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IdentificationPharmacologyInteractionsReferencesTrialsEconomicsPropertiesSpectraTaxonomyIdentification
- Name
- Spirapril
- Accession Number
- DB01348
- Type
- Small Molecule
- Groups
- Approved
- Description
Spirapril is an ACE inhibitor antihypertensive drug used to treat hypertension. Like many ACE inhibitors, this is a prodrug which is converted to the active metabolite spiraprilat following oral administration. ACE inhibitors are used primarily in treatment of hypertension and congestive heart failure.
- Structure
Structure for DB01348 (Spirapril)
- Synonyms
- Renormax
- Spirapril
- Product Ingredients
Ingredient UNII CAS InChI Key Spirapril hydrochloride OCC25LM897 94841-17-5 CLDOLNORSLLQDI-OOAIBONUSA-N - International/Other Brands
- Renormax
- Categories
- UNII
- 96U2K78I3V
- CAS number
- 83647-97-6
- Weight
- Average: 466.614
Monoisotopic: 466.15961346 - Chemical Formula
- C22H30N2O5S2
- InChI Key
- HRWCVUIFMSZDJS-SZMVWBNQSA-N
- InChI
- InChI=1S/C22H30N2O5S2/c1-3-29-21(28)17(10-9-16-7-5-4-6-8-16)23-15(2)19(25)24-14-22(30-11-12-31-22)13-18(24)20(26)27/h4-8,15,17-18,23H,3,9-14H2,1-2H3,(H,26,27)/t15-,17-,18-/m0/s1
- IUPAC Name
- (8S)-7-[(2S)-2-{[(2S)-1-ethoxy-1-oxo-4-phenylbutan-2-yl]amino}propanoyl]-1,4-dithia-7-azaspiro[4.4]nonane-8-carboxylic acid
- SMILES
- CCOC(=O)[C@H](CCC1=CC=CC=C1)N[C@@H](C)C(=O)N1CC2(C[C@H]1C(O)=O)SCCS2
Pharmacology
- Indication
Spirapril is an ACE inhibitor class drug used to treat hypertension.
- Pharmacodynamics
Spirapril is an angiotensin-converting enzyme (ACE) inhibitor. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. By blocking ACE, spirapril decreases angiotensin II which is a vasoconstrictor and inducer of aldosterone. So by inhibiting the enzymes, aldosterone secreation is decreased (so less sodium is reabsorbed) and there is a decrease in vasoconstriction. Combined, this leades to a decrease in blood pressure.
- Mechanism of action
Spiraprilat, the active metabolite of spirapril, competes with angiotensin I for binding at the angiotensin-converting enzyme, blocking the conversion of angiotensin I to angiotensin II. Inhibition of ACE results in decreased plasma angiotensin II. As angiotensin II is a vasoconstrictor and a negative-feedback mediator for renin activity, lower concentrations result in a decrease in blood pressure and stimulation of baroreceptor reflex mechanisms, which leads to decreased vasopressor activity and to decreased aldosterone secretion. Spiraprilat may also act on kininase II, an enzyme identical to ACE that degrades the vasodilator bradykinin.
Target Actions Organism AAngiotensin-converting enzyme inhibitorHuman - Absorption
Bioavailability is 50% following oral administration.
- Volume of distribution
- Not Available
- Protein binding
- Not Available
- Metabolism
Hepatic. Converted to spiraprilat following oral administration.
- Route of elimination
- Not Available
- Half life
30 to 35 hours
- Clearance
- Not Available
- Toxicity
- Not Available
- Affected organisms
- Humans and other mammals
- Pathways
Pathway Category Spirapril Action Pathway Drug action Spirapril Metabolism Pathway Drug metabolism Spirapril Action Pathway Drug action Spirapril Metabolism Pathway Drug metabolism - Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
Drug Interaction Drug group (4R)-limonene The risk or severity of adverse effects can be increased when (4R)-limonene is combined with Spirapril. Investigational 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the hypotensive activities of Spirapril. Experimental Abacavir The serum concentration of Abacavir can be decreased when it is combined with Spirapril. Approved, Investigational Acebutolol Acebutolol may increase the hypotensive activities of Spirapril. Approved, Investigational Aceclofenac The risk or severity of adverse effects can be increased when Aceclofenac is combined with Spirapril. Approved, Investigational Acemetacin The therapeutic efficacy of Spirapril can be decreased when used in combination with Acemetacin. Approved, Experimental, Investigational Acetylsalicylic acid The therapeutic efficacy of Spirapril can be decreased when used in combination with Acetylsalicylic acid. Approved, Vet Approved Adapalene The risk or severity of adverse effects can be increased when Adapalene is combined with Spirapril. Approved Alclofenac The risk or severity of adverse effects can be increased when Alclofenac is combined with Spirapril. Approved, Withdrawn Alfuzosin The serum concentration of Alfuzosin can be increased when it is combined with Spirapril. Approved, Investigational Aliskiren Aliskiren may increase the hypotensive, nephrotoxic, and hyperkalemic activities of Spirapril. Approved, Investigational Allopurinol The risk of a hypersensitivity reaction to Allopurinol is increased when it is combined with Spirapril. Approved Alminoprofen The risk or severity of adverse effects can be increased when Alminoprofen is combined with Spirapril. Experimental Alogliptin The risk or severity of adverse effects can be increased when Alogliptin is combined with Spirapril. Approved Aloxiprin The therapeutic efficacy of Spirapril can be decreased when used in combination with Aloxiprin. Experimental Alprazolam The serum concentration of Alprazolam can be increased when it is combined with Spirapril. Approved, Illicit, Investigational Alprenolol Alprenolol may increase the hypotensive activities of Spirapril. Approved, Withdrawn Aluminum hydroxide Aluminum hydroxide can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved, Investigational Ambrisentan Spirapril may increase the hypotensive activities of Ambrisentan. Approved, Investigational Ambroxol acefyllinate The serum concentration of Ambroxol acefyllinate can be decreased when it is combined with Spirapril. Experimental, Investigational Amifostine Spirapril may increase the hypotensive activities of Amifostine. Approved, Investigational Amiloride Amiloride may increase the hyperkalemic activities of Spirapril. Approved Amineptine The serum concentration of Amineptine can be increased when it is combined with Spirapril. Illicit, Withdrawn Aminophylline The serum concentration of Aminophylline can be decreased when it is combined with Spirapril. Approved Aminosalicylic Acid The therapeutic efficacy of Spirapril can be decreased when used in combination with Aminosalicylic Acid. Approved Amitriptyline The serum concentration of Amitriptyline can be increased when it is combined with Spirapril. Approved Amitriptylinoxide The serum concentration of Amitriptylinoxide can be increased when it is combined with Spirapril. Approved, Investigational Amlodipine Amlodipine may increase the hypotensive activities of Spirapril. Approved Amoxapine The serum concentration of Amoxapine can be increased when it is combined with Spirapril. Approved Amphetamine Amphetamine may increase the hypotensive activities of Spirapril. Approved, Illicit, Investigational Andrographolide The risk or severity of adverse effects can be increased when Andrographolide is combined with Spirapril. Investigational Anisodamine The risk or severity of adverse effects can be increased when Anisodamine is combined with Spirapril. Investigational Antipyrine The risk or severity of adverse effects can be increased when Antipyrine is combined with Spirapril. Approved, Investigational Apocynin The risk or severity of adverse effects can be increased when Apocynin is combined with Spirapril. Investigational Apremilast The risk or severity of adverse effects can be increased when Apremilast is combined with Spirapril. Approved, Investigational Aprotinin Aprotinin may decrease the antihypertensive activities of Spirapril. Approved, Investigational, Withdrawn Atenolol Atenolol may increase the hypotensive activities of Spirapril. Approved Atorvastatin The risk or severity of adverse effects can be increased when Atorvastatin is combined with Spirapril. Approved Avanafil Avanafil may increase the antihypertensive activities of Spirapril. Approved Azapropazone The risk or severity of adverse effects can be increased when Azapropazone is combined with