Details of the Drug

General Information of Drug (ID: DMS3GX2)

Drug Name

Telmisartan

Synonyms

Kinzal; Kinzalmono; Micardis; Pritor; Abbott brand of telmisartan; Boehringer Ingelheim brand of telmisartan; Glaxo Wellcome brand of telmisartan; GlaxoSmithKline brand of telmisartan; BIBR 277; BIBR 277SE; BIBR-277; BIBR-277SE; Bay 68-9291; Micardis (TN); Telmisartan [USAN:INN]; YM-086; BIBR-277-SE; Telmisartan (JAN/USAN/INN); Micardis, Targit, Temax, BIBR277, Telmisartan; 2-[4-[[4-methyl-6-(1-methylbenzimidazol-2-yl)-2-propylbenzimidazol-1-yl]methyl]phenyl]benzoic acid; 4'-((1,4'-dimethyl-2'-propyl(2,6'-bi-1H-benzimidazol)-1'-yl)methyl)-(1,1'-biphenyl)-2-carboxylic acid; 4'-((4-Methyl-6-(1-methyl-2-benzimidazolyl)-2-propyl-1-benzimidazolyl)methyl)-2-biphenylcarboxylic acid; 4'-((4-mehtyl-6-(1-methyl-2-benzimidazolyl)-2-propyl-1-benzimmidazolyl)methyl)-2-biphenylcarboxylic acid; 4'-[(1,4'-dimethyl-2'propyl[2,6'-bi-1H-benzimidazol]-1'-yl)methyl]-[1,1'-biphenyl]-2-carboxylic acid; 4'-[(1,7'-dimethyl-2'-propyl-1H,3'H-2,5'-bibenzimidazol-3'-yl)methyl][1,1'-biphenyl]-2-carboxylic acid; 4'-[(1,7'-dimethyl-2'-propyl-1H,3'H-2,5'-bibenzimidazol-3'-yl)methyl]biphenyl-2-carboxylic acid

Indication

Disease Entry	ICD 11	Status	REF
Hypertension	BA00-BA04	Approved	[1]
Malignant essential hypertension	BA00	Approved	[2]
Coronavirus Disease 2019 (COVID-19)	1D6Y	Phase 3	[3]
Stroke	8B20	Investigative	[2]
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Therapeutic Class

Antihypertensive Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 2

Molecular Weight (mw)

514.6

Logarithm of the Partition Coefficient (xlogp)

6.9

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 2: low solubility and high permeability [4]
Clearance: The drug present in the plasma can be removed from the body at the rate of 8.4 mL/min/kg [5]
Elimination: 0.5% of drug is excreted from urine in the unchanged form [4]
Half-life: The concentration or amount of drug in body reduced by one-half in 20 hours [5]
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 2.2207 micromolar/kg/day [6]
Unbound Fraction: The unbound fraction of drug in plasma is 0.004% [5]
Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 5.3 L/kg [5]

Chemical Identifiers

Formula: C33H30N4O2
IUPAC Name: 2-[4-[[4-methyl-6-(1-methylbenzimidazol-2-yl)-2-propylbenzimidazol-1-yl]methyl]phenyl]benzoic acid
Canonical SMILES: CCCC1=NC2=C(N1CC3=CC=C(C=C3)C4=CC=CC=C4C(=O)O)C=C(C=C2C)C5=NC6=CC=CC=C6N5C
InChI: InChI=1S/C33H30N4O2/c1-4-9-30-35-31-21(2)18-24(32-34-27-12-7-8-13-28(27)36(32)3)19-29(31)37(30)20-22-14-16-23(17-15-22)25-10-5-6-11-26(25)33(38)39/h5-8,10-19H,4,9,20H2,1-3H3,(H,38,39)
InChIKey: RMMXLENWKUUMAY-UHFFFAOYSA-N

Cross-matching ID

PubChem CID: 65999
ChEBI ID: CHEBI:9434
CAS Number: 144701-48-4
DrugBank ID: DB00966
TTD ID: D0N6RF
VARIDT ID: DR00248
INTEDE ID: DR1545
ACDINA ID: D00657

Combinatorial Drugs (CBD)

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Repurposed Drugs (RPD)

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Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Angiotensin II receptor type-1 (AGTR1)	TT8DBY3	AGTR1_HUMAN	Antagonist	[7]
HUMAN type-1 angiotensin II receptor (AGTR1)	TTPKMXQ	AGTR1_HUMAN	Blocker	[8]

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Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
Organic anion transporting polypeptide 2B1 (SLCO2B1)	DTPFTEQ	SO2B1_HUMAN	Substrate	[9]
Organic anion transporting polypeptide 1A2 (SLCO1A2)	DTE2B1D	SO1A2_HUMAN	Substrate	[10]
Organic anion transporting polypeptide 1B3 (SLCO1B3)	DT9C1TS	SO1B3_HUMAN	Substrate	[10]

