Zofenopril

Structural formula
General
Non-proprietary name	Zofenopril
other names	(2 S , 4 S ) -1 - [(2 S ) -3- (Benzoylsulfanyl) -2-methylpropanoyl] -4-phenylsulfanyl-pyrrolidine-2-carboxylic acid ( IUPAC )
Molecular formula	C 22 H 23 NO 4 S 2
External identifiers / databases
PubChem	92400
ChemSpider	83422
DrugBank	DB13166
Wikidata	Q218284
Drug information
ATC code	C09 AA15
Drug class	ACE inhibitors
Mechanism of action	Inhibition of angiotensin converting enzyme
properties
Molar mass	429.55 g · mol -1
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS hazard labeling ; no classification available
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Zofenopril is an active ingredient from the group of ACE inhibitors used to treat high blood pressure . It is used medicinally in the form of its calcium salt. The active ingredient was developed in the late 1980s, but has only been approved as a medicinal product in a few countries.

pharmacology

Mechanism of action

Zofenopril through inhibition of the angiotensin converting enzyme to decreased formation of angiotensin II from angiotensin I . This reduced formation of angiotensin II causes a decrease in the tone of the blood vessels and thus a reduction in blood pressure. The lower angiotensin II level also leads to a reduction in the release of aldosterone from the adrenal cortex and thus to an influence on the water balance. (see also renin-angiotensin-aldosterone system ).

application areas

The drug is used for the therapy of arterial hypertension and for the treatment of acute myocardial infarction . In both indications, doses of 7.5 to 60 mg per day are used in two separate doses, the dose being slowly titrated up to the desired effect.

Side effects

The most common side effect in almost 10% of those treated is a cough, which is causally related to the slower breakdown and accumulation of bradykinin. In addition, dizziness , gastrointestinal complaints, headaches and rarely exanthema are possible. A hyperkalemia is also possible, but the potassium level in the can by controlling blood easily determine.

Interactions

Due to the possibility of hyperkalemia, the use of potassium-sparing diuretics should be avoided. An involvement of the cytochrome system is not yet known.

Contraindications

Pregnancy and advanced liver failure are contraindications . The tolerance during breastfeeding is not documented and is therefore also considered a contraindication.

Finished medicinal products

Preparations with 7.5 mg, 15 mg, 30 mg and 60 mg as well as a combination of 30 mg zofenopril with 12.5 mg hydrochlorothiazide are available.

Monopreparations

Bifril (A), Zofenil (A, CH, D)

Combination preparations

with hydrochlorothiazide: Bifril plus (A), Zofenil plus (A, CH)

Literature and studies

Ettore Ambrosioni, Claudio Borghi, Bruno Magnani: The effect of the angiotensin-converting-enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. In: The New England Journal of Medicine . Vol. 12, No. 2, January 1995, pp. 80-5, PMID 7990904 , doi : 10.1056 / NEJM199501123320203 .
Claudio Borghi, Ettore Ambrosioni: Zofenopril: A Review of the Evidence of its Benefits in Hypertension and Acute Myocardial Infarction. In: Clinical Drug Investigation . Vol. 20, No. 5, 2000, pp. 371-384.
Claudio Borghi, Ettore Ambrosioni: Double-blind comparison between zofenopril and lisinopril in patients with acute myocardial infarction: results of the Survival of Myocardial Infarction Long-term Evaluation-2 (SMILE-2) study. In: American Heart Journal . Vol. 145, No. 1, January 2003, pp. 80-87, PMID 12514658 , doi : 10.1067 / mhj.2003.24 .
EMEA: Zofenopril (PDF; 96 kB) from December 15, 2000.
Antonio Marzo, Lorenzo Dal Boa, Paolo Mazzucchellia, Nunzia Ceppi Montia, Rosella Aleotti Tettamantia, Fabrizio Crivellia, Mario Richard Uhr, Shevquet Ismaili, Andrea Giusti: Pharmacokinetics and pharmacodynamics of zofenopril in healthy volunteers. In: drug research . Vol. 49, No. 2, December 1999, pp. 992-996, PMID 10635443 , doi : 10.1055 / s-0031-1300539 .
Marcus D. Flather, Salim Yusuf , Lars Køber, Marc Pfeffer, Alistair Hall, Gordon Murray, Christian Torp-Pedersen, Stephen Ball, Janice Pogue, Lemuel Moyé, Eugene Braunwald : Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. In: The Lancet . Vol. 355, No. 9215, May 2000, pp. 1575-1581, PMID 10821360 , doi : 10.1016 / S0140-6736 (00) 02212-1 .
A. Flückiger: ACE inhibitors after heart attack. In: pharma criticism. Vol. 17, No. 15, 1995, pp. 57-60, digital version (PDF; 33.44 KB) .

Individual evidence

↑ This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.
↑ ^a ^b ^c ^d ^e ^f Article on Infomed.org .
↑ Brigitte M. Gensthaler, Sven Siebenand: New on the market. Rupatadin and Zofenopril. In: Pharmaceutical newspaper. Vol. 33, 2008, p. 170, (online) .
^ Borghi, Ambrosioni: Zofenopril. In: Clinical Drug Investigation. Vol. 20, No. 5, 2000, pp. 371-384.
↑ ABDA database (as of September 1, 2008) of DIMDI.
↑ AM comp. d. Switzerland, as of October 2009.
↑ AGES-PharmMed, as of October 2009.

[NV-1] This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.

[IM-2] ↑ ^a ^b ^c ^d ^e ^f Article on Infomed.org .

[PZ-3] Brigitte M. Gensthaler, Sven Siebenand: New on the market. Rupatadin and Zofenopril. In: Pharmaceutical newspaper. Vol. 33, 2008, p. 170, (online) .

[M1-4] Borghi, Ambrosioni: Zofenopril. In: Clinical Drug Investigation. Vol. 20, No. 5, 2000, pp. 371-384.

[DIMDI-5] ABDA database (as of September 1, 2008) of DIMDI.

[6] AM comp. d. Switzerland, as of October 2009.

[7] AGES-PharmMed, as of October 2009.