Spirapril. Withdrawn Azathioprine The risk or severity of anemia and severe leukopenia can be increased when Spirapril is combined with Azathioprine. Approved Azelastine The risk or severity of adverse effects can be increased when Azelastine is combined with Spirapril. Approved Azilsartan medoxomil The risk or severity of adverse effects can be increased when Azilsartan medoxomil is combined with Spirapril. Approved, Investigational Azosemide Azosemide may increase the hypotensive activities of Spirapril. Investigational Balsalazide The risk or severity of adverse effects can be increased when Balsalazide is combined with Spirapril. Approved, Investigational Barnidipine Spirapril may increase the antihypertensive activities of Barnidipine. Approved Benazepril Benazepril may increase the hypotensive activities of Spirapril. Approved, Investigational Bendazac The risk or severity of adverse effects can be increased when Bendazac is combined with Spirapril. Experimental Bendroflumethiazide The risk or severity of hypotension can be increased when Bendroflumethiazide is combined with Spirapril. Approved Benorilate The risk or severity of adverse effects can be increased when Benorilate is combined with Spirapril. Experimental Benoxaprofen The risk or severity of adverse effects can be increased when Benoxaprofen is combined with Spirapril. Withdrawn Benzthiazide The risk or severity of hypotension can be increased when Benzthiazide is combined with Spirapril. Approved Benzydamine The risk or severity of adverse effects can be increased when Benzydamine is combined with Spirapril. Approved Bepridil Bepridil may increase the hypotensive activities of Spirapril. Approved, Withdrawn Betaxolol Betaxolol may increase the hypotensive activities of Spirapril. Approved, Investigational Bethanidine Bethanidine may increase the hypotensive activities of Spirapril. Approved Bevonium The risk or severity of adverse effects can be increased when Bevonium is combined with Spirapril. Experimental Bietaserpine Bietaserpine may increase the hypotensive activities of Spirapril. Experimental Bimatoprost Bimatoprost may increase the hypotensive activities of Spirapril. Approved, Investigational Bisoprolol Bisoprolol may increase the hypotensive activities of Spirapril. Approved Boceprevir The serum concentration of Spirapril can be decreased when it is combined with Boceprevir. Approved, Withdrawn Bosentan Bosentan may increase the hypotensive activities of Spirapril. Approved, Investigational BQ-123 Spirapril may increase the hypotensive activities of BQ-123. Investigational Bretylium Bretylium may increase the hypotensive activities of Spirapril. Approved Brimonidine Brimonidine may increase the antihypertensive activities of Spirapril. Approved Brofaromine Brofaromine may increase the hypotensive activities of Spirapril. Experimental Bromfenac The risk or severity of adverse effects can be increased when Bromfenac is combined with Spirapril. Approved Bromocriptine The serum concentration of Bromocriptine can be increased when it is combined with Spirapril. Approved, Investigational Bucillamine The risk or severity of adverse effects can be increased when Bucillamine is combined with Spirapril. Investigational Bufexamac The risk or severity of adverse effects can be increased when Bufexamac is combined with Spirapril. Approved, Experimental Bumadizone The risk or severity of adverse effects can be increased when Bumadizone is combined with Spirapril. Experimental Bumetanide Bumetanide may increase the hypotensive activities of Spirapril. Approved Bupranolol Spirapril may increase the hypotensive activities of Bupranolol. Approved Butriptyline The serum concentration of Butriptyline can be increased when it is combined with Spirapril. Approved Cabergoline The serum concentration of Cabergoline can be increased when it is combined with Spirapril. Approved Cadralazine Cadralazine may increase the hypotensive activities of Spirapril. Experimental Cafedrine Spirapril may increase the hypotensive activities of Cafedrine. Investigational Calcium Carbonate Calcium Carbonate can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved, Investigational Canagliflozin The risk or severity of renal failure and hyperkalemia can be increased when Canagliflozin is combined with Spirapril. Approved Candesartan The risk or severity of adverse effects can be increased when Candesartan is combined with Spirapril. Experimental Candesartan cilexetil The risk or severity of adverse effects can be increased when Candesartan cilexetil is combined with Spirapril. Approved Candoxatril Candoxatril may increase the hypotensive activities of Spirapril. Experimental Captopril Captopril may increase the hypotensive activities of Spirapril. Approved Carbaspirin calcium The therapeutic efficacy of Spirapril can be decreased when used in combination with Carbaspirin calcium. Experimental, Investigational Carprofen The risk or severity of adverse effects can be increased when Carprofen is combined with Spirapril. Approved, Vet Approved, Withdrawn Carteolol Carteolol may increase the hypotensive activities of Spirapril. Approved Carvedilol Carvedilol may increase the hypotensive activities of Spirapril. Approved, Investigational Castanospermine The risk or severity of adverse effects can be increased when Castanospermine is combined with Spirapril. Experimental Celecoxib The risk or severity of adverse effects can be increased when Celecoxib is combined with Spirapril. Approved, Investigational Celiprolol Spirapril may increase the hypotensive activities of Celiprolol. Approved, Investigational Chloroquine The risk or severity of adverse effects can be increased when Chloroquine is combined with Spirapril. Approved, Investigational, Vet Approved Chlorothiazide The risk or severity of hypotension can be increased when Chlorothiazide is combined with Spirapril. Approved, Vet Approved Chlorthalidone The risk or severity of hypotension can be increased when Chlorthalidone is combined with Spirapril. Approved Choline magnesium trisalicylate The risk or severity of adverse effects can be increased when Choline magnesium trisalicylate is combined with Spirapril. Approved Cicletanine Spirapril may increase the hypotensive activities of Cicletanine. Investigational Cilazapril Cilazapril may increase the hypotensive activities of Spirapril. Approved Ciprofloxacin The risk or severity of hyperkalemia can be increased when Spirapril is combined with Ciprofloxacin. Approved, Investigational Clarithromycin The therapeutic efficacy of Clarithromycin can be decreased when used in combination with Spirapril. Approved Clomipramine The serum concentration of Clomipramine can be increased when it is combined with Spirapril. Approved, Investigational, Vet Approved Clonidine Clonidine may increase the hypotensive activities of Spirapril. Approved Clonixin The risk or severity of adverse effects can be increased when Clonixin is combined with Spirapril. Approved Cloranolol Spirapril may increase the hypotensive activities of Cloranolol. Experimental Cryptenamine Cryptenamine may increase the hypotensive activities of Spirapril. Approved Curcumin The risk or severity of adverse effects can be increased when Curcumin is combined with Spirapril. Approved, Investigational Cyclopenthiazide The risk or severity of hypotension can be increased when Cyclopenthiazide is combined with Spirapril. Experimental Cyclophosphamide The risk or severity of adverse effects can be increased when Spirapril is combined with Cyclophosphamide. Approved, Investigational Cyclosporine The risk or severity of hyperkalemia can be increased when Spirapril is combined with Cyclosporine. Approved, Investigational, Vet Approved Dapagliflozin The risk or severity of renal failure and hyperkalemia can be increased when Dapagliflozin is combined with Spirapril. Approved Dapoxetine Dapoxetine may increase the orthostatic hypotensive activities of Spirapril. Investigational Debrisoquin Debrisoquin may increase the hypotensive activities of Spirapril. Approved, Investigational Delapril Spirapril may increase the hypotensive activities of