2). AT1, a G-protein coupled receptor, mediates the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Candesartan cilexetil is available as a tablet.
References
Candesartan cilexetil Pathway References
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Pubmed: 29126136
Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5.
Cervenka L, Navar LG: Renal responses of the nonclipped kidney of two-kidney/one-clip Goldblatt hypertensive rats to type 1 angiotensin II receptor blockade with candesartan. J Am Soc Nephrol. 1999 Jan;10 Suppl 11:S197-201.
Pubmed: 9892163
Wada T, Inada Y, Ojima M, Sanada T, Shibouta Y, Nishikawa K: Comparison of the antihypertensive effects of the new angiotensin II (AT1) receptor antagonist candesartan cilexetil (TCV-116) and the angiotensin converting enzyme inhibitor enalapril in rats. Hypertens Res. 1996 Jun;19(2):75-81. doi: 10.1291/hypres.19.75.
Pubmed: 10968199
Mendis B, Page SR: Candesartan: widening indications for this angiotensin II receptor blocker? Expert Opin Pharmacother. 2009 Aug;10(12):1995-2007. doi: 10.1517/14656560903092197.
Pubmed: 19563275
Meredith PA: Candesartan cilexetil--a review of effects on cardiovascular complications in hypertension and chronic heart failure. Curr Med Res Opin. 2007 Jul;23(7):1693-705. doi: 10.1185/030079907x210723.
Pubmed: 17588300
Baguet JP, Barone-Rochette G, Neuder Y: Candesartan cilexetil in the treatment of chronic heart failure. Vasc Health Risk Manag. 2009;5(1):257-64. doi: 10.2147/vhrm.s4650. Epub 2009 Apr 8.
Pubmed: 19436650
Lee SR, Chae IH, Kim HL, Kang DY, Kim SH, Kim HS: Predictors of candesartan's effect on vascular reactivity in patients with coronary artery disease. Cardiovasc Ther. 2017 Oct;35(5):e12291. doi: 10.1111/1755-5922.12291.
Pubmed: 28796934
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