Details of Drug

Drug General Information (ID: D1125)
Drug Name	Nesiritide
Drug Type	Hormones
Drug Synonymous	Natriuretic peptide, brain; Brain natriuretic peptide; Natriuretic factor, brain; Natriuretic peptide type-B; Brain natriuretic factor; Nesiritide [USAN:INN]; B-Tye natriuretic peptide; UNII-07Y2V56IUP; 07Y2V56IUP; Human brain natriuretic factor-32; Human brain natriuretic peptide-32; Natriuretic factor-32 (human brain clone lambda hBNP57); Natriuretic factor-32 (human brain clone lambdahBNP57); 1,2-Dithia-5,8,11,14,17,20,23,26,29,32,35,38,41,44,47,50-hexadecaazacyclotripentacontane, cyclic peptide deriv.; L-Histidine, L-seryl-L-prolyl-L-lysyl-L-methionyl-L-valyl-L-glutaminylglycyl-L-serylglycyl-L-cysteinyl-L-phenylalanylglycyl-L_arginyl-L-lysyl-L-methionyl-L-alpha-aspartyl-L-arginyl-L-isoleucyl-L-seryl-L-seryl-L-seryl-L-serylglycyl-L-leucylglycyl-L-cysteinyl-L-lysyl-L-valyl-L-leucyl-L-arginyl-L-arginyl-, cyclic (10-26)-disulfide; L-Seryl-L-prolyl-L-lysyl-L-methionyl-L-valyl-L-glutaminylglycyl-L-serylglycyl-L-cysteinyl-L-phenylalanylglycyl-L-arginyl-L-lysyl-L-methionyl-L-aspartyl-L-arginyl-L-isoleucyl-L-seryl-L-seryl-L-seryl-L-serylglycyl-L-leucylglycyl-L-cysteinyl-L-lysyl-L-valyl-L-leucyl-L-arginyl-L-arginyl-L-histidine cyclic (10-26)-disulfide Click to Show/Hide
Therapeutic Class	Recombinant Natriuretic Peptide
Structure
Structure	3D Structure		2D Structure
Formula	C143H244N50O42S4
InChI	InChI=1S/C143H244N50O42S4/c1-13-76(10)112-137(232)189-99(68-199)131(226)188-98(67-198)130(225)187-97(66-197)129(224)186-96(65-196)117(212)166-59-105(202)169-90(52-72(2)3)114(209)163-61-107(204)171-100(132(227)177-83(32-19-22-44-146)124(219)190-111(75(8)9)136(231)184-91(53-73(4)5)127(222)175-84(34-24-46-159-141(151)152)121(216)174-85(35-25-47-160-142(153)154)122(217)185-94(139(234)235)55-78-57-157-71-167-78)69-238-239-70-101(172-108(205)62-165-116(211)95(64-195)170-106(203)60-162-113(208)87(38-39-103(148)200)181-135(230)110(74(6)7)191-126(221)89(41-51-237-12)179-120(215)82(31-18-21-43-145)180-134(229)102-37-27-49-193(102)138(233)79(147)63-194)133(228)182-92(54-77-28-15-14-16-29-77)115(210)164-58-104(201)168-80(33-23-45-158-140(149)150)118(213)173-81(30-17-20-42-144)119(214)178-88(40-50-236-11)123(218)183-93(56-109(206)207)128(223)176-86(125(220)192-112)36-26-48-161-143(155)156/h14-16,28-29,57,71-76,79-102,110-112,194-199H,13,17-27,30-56,58-70,144-147H2,1-12H3,(H2,148,200)(H,157,167)(H,162,208)(H,163,209)(H,164,210)(H,165,211)(H,166,212)(H,168,201)(H,169,202)(H,170,203)(H,171,204)(H,172,205)(H,173,213)(H,174,216)(H,175,222)(H,176,223)(H,177,227)(H,178,214)(H,179,215)(H,180,229)(H,181,230)(H,182,228)(H,183,218)(H,184,231)(H,185,217)(H,186,224)(H,187,225)(H,188,226)(H,189,232)(H,190,219)(H,191,221)(H,192,220)(H,206,207)(H,234,235)(H4,149,150,158)(H4,151,152,159)(H4,153,154,160)(H4,155,156,161)/t76-,79-,80-,81-,82-,83-,84-,85-,86-,87-,88-,89-,90-,91-,92-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,110-,111-,112-/m0/s1
InChIKey	HPNRHPKXQZSDFX-OAQDCNSJSA-N
Canonical SMILES	CC[C@H](C)[C@H]1C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)NCC(=O)N[C@H](C(=O)NCC(=O)N[C@@H](CSSC[C@@H](C(=O)N[C@H](C(=O)NCC(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N1)CCCNC(=N)N)CC(=O)O)CCSC)CCCCN)CCCNC(=N)N)CC2=CC=CC=C2)NC(=O)CNC(=O)[C@H](CO)NC(=O)CNC(=O)[C@H](CCC(=O)N)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CCSC)NC(=O)[C@H](CCCCN)NC(=O)[C@@H]3CCCN3C(=O)[C@H](CO)N)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCCNC(=N)N)C(=O)N[C@@H](CCCNC(=N)N)C(=O)N[C@@H](CC4=CN=CN4)C(=O)O)CC(C)C)CO)CO)CO)CO
External Link
	Pubchem ID	53325981
	TTD ID	D05GRY

