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manidipine

Indications: - essential mild-to-moderate hypertension [3] * potential to be repurposed as COVID-19 therapy [6] Dosage: 5, 10, 20 mg PO QD 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 interactions: - potentially many 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]

Interactions

drug adverse effects of calcium channel blockers

General

calcium channel blocker (CCB) dihydropyridine

Database Correlations

PUBCHEM cid=4008

References

  1. Wikipedia: Mandipine https://en.wikipedia.org/wiki/Manidipine
  2. DRUGBANK Online https://go.drugbank.com/drugs/DB09238
  3. McKeage K, Scott LJ. Manidipine: a review of its use in the management of hypertension. Drugs. 2004;64(17):1923-40. PMID: 15329044
  4. 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: 21155616
  5. 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: 27885840
  6. 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