Delapril. Investigational Delavirdine The serum concentration of Delavirdine can be decreased when it is combined with Spirapril. Approved Dersalazine The therapeutic efficacy of Spirapril can be decreased when used in combination with Dersalazine. Investigational Deserpidine Spirapril may increase the hypotensive activities of Deserpidine. Approved Desipramine The serum concentration of Desipramine can be increased when it is combined with Spirapril. Approved, Investigational Dexniguldipine Spirapril may increase the hypotensive activities of Dexniguldipine. Experimental Diazoxide Diazoxide may increase the hypotensive activities of Spirapril. Approved Dibenzepin The serum concentration of Dibenzepin can be increased when it is combined with Spirapril. Experimental Diclofenac The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Diclofenac is combined with Spirapril. Approved, Vet Approved Diethylnorspermine Spirapril may increase the hypotensive activities of Diethylnorspermine. Investigational Diethylstilbestrol The serum concentration of Diethylstilbestrol can be decreased when it is combined with Spirapril. Approved, Investigational Difenpiramide The risk or severity of adverse effects can be increased when Difenpiramide is combined with Spirapril. Experimental Diflunisal The therapeutic efficacy of Spirapril can be decreased when used in combination with Diflunisal. Approved, Investigational Digoxin The serum concentration of Digoxin can be increased when it is combined with Spirapril. Approved Dihydralazine Dihydralazine may increase the hypotensive activities of Spirapril. Approved, Investigational Dihydroergotamine The serum concentration of Dihydroergotamine can be increased when it is combined with Spirapril. Approved, Investigational Diltiazem Diltiazem may increase the hypotensive activities of Spirapril. Approved, Investigational Dimetacrine The serum concentration of Dimetacrine can be increased when it is combined with Spirapril. Approved, Withdrawn Dipyridamole Dipyridamole may increase the antihypertensive activities of Spirapril. Approved Dorzolamide Dorzolamide may increase the hypotensive activities of Spirapril. Approved Dosulepin The serum concentration of Dosulepin can be increased when it is combined with Spirapril. Approved Doxazosin Doxazosin may increase the hypotensive activities of Spirapril. Approved Doxepin The serum concentration of Doxepin can be increased when it is combined with Spirapril. Approved, Investigational Drospirenone Spirapril may increase the hyperkalemic activities of Drospirenone. Approved Droxicam The risk or severity of adverse effects can be increased when Droxicam is combined with Spirapril. Withdrawn Duvelisib The risk or severity of adverse effects can be increased when Duvelisib is combined with Spirapril. Investigational Dyphylline The serum concentration of Dyphylline can be decreased when it is combined with Spirapril. Approved E-6201 The risk or severity of adverse effects can be increased when E-6201 is combined with Spirapril. Investigational Efonidipine Spirapril may increase the hypotensive activities of Efonidipine. Approved, Investigational Empagliflozin The risk or severity of renal failure and hyperkalemia can be increased when Empagliflozin is combined with Spirapril. Approved Enalaprilat Spirapril may increase the hypotensive activities of Enalaprilat. Approved Endralazine Endralazine may increase the hypotensive activities of Spirapril. Experimental Enfuvirtide The serum concentration of Enfuvirtide can be increased when it is combined with Spirapril. Approved, Investigational Epanolol Spirapril may increase the hypotensive activities of Epanolol. Experimental Epirizole The risk or severity of adverse effects can be increased when Epirizole is combined with Spirapril. Approved Epitizide The risk or severity of hypotension can be increased when Epitizide is combined with Spirapril. Experimental Eplerenone Eplerenone may increase the hyperkalemic activities of Spirapril. Approved Epoprostenol Epoprostenol may increase the hypotensive activities of Spirapril. Approved Eprosartan The risk or severity of adverse effects can be increased when Eprosartan is combined with Spirapril. Approved Ergoloid mesylate The serum concentration of Ergoloid mesylate can be increased when it is combined with Spirapril. Approved Ergonovine The serum concentration of Ergonovine can be increased when it is combined with Spirapril. Approved Ergotamine The serum concentration of Ergotamine can be increased when it is combined with Spirapril. Approved Estradiol cypionate The serum concentration of Estradiol cypionate can be decreased when it is combined with Spirapril. Approved, Investigational, Vet Approved Estradiol valerate The serum concentration of Estradiol valerate can be decreased when it is combined with Spirapril. Approved, Investigational, Vet Approved Etacrynic acid Etacrynic acid may increase the hypotensive activities of Spirapril. Approved, Investigational Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Spirapril. Approved, Investigational Ethenzamide The risk or severity of adverse effects can be increased when Ethenzamide is combined with Spirapril. Experimental Etodolac The risk or severity of adverse effects can be increased when Etodolac is combined with Spirapril. Approved, Investigational, Vet Approved Etofenamate The risk or severity of adverse effects can be increased when Etofenamate is combined with Spirapril. Approved, Investigational Etoricoxib The risk or severity of adverse effects can be increased when Etoricoxib is combined with Spirapril. Approved, Investigational Etravirine The serum concentration of Etravirine can be decreased when it is combined with Spirapril. Approved Evening primrose oil The risk or severity of adverse effects can be increased when Evening primrose oil is combined with Spirapril. Investigational, Nutraceutical Everolimus The risk or severity of adverse effects can be increased when Everolimus is combined with Spirapril. Approved Exisulind The risk or severity of adverse effects can be increased when Exisulind is combined with Spirapril. Investigational Felbinac The risk or severity of adverse effects can be increased when Felbinac is combined with Spirapril. Experimental Felodipine Felodipine may increase the hypotensive activities of Spirapril. Approved, Investigational Fenbufen The risk or severity of adverse effects can be increased when Fenbufen is combined with Spirapril. Approved Fenoldopam Fenoldopam may increase the hypotensive activities of Spirapril. Approved Fenoprofen The risk or severity of adverse effects can be increased when Fenoprofen is combined with Spirapril. Approved Fentiazac The risk or severity of adverse effects can be increased when Fentiazac is combined with Spirapril. Experimental Feprazone The risk or severity of adverse effects can be increased when Feprazone is combined with Spirapril. Experimental Ferulic acid Spirapril may increase the hypotensive activities of Ferulic acid. Experimental Fimasartan The risk or severity of adverse effects can be increased when Fimasartan is combined with Spirapril. Approved, Investigational Floctafenine The risk or severity of adverse effects can be increased when Floctafenine is combined with Spirapril. Approved, Withdrawn Flunixin The risk or severity of adverse effects can be increased when Flunixin is combined with Spirapril. Vet Approved Flunoxaprofen The risk or severity of adverse effects can be increased when Flunoxaprofen is combined with Spirapril. Experimental Flurbiprofen The risk or severity of adverse effects can be increased when Flurbiprofen is combined with Spirapril. Approved, Investigational Forasartan The risk or severity of adverse effects can be increased when Forasartan is combined with Spirapril. Experimental Fosinopril Fosinopril may increase the hypotensive activities of Spirapril. Approved Fostamatinib Fostamatinib may increase the antihypertensive activities of Spirapril. Approved, Investigational Furazolidone Furazolidone may increase the hypotensive activities of Spirapril. Approved, Investigational, Vet Approved Furosemide