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Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
UDP-glucuronosyltransferase 1A1 (UGT1A1)	DEYGVN4	UD11_HUMAN	Substrate	[11]
UDP-glucuronosyltransferase 1A3 (UGT1A3)	DEF2WXN	UD13_HUMAN	Substrate	[12]

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Drug Off-Target (DOT)

DOT Name	DOT ID	UniProt ID	Interaction	REF
Adiponectin (ADIPOQ)	OTNX23LE	ADIPO_HUMAN	Gene/Protein Processing	[13]
Albumin (ALB)	OTVMM513	ALBU_HUMAN	Gene/Protein Processing	[14]
ATP-binding cassette sub-family G member 1 (ABCG1)	OT5BG6MK	ABCG1_HUMAN	Gene/Protein Processing	[15]
Bile salt export pump (ABCB11)	OTRU7THO	ABCBB_HUMAN	Gene/Protein Processing	[16]
C-C motif chemokine 5 (CCL5)	OTSCA5CK	CCL5_HUMAN	Protein Interaction/Cellular Processes	[17]
C-reactive protein (CRP)	OT0RFT8F	CRP_HUMAN	Gene/Protein Processing	[13]
Cytochrome P450 2J2 (CYP2J2)	OTJBTEH8	CP2J2_HUMAN	Gene/Protein Processing	[18]
Insulin (INS)	OTZ85PDU	INS_HUMAN	Gene/Protein Processing	[19]
Interleukin-8 (CXCL8)	OTS7T5VH	IL8_HUMAN	Gene/Protein Processing	[20]
Natriuretic peptides B (NPPB)	OTSN2IPY	ANFB_HUMAN	Gene/Protein Processing	[21]

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Molecular Interaction Atlas (MIA)

MIA Detail

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Molecular Expression Atlas of This Drug

The Studied Disease

Hypertension

ICD Disease Classification

BA00-BA04

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Angiotensin II receptor type-1 (AGTR1)	DTT	AGTR1	8.95E-01	1.34E-02	0.07
Organic anion transporting polypeptide 2B1 (SLCO2B1)	DTP	OATP2B1	6.30E-05	2.52E-01	5.88E-01
Organic anion transporting polypeptide 1A2 (SLCO1A2)	DTP	OATP1A2	1.16E-03	4.00E-01	4.43E-01
Organic anion transporting polypeptide 1B3 (SLCO1B3)	DTP	OATP1B3	9.69E-01	1.16E-03	3.56E-03
UDP-glucuronosyltransferase 1A1 (UGT1A1)	DME	UGT1A1	1.10E-01	-5.91E-02	-3.60E-01

Molecular Expression Atlas (MEA)

MEA Detail

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Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Telmisartan

