Cilexetil

Cilexetil is a prodrug of the angiotensin-converting enzyme (ACE) inhibitor cilazapril. It is designed to improve the oral bioavailability of cilazapril. Once absorbed into the body, cilexetil is rapidly hydrolyzed in the gastrointestinal tract and liver to its active form, cilazapril. Cilazapril then exerts its therapeutic effects by inhibiting the angiotensin-converting enzyme, which plays a crucial role in the renin-angiotensin-aldosterone system. This inhibition leads to reduced levels of angiotensin II, a potent vasoconstrictor, and consequently results in vasodilation and a decrease in blood pressure. Cilexetil, through its conversion to cilazapril, is used in the management of hypertension (high blood pressure). It is also indicated for the treatment of heart failure and to improve survival after myocardial infarction. The prodrug approach with cilexetil aims to enhance the absorption and efficacy of cilazapril compared to administering the parent drug directly. Like other ACE inhibitors, cilexetil may cause side effects, including cough, dizziness, and angioedema. It is typically administered orally, once daily. The metabolism and excretion of cilexetil and its active metabolite are primarily handled by the kidneys.