Furosemide may increase the hypotensive activities of Spirapril. Approved, Vet Approved Garlic The serum concentration of Spirapril can be decreased when it is combined with Garlic. Approved, Nutraceutical Guacetisal The therapeutic efficacy of Spirapril can be decreased when used in combination with Guacetisal. Experimental Guanabenz Guanabenz may increase the hypotensive activities of Spirapril. Approved, Investigational Guanadrel Guanadrel may increase the hypotensive activities of Spirapril. Approved Guanazodine Spirapril may increase the hypotensive activities of Guanazodine. Experimental Guanethidine Guanethidine may increase the hypotensive activities of Spirapril. Approved Guanfacine Guanfacine may increase the hypotensive activities of Spirapril. Approved, Investigational Guanoclor Spirapril may increase the hypotensive activities of Guanoclor. Experimental Guanoxabenz Spirapril may increase the hypotensive activities of Guanoxabenz. Experimental Guanoxan Spirapril may increase the hypotensive activities of Guanoxan. Experimental Harmaline Harmaline may increase the hypotensive activities of Spirapril. Experimental Hemoglobin crosfumaril The therapeutic efficacy of Spirapril can be decreased when used in combination with Hemoglobin crosfumaril. Experimental Heparin The risk or severity of hyperkalemia can be increased when Spirapril is combined with Heparin. Approved, Investigational Hexamethonium Spirapril may increase the hypotensive activities of Hexamethonium. Experimental Higenamine The risk or severity of adverse effects can be increased when Higenamine is combined with Spirapril. Investigational Hydracarbazine Hydracarbazine may increase the hypotensive activities of Spirapril. Experimental Hydralazine Hydralazine may increase the hypotensive activities of Spirapril. Approved Hydrochlorothiazide The risk or severity of hypotension can be increased when Hydrochlorothiazide is combined with Spirapril. Approved, Vet Approved Hydroflumethiazide The risk or severity of hypotension can be increased when Hydroflumethiazide is combined with Spirapril. Approved, Investigational Ibuprofen The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Ibuprofen is combined with Spirapril. Approved Ibuproxam The risk or severity of adverse effects can be increased when Ibuproxam is combined with Spirapril. Withdrawn Icatibant Icatibant may decrease the antihypertensive activities of Spirapril. Approved, Investigational Iloprost Iloprost may increase the hypotensive activities of Spirapril. Approved, Investigational Imidapril Spirapril may increase the hypotensive activities of Imidapril. Investigational Imidazole salicylate The risk or severity of adverse effects can be increased when Imidazole salicylate is combined with Spirapril. Experimental Imipramine The serum concentration of Imipramine can be increased when it is combined with Spirapril. Approved Indapamide The risk or severity of hypotension can be increased when Indapamide is combined with Spirapril. Approved Indenolol Spirapril may increase the hypotensive activities of Indenolol. Withdrawn Indobufen The risk or severity of adverse effects can be increased when Indobufen is combined with Spirapril. Investigational Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Spirapril. Approved, Investigational Indoprofen The risk or severity of adverse effects can be increased when Indoprofen is combined with Spirapril. Withdrawn Indoramin Indoramin may increase the hypotensive activities of Spirapril. Withdrawn Iprindole The serum concentration of Iprindole can be increased when it is combined with Spirapril. Experimental Iproclozide Iproclozide may increase the hypotensive activities of Spirapril. Withdrawn Iproniazid Iproniazid may increase the hypotensive activities of Spirapril. Withdrawn Irbesartan The risk or severity of adverse effects can be increased when Irbesartan is combined with Spirapril. Approved, Investigational Iron Iron can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved Iron Dextran The risk or severity of adverse effects can be increased when Spirapril is combined with Iron Dextran. Approved, Vet Approved Isocarboxazid Isocarboxazid may increase the hypotensive activities of Spirapril. Approved Isoxicam The risk or severity of adverse effects can be increased when Isoxicam is combined with Spirapril. Withdrawn Isradipine Isradipine may increase the hypotensive activities of Spirapril. Approved, Investigational Kebuzone The risk or severity of adverse effects can be increased when Kebuzone is combined with Spirapril. Experimental Ketanserin Ketanserin may increase the hypotensive activities of Spirapril. Investigational Ketoprofen The risk or severity of adverse effects can be increased when Ketoprofen is combined with Spirapril. Approved, Vet Approved Ketorolac The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Ketorolac is combined with Spirapril. Approved Labetalol Labetalol may increase the hypotensive activities of Spirapril. Approved Lacidipine Spirapril may increase the hypotensive activities of Lacidipine. Approved, Investigational Lanthanum carbonate The serum concentration of Spirapril can be decreased when it is combined with Lanthanum carbonate. Approved Latanoprost Latanoprost may increase the hypotensive activities of Spirapril. Approved, Investigational Leflunomide The risk or severity of adverse effects can be increased when Leflunomide is combined with Spirapril. Approved, Investigational Lercanidipine Lercanidipine may increase the hypotensive activities of Spirapril. Approved, Investigational Linagliptin The risk or severity of adverse effects can be increased when Linagliptin is combined with Spirapril. Approved Linsidomine Spirapril may increase the hypotensive activities of Linsidomine. Experimental Lisinopril Lisinopril may increase the hypotensive activities of Spirapril. Approved, Investigational Lisofylline The risk or severity of adverse effects can be increased when Lisofylline is combined with Spirapril. Investigational Lithium cation The serum concentration of Lithium can be increased when it is combined with Spirapril. Experimental Lofepramine The serum concentration of Lofepramine can be increased when it is combined with Spirapril. Experimental Lofexidine Spirapril may increase the hypotensive activities of Lofexidine. Approved, Investigational Lonazolac The risk or severity of adverse effects can be increased when Lonazolac is combined with Spirapril. Experimental Lornoxicam The risk or severity of adverse effects can be increased when Lornoxicam is combined with Spirapril. Approved, Investigational Losartan The risk or severity of adverse effects can be increased when Losartan is combined with Spirapril. Approved Lovastatin The serum concentration of Lovastatin can be increased when it is combined with Spirapril. Approved, Investigational Loxoprofen The risk or severity of adverse effects can be increased when Loxoprofen is combined with Spirapril. Approved, Investigational Lumiracoxib The risk or severity of adverse effects can be increased when Lumiracoxib is combined with Spirapril. Approved, Investigational Macitentan Spirapril may increase the hypotensive activities of Macitentan. Approved Magnesium carbonate Magnesium carbonate can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved, Investigational Magnesium hydroxide Magnesium hydroxide can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved, Investigational Magnesium salicylate The risk or severity of adverse effects can be increased when Magnesium salicylate is combined with Spirapril. Approved Magnesium Trisilicate Magnesium Trisilicate can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved Manidipine Spirapril may increase the hypotensive activities of Manidipine. Approved, Investigational Masoprocol The risk or severity of adverse effects can be increased when Masoprocol is combined with Spirapril. Approved, Investigational Mebanazine Mebanazine may increase the hypotensive activities of Spirapril. Withdrawn Mecamylamine Mecamylamine may increase the hypotensive activities of Spirapril. Approved, Investigational Meclofenamic