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Aliskiren	DM1BV7W	Major	Increased risk of hyperkalemia by the combination of Telmisartan and Aliskiren.	Hypertension [BA00-BA04]	[22]
Captopril	DM458UM	Major	Increased risk of hyperkalemia by the combination of Telmisartan and Captopril.	Hypertension [BA00-BA04]	[23]
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Coadministration of a Drug Treating the Disease Different from Telmisartan (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Insulin-glulisine	DMQI0FU	Moderate	Increased risk of hypoglycemia by the combination of Telmisartan and Insulin-glulisine.	Acute diabete complication [5A2Y]	[24]
Insulin-aspart	DMX7V28	Moderate	Increased risk of hypoglycemia by the combination of Telmisartan and Insulin-aspart.	Acute diabete complication [5A2Y]	[25]
Cariprazine	DMJYDVK	Moderate	Additive hypotensive effects by the combination of Telmisartan and Cariprazine.	Bipolar disorder [6A60]	[26]
Drospirenone	DM1A9W3	Moderate	Increased risk of hyperkalemia by the combination of Telmisartan and Drospirenone.	Contraceptive management [QA21]	[27]
Ardeparin	DMYRX8B	Moderate	Increased risk of hyperkalemia by the combination of Telmisartan and Ardeparin.	Coronary thrombosis [BA43]	[23]
Mycophenolic acid	DMRBMAU	Moderate	Increased metabolism of Telmisartan caused by Mycophenolic acid mediated induction of UGT.	Crohn disease [DD70]	[28]
Selegiline	DM6034S	Moderate	Additive hypotensive effects by the combination of Telmisartan and Selegiline.	Depression [6A70-6A7Z]	[29]
Isocarboxazid	DMAF1NB	Moderate	Additive hypotensive effects by the combination of Telmisartan and Isocarboxazid.	Depression [6A70-6A7Z]	[29]
OPC-34712	DMHG57U	Moderate	Additive hypotensive effects by the combination of Telmisartan and OPC-34712.	Depression [6A70-6A7Z]	[26]
Procarbazine	DMIK367	Moderate	Additive hypotensive effects by the combination of Telmisartan and Procarbazine.	Hodgkin lymphoma [2B30]	[29]
Tolvaptan	DMIWFRL	Moderate	Increased risk of hyperkalemia by the combination of Telmisartan and Tolvaptan.	Hypo-osmolality/hyponatraemia [5C72]	[30]
ITI-007	DMUQ1DO	Moderate	Additive hypotensive effects by the combination of Telmisartan and ITI-007.	Insomnia [7A00-7A0Z]	[26]
Ozanimod	DMT6AM2	Moderate	Additive hypotensive effects by the combination of Telmisartan and Ozanimod.	Multiple sclerosis [8A40]	[29]
Promethazine	DM6I5GR	Moderate	Additive hypotensive effects by the combination of Telmisartan and Promethazine.	Nausea/vomiting [MD90]	[26]
Safinamide	DM0YWJC	Moderate	Additive hypotensive effects by the combination of Telmisartan and Safinamide.	Parkinsonism [8A00]	[29]
Rasagiline	DM3WKQ4	Moderate	Additive hypotensive effects by the combination of Telmisartan and Rasagiline.	Parkinsonism [8A00]	[29]
Levomepromazine	DMIKFEL	Moderate	Additive hypotensive effects by the combination of Telmisartan and Levomepromazine.	Psychotic disorder [6A20-6A25]	[26]
Quetiapine	DM1N62C	Moderate	Additive hypotensive effects by the combination of Telmisartan and Quetiapine.	Schizophrenia [6A20]	[26]
Aripiprazole	DM3NUMH	Moderate	Additive hypotensive effects by the combination of Telmisartan and Aripiprazole.	Schizophrenia [6A20]	[26]
Iloperidone	DM6AUFY	Moderate	Additive hypotensive effects by the combination of Telmisartan and Iloperidone.	Schizophrenia [6A20]	[26]
Paliperidone	DM7NPJS	Moderate	Additive hypotensive effects by the combination of Telmisartan and Paliperidone.	Schizophrenia [6A20]	[26]
Molindone	DMAH70G	Moderate	Additive hypotensive effects by the combination of Telmisartan and Molindone.	Schizophrenia [6A20]	[26]
Thiothixene	DMDINC4	Moderate	Additive hypotensive effects by the combination of Telmisartan and Thiothixene.	Schizophrenia [6A20]	[26]
Amisulpride	DMSJVAM	Moderate	Additive hypotensive effects by the combination of Telmisartan and Amisulpride.	Schizophrenia [6A20]	[26]
Asenapine	DMSQZE2	Moderate	Additive hypotensive effects by the combination of Telmisartan and Asenapine.	Schizophrenia [6A20]	[26]
Insulin-detemir	DMOA4VW	Moderate	Increased risk of hypoglycemia by the combination of Telmisartan and Insulin-detemir.	Type-1/2 diabete [5A10-5A11]	[24]
Insulin degludec	DMPL395	Moderate	Increased risk of hypoglycemia by the combination of Telmisartan and Insulin degludec.	Type-1/2 diabete [5A10-5A11]	[24]
Trimeprazine	DMEMV9D	Moderate	Additive hypotensive effects by the combination of Telmisartan and Trimeprazine.	Vasomotor/allergic rhinitis [CA08]	[31]
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Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Mannitol	E00103	6251	Diluent; Flavoring agent; Lyophilization aid; Plasticizing agent; Tonicity agent
Meglumine	E00181	8567	Buffering agent
Sodium stearyl fumarate	E00545	23665634	lubricant
Beta-D-lactose	E00099	6134	Diluent; Dry powder inhaler carrier; Lyophilization aid
Crospovidone	E00626	Not Available	Disintegrant
Eisenoxyd	E00585	56841934	Colorant
Hexahydric alcohol	E00083	5780	Diluent; Flavoring agent; Humectant; Plasticizing agent
Lactose monohydrate	E00393	104938	Binding agent; Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate	E00208	11177	lubricant
Povidone	E00667	Not Available	Binding agent; Coating agent; Disintegrant; Film/membrane-forming agent; Solubilizing agent; Suspending agent
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Sodium hydroxide	E00234	14798	Alkalizing agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
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⏷ Show the Full List of 13 Pharmaceutical Excipients of This Drug

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Telmisartan 20 mg tablet	20 mg	Oral Tablet	Oral
Telmisartan 40 mg tablet	40 mg	Oral Tablet	Oral
Telmisartan 80 mg tablet	80 mg	Oral Tablet	Oral