acid The risk or severity of adverse effects can be increased when Meclofenamic acid is combined with Spirapril. Approved, Vet Approved Mefenamic acid The risk or severity of adverse effects can be increased when Mefenamic acid is combined with Spirapril. Approved Melitracen The serum concentration of Melitracen can be increased when it is combined with Spirapril. Experimental, Investigational Meloxicam The risk or severity of adverse effects can be increased when Meloxicam is combined with Spirapril. Approved, Vet Approved Mesalazine The therapeutic efficacy of Spirapril can be decreased when used in combination with Mesalazine. Approved Mestranol The serum concentration of Mestranol can be decreased when it is combined with Spirapril. Approved Metamizole The risk or severity of adverse effects can be increased when Metamizole is combined with Spirapril. Approved, Investigational, Withdrawn Methoserpidine Spirapril may increase the hypotensive activities of Methoserpidine. Experimental Methyclothiazide The risk or severity of hypotension can be increased when Methyclothiazide is combined with Spirapril. Approved Methyl salicylate The risk or severity of renal failure can be increased when Methyl salicylate is combined with Spirapril. Approved, Vet Approved Methyldopa Methyldopa may increase the hypotensive activities of Spirapril. Approved Methylene blue Methylene blue may increase the hypotensive activities of Spirapril. Approved, Investigational Methylergometrine The serum concentration of Methylergometrine can be increased when it is combined with Spirapril. Approved Methylphenidate Methylphenidate may decrease the antihypertensive activities of Spirapril. Approved, Investigational Metipranolol Metipranolol may increase the hypotensive activities of Spirapril. Approved Metolazone The risk or severity of hypotension can be increased when Metolazone is combined with Spirapril. Approved Metoprolol Metoprolol may increase the hypotensive activities of Spirapril. Approved, Investigational Metyrosine Spirapril may increase the hypotensive activities of Metyrosine. Approved Mibefradil Spirapril may increase the hypotensive activities of Mibefradil. Investigational, Withdrawn Midazolam The serum concentration of Midazolam can be increased when it is combined with Spirapril. Approved, Illicit Minaprine Minaprine may increase the hypotensive activities of Spirapril. Approved Minoxidil Minoxidil may increase the hypotensive activities of Spirapril. Approved, Investigational Mirodenafil Mirodenafil may increase the antihypertensive activities of Spirapril. Investigational Mizoribine The risk or severity of adverse effects can be increased when Mizoribine is combined with Spirapril. Investigational Moclobemide Moclobemide may increase the hypotensive activities of Spirapril. Approved, Investigational Moexipril Moexipril may increase the hypotensive activities of Spirapril. Approved Mofebutazone The risk or severity of adverse effects can be increased when Mofebutazone is combined with Spirapril. Experimental Molsidomine Molsidomine may increase the hypotensive activities of Spirapril. Approved, Investigational Moxonidine Moxonidine may increase the hypotensive activities of Spirapril. Approved, Investigational Muzolimine Spirapril may increase the hypotensive activities of Muzolimine. Experimental Mycophenolate mofetil The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Spirapril. Approved, Investigational Mycophenolic acid The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Spirapril. Approved Nabumetone The risk or severity of adverse effects can be increased when Nabumetone is combined with Spirapril. Approved Nadolol Nadolol may increase the hypotensive activities of Spirapril. Approved Nafamostat The risk or severity of adverse effects can be increased when Nafamostat is combined with Spirapril. Approved, Investigational Naftifine The risk or severity of adverse effects can be increased when Naftifine is combined with Spirapril. Approved Naftopidil Spirapril may increase the hypotensive activities of Naftopidil. Investigational Naproxen The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Naproxen is combined with Spirapril. Approved, Vet Approved Nebivolol Spirapril may increase the hypotensive activities of Nebivolol. Approved, Investigational Nefazodone The serum concentration of Nefazodone can be increased when it is combined with Spirapril. Approved, Withdrawn Nepafenac The risk or severity of adverse effects can be increased when Nepafenac is combined with Spirapril. Approved, Investigational Nialamide Nialamide may increase the hypotensive activities of Spirapril. Withdrawn Nicardipine Nicardipine may increase the hypotensive activities of Spirapril. Approved, Investigational Nicorandil Nicorandil may increase the vasodilatory activities of Spirapril. Approved, Investigational Nifenazone The risk or severity of adverse effects can be increased when Nifenazone is combined with Spirapril. Experimental Niflumic Acid The risk or severity of adverse effects can be increased when Niflumic Acid is combined with Spirapril. Approved Niguldipine Spirapril may increase the hypotensive activities of Niguldipine. Experimental Nilvadipine Spirapril may increase the hypotensive activities of Nilvadipine. Approved, Investigational Nimesulide The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Nimesulide is combined with Spirapril. Approved, Investigational, Withdrawn Nimodipine Nimodipine may increase the hypotensive activities of Spirapril. Approved, Investigational Nisoldipine Nisoldipine may increase the hypotensive activities of Spirapril. Approved Nitrendipine Nitrendipine may increase the hypotensive activities of Spirapril. Approved, Investigational Nitroaspirin The therapeutic efficacy of Spirapril can be decreased when used in combination with Nitroaspirin. Investigational Nitroprusside Nitroprusside may increase the hypotensive activities of Spirapril. Approved, Investigational Nortriptyline The serum concentration of Nortriptyline can be increased when it is combined with Spirapril. Approved Obinutuzumab Spirapril may increase the hypotensive activities of Obinutuzumab. Approved, Investigational Octamoxin Octamoxin may increase the hypotensive activities of Spirapril. Withdrawn Olmesartan The risk or severity of adverse effects can be increased when Olmesartan is combined with Spirapril. Approved, Investigational Olopatadine The risk or severity of adverse effects can be increased when Olopatadine is combined with Spirapril. Approved Olsalazine The risk or severity of adverse effects can be increased when Olsalazine is combined with Spirapril. Approved Omapatrilat Omapatrilat may increase the hypotensive activities of Spirapril. Investigational Omeprazole Omeprazole can cause a decrease in the absorption of Spirapril resulting in a reduced serum concentration and potentially a decrease in efficacy. Approved, Investigational, Vet Approved Opipramol The serum concentration of Opipramol can be increased when it is combined with Spirapril. Investigational Orgotein The risk or severity of adverse effects can be increased when Orgotein is combined with Spirapril. Vet Approved Oxaprozin The risk or severity of adverse effects can be increased when Oxaprozin is combined with Spirapril. Approved Oxprenolol Spirapril may increase the hypotensive activities of Oxprenolol. Approved Oxyphenbutazone The risk or severity of adverse effects can be increased when Oxyphenbutazone is combined with Spirapril. Approved, Withdrawn Palmidrol The risk or severity of adverse effects can be increased when Palmidrol is combined with Spirapril. Experimental, Nutraceutical Parecoxib The risk or severity of adverse effects can be increased when Parecoxib is combined with Spirapril. Approved Pargyline Pargyline may increase the hypotensive activities of Spirapril. Approved Parthenolide The risk or severity of adverse effects can be increased when Parthenolide is combined with Spirapril. Approved, Investigational Patent Blue The therapeutic efficacy of Spirapril can be decreased when used in combination with Patent Blue. Approved Penbutolol Spirapril may increase the hypotensive activities of Penbutolol. Approved, Investigational Pentolinium Pentolinium may increase the hypotensive activities of Spirapril. Approved Pentoxifylline Pentoxifylline may increase the hypotensive activities of Spirapril. Approved, Investigational Perindopril Perindopril may increase the hypotensive activities of Spirapril. Approved Pethidine The risk or severity of adverse effects can be increased when Spirapril is combined with Pethidine. Approved Phenelzine Phenelzine may increase the hypotensive activities of Spirapril. Approved Pheniprazine Pheniprazine may increase the hypotensive activities of Spirapril. Withdrawn Phenoxybenzamine Phenoxybenzamine may increase the hypotensive activities of Spirapril. Approved Phenoxypropazine Phenoxypropazine may increase the hypotensive activities of Spirapril. Withdrawn Phentolamine Phentolamine may increase the hypotensive activities of Spirapril. Approved Phenyl aminosalicylate The therapeutic efficacy of Spirapril can be decreased when used in combination with Phenyl aminosalicylate. Approved Phenylbutazone The risk or severity of adverse effects can be increased when Phenylbutazone is combined with Spirapril. Approved, Vet Approved Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Spirapril. Approved, Investigational Pinacidil Pinacidil may increase the hypotensive activities of Spirapril. Approved Pindolol Pindolol may increase the hypotensive activities of Spirapril. Approved, Investigational Piretanide Piretanide may increase the hypotensive activities of Spirapril. Approved Pirfenidone The risk or severity of adverse effects can be increased when Pirfenidone is combined with Spirapril. Approved, Investigational Pirlindole Pirlindole may increase the hypotensive activities of Spirapril. Approved Piroxicam The risk or severity of adverse effects can be increased when Piroxicam is combined with Spirapril. Approved, Investigational Pirprofen The risk or severity of adverse effects can be increased when Pirprofen is combined with Spirapril. Experimental Pivhydrazine Pivhydrazine may increase the hypotensive activities of Spirapril. Withdrawn Platelet Activating Factor Spirapril may increase the hypotensive activities of Platelet Activating Factor. Experimental Polythiazide The risk or severity of hypotension can be increased when Polythiazide is combined with Spirapril. Approved Potassium bicarbonate Potassium bicarbonate may increase the hyperkalemic activities of Spirapril. Approved Potassium cation Potassium may increase the hyperkalemic activities of Spirapril. Approved, Investigational Potassium Chloride The risk or severity of hyperkalemia can be increased when Potassium Chloride is combined with Spirapril. Approved, Withdrawn Potassium Citrate Potassium Citrate may increase the hyperkalemic activities of Spirapril. Approved, Investigational, Vet Approved Pranoprofen The risk or severity of adverse effects can be increased when Pranoprofen is combined with Spirapril. Experimental, Investigational Prazosin Prazosin may increase the hypotensive activities of Spirapril. Approved Pregabalin The risk or severity of angioedema can be increased when Spirapril is combined with Pregabalin. Approved, Illicit, Investigational Procaine Procaine may increase the hypotensive activities of Spirapril. Approved, Investigational, Vet Approved Procarbazine Procarbazine may increase the hypotensive activities of Spirapril. Approved, Investigational Proglumetacin The risk or severity of adverse effects can be increased when Proglumetacin is combined with Spirapril. Experimental Propacetamol The risk or severity of adverse effects can be increased when Propacetamol is combined with Spirapril. Approved, Investigational Propafenone The risk or severity of hyperkalemia can be increased when Spirapril is combined with Propafenone. Approved Propranolol Spirapril may increase the hypotensive activities of Propranolol. Approved, Investigational Propyphenazone The risk or severity of adverse effects can be increased when Propyphenazone is combined with Spirapril. Experimental Proquazone The risk or severity of adverse effects can be increased when Proquazone is combined with Spirapril. Experimental Protriptyline The serum concentration of Protriptyline can be increased when it is combined with Spirapril. Approved PTC299 The risk or severity of adverse effects can be increased when PTC299 is combined with Spirapril. Investigational Quinapril Quinapril may increase the hypotensive activities of Spirapril. Approved, Investigational Quinethazone The risk or severity of hypotension can be increased when Quinethazone is combined with Spirapril. Approved Quinine Quinine may increase the hypotensive activities of Spirapril. Approved Ramipril Ramipril may increase the hypotensive activities of Spirapril. Approved Rasagiline Rasagiline may increase the hypotensive activities of Spirapril. Approved Remikiren Remikiren may increase the hypotensive activities of Spirapril. Approved Rescinnamine Spirapril may increase the hypotensive activities of Rescinnamine. Approved Reserpine Reserpine may increase the hypotensive activities of Spirapril. Approved, Investigational Resveratrol The risk or severity of adverse effects can be increased when Resveratrol is combined with Spirapril. Approved, Experimental, Investigational Rilmenidine Rilmenidine may increase the hypotensive activities of Spirapril. Approved, Investigational Riociguat The serum concentration of Riociguat can be increased when it is combined with Spirapril. Approved Rituximab Spirapril may increase the hypotensive activities of Rituximab. Approved Rofecoxib The risk or severity of adverse effects can be increased when Rofecoxib is combined with Spirapril. Approved, Investigational, Withdrawn Sacubitril The risk or severity of angioedema can be increased when Spirapril is combined with Sacubitril. Approved Safrazine Safrazine may increase the hypotensive activities of Spirapril. Withdrawn Salicylamide The risk or severity of adverse effects can be increased when Salicylamide is combined with Spirapril. Approved Salicylic acid The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Salicylic acid is combined with Spirapril. Approved, Investigational, Vet Approved Salsalate The risk or severity of adverse effects can be increased when Salsalate is combined with Spirapril. Approved Saprisartan The risk or severity of adverse effects can be increased when Saprisartan is combined with Spirapril. Experimental Saralasin The risk or severity of adverse effects can be increased when Saralasin is combined with Spirapril. Investigational Saxagliptin The risk or severity of angioedema can be increased when Saxagliptin is combined with Spirapril. Approved Selegiline Selegiline may increase the hypotensive activities of Spirapril. Approved, Investigational, Vet Approved Selexipag Spirapril may increase the hypotensive activities of Selexipag. Approved Semapimod The risk or severity of adverse effects can be increased when Semapimod is combined with Spirapril. Investigational Seratrodast The risk or severity of adverse effects can be increased when Seratrodast is combined with Spirapril. Approved Serrapeptase The risk or severity of adverse effects can be increased when Serrapeptase is combined with Spirapril. Investigational Sildenafil The serum concentration of Sildenafil can be increased when it is combined with Spirapril. Approved, Investigational Simvastatin The serum concentration of Simvastatin can be increased when it is combined with Spirapril. Approved Sirolimus The risk or severity of angioedema can be increased when Sirolimus is combined with Spirapril. Approved, Investigational Sitagliptin The risk or severity of angioedema can be increased when Sitagliptin is combined with Spirapril. Approved, Investigational Sitaxentan Spirapril may increase the hypotensive activities of Sitaxentan. Approved, Investigational, Withdrawn Sodium aurothiomalate The risk or severity of hypotension, nitritoid reactions, facial flushing, nausea, and vomiting can be increased when Spirapril is combined with Sodium