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References

1	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 592).
2	Telmisartan FDA Label
3	ClinicalTrials.gov (NCT04359953) Efficacy of Hydroxychloroquine, Telmisartan and Azithromycin on the Survival of Hospitalized Elderly Patients With COVID-19. U.S. National Institutes of Health.
4	BDDCS applied to over 900 drugs
5	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
6	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
7	Deletion of angiotensin II type I receptor reduces hepatic steatosis. J Hepatol. 2009 Jun;50(6):1226-35.
8	Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic. Nat Rev Nephrol. 2020 Apr 3.
9	Establishment of a set of double transfectants coexpressing organic anion transporting polypeptide 1B3 and hepatic efflux transporters for the characterization of the hepatobiliary transport of telmisartan acylglucuronide. Drug Metab Dispos. 2008 Apr;36(4):796-805.
10	Predominant contribution of OATP1B3 to the hepatic uptake of telmisartan, an angiotensin II receptor antagonist, in humans. Drug Metab Dispos. 2006 Jul;34(7):1109-15.
11	The impact of pharmacogenetics of metabolic enzymes and transporters on the pharmacokinetics of telmisartan in healthy volunteers. Pharmacogenet Genomics. 2011 Sep;21(9):523-30.
12	Characterization of in vitro glucuronidation clearance of a range of drugs in human kidney microsomes: comparison with liver and intestinal glucuronidation and impact of albumin. Drug Metab Dispos. 2012 Apr;40(4):825-35.
13	Improvement of endothelial function in patients with hypertension and type 2 diabetes after treatment with telmisartan. Hypertens Res. 2010 Aug;33(8):796-801. doi: 10.1038/hr.2010.107. Epub 2010 Jun 17.
14	Effect of telmisartan on ambulatory blood pressure monitoring, plasma brain natriuretic peptide, and oxidative status of serum albumin in hemodialysis patients. Hypertens Res. 2005 Dec;28(12):987-94. doi: 10.1291/hypres.28.987.
15	Telmisartan ameliorates lipopolysaccharide-induced innate immune response through peroxisome proliferator-activated receptor- activation in human monocytes. J Hypertens. 2012 Jan;30(1):87-96. doi: 10.1097/HJH.0b013e32834dde5f.
16	Interference with bile salt export pump function is a susceptibility factor for human liver injury in drug development. Toxicol Sci. 2010 Dec; 118(2):485-500.
17	Telmisartan inhibits CD4-positive lymphocyte migration independent of the angiotensin type 1 receptor via peroxisome proliferator-activated receptor-gamma. Hypertension. 2008 Feb;51(2):259-66. doi: 10.1161/HYPERTENSIONAHA.107.099028. Epub 2007 Dec 24.
18	Inhibitory effects of antihypertensive drugs on human cytochrome P450 2J2 activity: Potent inhibition by azelnidipine and manidipine. Chem Biol Interact. 2019 Jun 1;306:1-9.
19	Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol. 2005 May 15;4:6. doi: 10.1186/1475-2840-4-6.
20	Toxicological evaluation of acyl glucuronides utilizing half-lives, peptide adducts, and immunostimulation assays. Toxicol In Vitro. 2015 Dec 25;30(1 Pt B):241-9.
21	Comparison of the effects of telmisartan and olmesartan on home blood pressure, glucose, and lipid profiles in patients with hypertension, chronic heart failure, and metabolic syndrome. Hypertens Res. 2008 May;31(5):921-9. doi: 10.1291/hypres.31.921.
22	Health Canada "Potential risks of cardiovascular and renal adverse events in patients with type 2 diabetes treated with aliskiren (RASILEZ) or aliskiren/hydrochlorothiazide (RASILEZ HCT)." .
23	Product Information. Diovan (valsartan). Novartis Pharmaceuticals, East Hanover, NJ.
24	Abad S, Moachon L, Blanche P, Bavoux F, Sicard D, Salmon-Ceron D "Possible interaction between glicazide, fluconazole and sulfamethoxazole resulting in severe hypoglycaemia." Br J Clin Pharmacol 52 (2001): 456-7. [PMID: 11678792]
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26	Aronowitz JS, Chakos MH, Safferman AZ, Lieberman JA "Syncope associated with the combination of clozapine and enalapril." J Clin Psychopharmacol 14 (1994): 429-30. [PMID: 7884028]
27	Product Information. Yasmin (drospirenone-ethinyl estradiol) Berlex Laboratories, Richmond, CA.
28	Cerner Multum, Inc. "Australian Product Information.".
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30	Product Information. Samsca (tolvaptan). Otsuka American Pharmaceuticals Inc, Rockville, MD.
31	Product Information. Clozaril (clozapine). Novartis Pharmaceuticals, East Hanover, NJ.