aurothiomalate. Approved, Investigational Sodium phosphate, monobasic The risk or severity of nephrotoxicity can be increased when Spirapril is combined with Sodium phosphate, monobasic. Approved Spironolactone The risk or severity of hyperkalemia can be increased when Spironolactone is combined with Spirapril. Approved SRT501 The risk or severity of adverse effects can be increased when SRT501 is combined with Spirapril. Investigational St. John's Wort The metabolism of Spirapril can be increased when combined with St. John's Wort. Approved, Investigational, Nutraceutical Sulfasalazine The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Sulfasalazine is combined with Spirapril. Approved Sulindac The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Sulindac is combined with Spirapril. Approved, Investigational Suprofen The risk or severity of adverse effects can be increased when Suprofen is combined with Spirapril. Approved, Withdrawn Suxibuzone The risk or severity of adverse effects can be increased when Suxibuzone is combined with Spirapril. Experimental Tacrolimus The metabolism of Tacrolimus can be decreased when combined with Spirapril. Approved, Investigational Tadalafil Tadalafil may increase the antihypertensive activities of Spirapril. Approved, Investigational Talinolol Spirapril may increase the hypotensive activities of Talinolol. Investigational Tarenflurbil The risk or severity of adverse effects can be increased when Tarenflurbil is combined with Spirapril. Investigational Tasosartan The risk or severity of adverse effects can be increased when Tasosartan is combined with Spirapril. Approved Telmisartan The risk or severity of adverse effects can be increased when Telmisartan is combined with Spirapril. Approved, Investigational Temocapril Spirapril may increase the hypotensive activities of Temocapril. Experimental, Investigational Temsirolimus The risk or severity of adverse effects can be increased when Spirapril is combined with Temsirolimus. Approved Tenidap The risk or severity of adverse effects can be increased when Tenidap is combined with Spirapril. Experimental Tenoxicam The risk or severity of adverse effects can be increased when Tenoxicam is combined with Spirapril. Approved Tepoxalin The risk or severity of adverse effects can be increased when Tepoxalin is combined with Spirapril. Vet Approved Teriflunomide The risk or severity of adverse effects can be increased when Teriflunomide is combined with Spirapril. Approved Terlipressin Spirapril may increase the hypotensive activities of Terlipressin. Approved, Investigational Tetrahydropalmatine Spirapril may increase the hypotensive activities of Tetrahydropalmatine. Investigational Theodrenaline Spirapril may increase the hypotensive activities of Theodrenaline. Investigational Theophylline The serum concentration of Theophylline can be decreased when it is combined with Spirapril. Approved Tianeptine The serum concentration of Tianeptine can be increased when it is combined with Spirapril. Approved, Investigational Tiaprofenic acid The risk or severity of adverse effects can be increased when Tiaprofenic acid is combined with Spirapril. Approved Tibolone Spirapril may increase the hypotensive activities of Tibolone. Approved, Investigational Ticrynafen Spirapril may increase the hypotensive activities of Ticrynafen. Withdrawn Timolol Timolol may increase the hypotensive activities of Spirapril. Approved Tinoridine The risk or severity of adverse effects can be increased when Tinoridine is combined with Spirapril. Investigational Tipranavir The serum concentration of Spirapril can be decreased when it is combined with Tipranavir. Approved, Investigational Tizanidine The risk or severity of hypotension can be increased when Tizanidine is combined with Spirapril. Approved, Investigational Tolazoline Tolazoline may increase the hypotensive activities of Spirapril. Approved, Vet Approved Tolfenamic Acid The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Tolfenamic Acid is combined with Spirapril. Approved, Investigational Tolmetin The risk or severity of adverse effects can be increased when Tolmetin is combined with Spirapril. Approved Tolonidine Spirapril may increase the hypotensive activities of Tolonidine. Experimental Toloxatone Toloxatone may increase the hypotensive activities of Spirapril. Approved Tolvaptan Tolvaptan may increase the hyperkalemic activities of Spirapril. Approved Torasemide Torasemide may increase the hypotensive activities of Spirapril. Approved Tranylcypromine Tranylcypromine may increase the hypotensive activities of Spirapril. Approved, Investigational Travoprost Travoprost may increase the hypotensive activities of Spirapril. Approved Treprostinil Treprostinil may increase the hypotensive activities of Spirapril. Approved, Investigational Triamterene Triamterene may increase the hyperkalemic activities of Spirapril. Approved Triazolam The serum concentration of Triazolam can be increased when it is combined with Spirapril. Approved, Investigational Tribenoside The risk or severity of adverse effects can be increased when Tribenoside is combined with Spirapril. Experimental Trichlormethiazide The risk or severity of hypotension can be increased when Trichlormethiazide is combined with Spirapril. Approved, Vet Approved Trimazosin Trimazosin may increase the hypotensive activities of Spirapril. Experimental Trimethaphan Trimethaphan may increase the hypotensive activities of Spirapril. Approved, Investigational Trimethoprim Trimethoprim may increase the hyperkalemic activities of Spirapril. Approved, Vet Approved Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Spirapril. Approved Triptolide The risk or severity of adverse effects can be increased when Triptolide is combined with Spirapril. Investigational Trolamine salicylate The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Trolamine salicylate is combined with Spirapril. Approved Udenafil Udenafil may increase the antihypertensive activities of Spirapril. Approved, Investigational Unoprostone Spirapril may increase the hypotensive activities of Unoprostone. Approved, Investigational Urapidil Urapidil may increase the hypotensive activities of Spirapril. Investigational Valdecoxib The risk or severity of adverse effects can be increased when Valdecoxib is combined with Spirapril. Approved, Investigational, Withdrawn Valsartan The risk or severity of adverse effects can be increased when Valsartan is combined with Spirapril. Approved, Investigational Vardenafil Vardenafil may increase the antihypertensive activities of Spirapril. Approved Vildagliptin The risk or severity of adverse effects can be increased when Vildagliptin is combined with Spirapril. Approved, Investigational Vincamine Spirapril may increase the hypotensive activities of Vincamine. Experimental Xipamide Spirapril may increase the hypotensive activities of Xipamide. Experimental Xylometazoline Spirapril may increase the hypotensive activities of Xylometazoline. Approved, Investigational Yohimbine Yohimbine may decrease the antihypertensive activities of Spirapril. Approved, Investigational, Vet Approved Zaltoprofen The risk or severity of adverse effects can be increased when Zaltoprofen is combined with Spirapril. Approved, Investigational Zileuton The risk or severity of adverse effects can be increased when Zileuton is combined with Spirapril. Approved, Investigational, Withdrawn Zofenopril Spirapril may increase the hypotensive activities of Zofenopril. Experimental Zomepirac The risk or severity of adverse effects can be increased when Zomepirac is combined with Spirapril. Withdrawn - Food Interactions
- Avoid alcohol.
- Do not take calcium, aluminum, magnesium or iron supplements within 2 hours of taking this medication.
- Herbs that may attenuate the antihypertensive effect of spirapril include: bayberry, blue cohash, cayenne, ephedra, ginger, ginseng (American), kola and licorice.
- High salt intake may attenuate the antihypertensive effect of spirapril.
- Spirapril may decrease the excretion of potassium. Salt substitutes containing potassium may increase the risk of hyperkalemia.
References
- General References
- Hannedouche T, Ikeni A, Marques LP, Natov S, Dechaux M, Schmitt F, Lacour B, Grunfeld JP: Renal effects of angiotensin II in normotensive subjects on short-term cilazapril treatment. J Cardiovasc Pharmacol. 1992;19 Suppl 6:S25-7. [PubMed:1382161]
- Noble S, Sorkin EM: Spirapril. A preliminary review of its pharmacology and therapeutic efficacy in the treatment of hypertension. Drugs. 1995 May;49(5):750-66. [PubMed:7601014]
- Rosendorff C, Patton J, Radford HM, Kalliatakis B: Alpha-adrenergic and angiotensin II pressor sensitivity in hypertensive patients treated with an angiotensin-converting enzyme inhibitor. J Cardiovasc Pharmacol. 1992;19 Suppl 6:S105-9. [PubMed:1382157]
- Shohat J, Wittenberg C, Erman A, Rosenfeld J, Boner G: Acute and chronic effects of spirapril, alone or in combination with isradipine on kidney function and blood pressure in patients with reduced kidney function and hypertension. Scand J Urol Nephrol. 1999 Feb;33(1):57-62. [PubMed:10100366]
- External Links
- Human Metabolome Database
- HMDB0015438
- PubChem Compound
- 5311447
- PubChem Substance
- 46506126
- ChemSpider
- 4470933
- BindingDB
- 50017124
- ChEBI
- 135756
- ChEMBL
- CHEMBL431
- Therapeutic Targets Database
- DAP000911
- PharmGKB
- PA164776913
- Wikipedia
- Spirapril
- ATC Codes
- C09AA11 — Spirapril
Clinical Trials
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage forms
- Not Available
- Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
Property Value Source Water Solubility 0.0293 mg/mL ALOGPS logP 1.79 ALOGPS logP 1.6 ChemAxon logS -4.2 ALOGPS pKa (Strongest Acidic) 3.62 ChemAxon pKa (Strongest Basic) 5.2 ChemAxon Physiological Charge -1 ChemAxon Hydrogen Acceptor Count 5 ChemAxon Hydrogen Donor Count 2 ChemAxon Polar Surface Area 95.94 Å2 ChemAxon Rotatable Bond Count 10 ChemAxon Refractivity 121.94 m3·mol-1 ChemAxon Polarizability 48.74 Å3 ChemAxon Number of Rings 3 ChemAxon Bioavailability 1 ChemAxon Rule of Five Yes ChemAxon Ghose Filter Yes ChemAxon Veber's Rule No ChemAxon MDDR-like Rule Yes ChemAxon - Predicted ADMET features
Property Value Probability Human Intestinal Absorption - 0.5287 Blood Brain Barrier - 0.9614 Caco-2 permeable - 0.83 P-glycoprotein substrate Substrate 0.8223 P-glycoprotein inhibitor I Non-inhibitor 0.6938 P-glycoprotein inhibitor II Non-inhibitor 0.7426 Renal organic cation transporter Non-inhibitor 0.8836 CYP450 2C9 substrate Non-substrate 0.833 CYP450 2D6 substrate Non-substrate 0.8553 CYP450 3A4 substrate Non-substrate 0.5658 CYP450 1A2 substrate Non-inhibitor 0.8439 CYP450 2C9 inhibitor Non-inhibitor 0.7259 CYP450 2D6 inhibitor Non-inhibitor 0.8813 CYP450 2C19 inhibitor Non-inhibitor 0.5956 CYP450 3A4 inhibitor Inhibitor 0.5073 CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.6331 Ames test Non AMES toxic 0.8764 Carcinogenicity Non-carcinogens 0.908 Biodegradation Not ready biodegradable 0.9115 Rat acute toxicity 2.2396 LD50, mol/kg Not applicable hERG inhibition (predictor I) Weak inhibitor 0.9961 hERG inhibition (predictor II) Non-inhibitor 0.5579
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
Taxonomy
- Description
- This compound belongs to the class of organic compounds known as dipeptides. These are organic compounds containing a sequence of exactly two alpha-amino acids joined by a peptide bond.
- Kingdom
- Organic compounds
- Super Class
- Organic acids and derivatives
- Class
- Carboxylic acids and derivatives
- Sub Class
- Amino acids, peptides, and analogues
- Direct Parent
- Dipeptides
- Alternative Parents
- N-acyl-L-alpha-amino acids / Alpha amino acid esters / Alpha amino acid amides / Pyrrolidine carboxylic acids / N-acylpyrrolidines / Fatty acid esters / Dithioketals / Aralkylamines / Dicarboxylic acids and derivatives / Benzene and substituted derivatives show 12 more
- Substituents
- Alpha-dipeptide / Alpha-amino acid ester / N-acyl-alpha-amino acid / N-acyl-alpha amino acid or derivatives / N-acyl-l-alpha-amino acid / Alpha-amino acid amide / Alpha-amino acid or derivatives / N-acylpyrrolidine / Pyrrolidine carboxylic acid / Pyrrolidine carboxylic acid or derivatives show 33 more
- Molecular Framework
- Aromatic heteropolycyclic compounds
- External Descriptors
- Not Available
Targets
- Kind
- Protein
- Organism
- Human
- Pharmacological action
- Yes
- Actions
- Inhibitor
- General Function
- Zinc ion binding
- Specific Function
- Converts angiotensin I to angiotensin II by release of the terminal His-Leu, this results in an increase of the vasoconstrictor activity of angiotensin. Also able to inactivate bradykinin, a potent...
- Gene Name
- ACE
- Uniprot ID
- P12821
- Uniprot Name
- Angiotensin-converting enzyme
- Molecular Weight
- 149713.675 Da
References
- Song JC, White CM: Clinical pharmacokinetics and selective pharmacodynamics of new angiotensin converting enzyme inhibitors: an update. Clin Pharmacokinet. 2002;41(3):207-24. [PubMed:11929321]
- Maul B, Krause W, Pankow K, Becker M, Gembardt F, Alenina N, Walther T, Bader M, Siems WE: Central angiotensin II controls alcohol consumption via its AT1 receptor. FASEB J. 2005 Sep;19(11):1474-81. [PubMed:16126915]
- Hermida RC, Ayala DE, Fontao MJ, Mojon A, Alonso I, Fernandez JR: Administration-time-dependent effects of spirapril on ambulatory blood pressure in uncomplicated essential hypertension. Chronobiol Int. 2010 May;27(3):560-74. doi: 10.3109/07420528.2010.485411. [PubMed:20524801]
- Arend U, Albrecht S, Meisel E, Schmidt J: [Influence of ACE inhibitor spirapril on left ventricular hypertrophy]. Fortschr Med Orig. 2002 Dec 5;120(4):147-50. [PubMed:12613273]
- Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
Transporters
- Kind
- Protein
- Organism
- Human
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Proton-dependent oligopeptide secondary active transmembrane transporter activity
- Specific Function
- Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides. May constitute a major route for the absorption of protein digestion end-products.
- Gene Name
- SLC15A1
- Uniprot ID
- P46059
- Uniprot Name
- Solute carrier family 15 member 1
- Molecular Weight
- 78805.265 Da
References
- Knutter I, Wollesky C, Kottra G, Hahn MG, Fischer W, Zebisch K, Neubert RH, Daniel H, Brandsch M: Transport of angiotensin-converting enzyme inhibitors by H+/peptide transporters revisited. J Pharmacol Exp Ther. 2008 Nov;327(2):432-41. doi: 10.1124/jpet.108.143339. Epub 2008 Aug 19. [PubMed:18713951]
- Kind
- Protein
- Organism
- Human
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Peptide:proton symporter activity
- Specific Function
- Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides.
- Gene Name
- SLC15A2
- Uniprot ID
- Q16348
- Uniprot Name
- Solute carrier family 15 member 2
- Molecular Weight
- 81782.77 Da
References
- Knutter I, Wollesky C, Kottra G, Hahn MG, Fischer W, Zebisch K, Neubert RH, Daniel H, Brandsch M: Transport of angiotensin-converting enzyme inhibitors by H+/peptide transporters revisited. J Pharmacol Exp Ther. 2008 Nov;327(2):432-41. doi: 10.1124/jpet.108.143339. Epub 2008 Aug 19. [PubMed:18713951]
Drug created on June 30, 2007 12:15 / Updated on August 02, 2018 07:54