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM042 Additive hypotensive effects BM089 Antagonize the effect of antihypertensive agents
Relation Graph

Full list of drugs interacting with Nesiritide
Pharmacodynamic additive effects
	Additive hypotensive effects					Drug Num: 56
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1596		Tizanidine	C9H8ClN5S	5487	Major		Inter Info	[1]
D0055		Amifostine	C5H15N2O3PS	2141	Moderate		Inter Info	[2], [3], [4]
D0083		Amyl Nitrite	C5H11NO2	10026	Moderate		Inter Info	[5]
D0097		Apomorphine	C17H17NO2	6005	Moderate		Inter Info	[2], [6], [7]
D0098		Apraclonidine	C9H10Cl2N4	2216	Moderate		Inter Info	[8], [9], [10]
D0156		Benazepril	C24H28N2O5	5362124	Moderate		Inter Info	[11], [12], [5]
D0205		Brimonidine (ophthalmic)	C11H10BrN5	2435	Moderate		Inter Info	[8], [9], [10]
D0206		Brimonidine (topical)	C11H10BrN5	2435	Moderate		Inter Info	[8], [9], [10]
D0254		Captopril	C9H15NO3S	44093	Moderate		Inter Info	[11], [12], [5]
D0474		Diazoxide	C8H7ClN2O2S	3019	Moderate		Inter Info	[5]
D0506		Dipyridamole	C24H40N8O4	3108	Moderate		Inter Info	[5]
D0567		Enalapril	C20H28N2O5	5388962	Moderate		Inter Info	[11], [12], [5]
D0586		Epoprostenol	C20H32O5	5282411	Moderate		Inter Info	[13], [14], [15]
D0644		Fenoldopam	C16H16ClNO3	3341	Moderate		Inter Info	[5]
D0695		Fosinopril	C30H46NO7P	55891	Moderate		Inter Info	[11], [12], [5]
D0770		Hydralazine	C8H8N4	3637	Moderate		Inter Info	[5]
D0792		Iloprost	C22H32O4	5311181	Moderate		Inter Info	[13], [14], [15]
D0853		Isocarboxazid	C12H13N3O2	3759	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D0861		Isosorbide dinitrate	C6H8N2O8	6883	Moderate		Inter Info	[5]
D0862		Isosorbide mononitrate	C6H9NO6	27661	Moderate		Inter Info	[5]
D0933		Linezolid	C16H20FN3O4	441401	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D0938		Lisinopril	C21H31N3O5	5362119	Moderate		Inter Info	[11], [12], [5]
D1072		Minoxidil	C9H15N5O	4201	Moderate		Inter Info	[5]
D1848		Minoxidil (topical)	C9H15N5O	4201	Moderate		Inter Info	[28], [29]
D1082		Moexipril	C27H34N2O7	91270	Moderate		Inter Info	[11], [12], [5]
D1117		Nefazodone	C25H32ClN5O2	4449	Moderate		Inter Info	[30], [31], [32]
D0128		Avanafil	C23H26ClN7O3	9869929	Moderate		Inter Info	[33], [34], [35]
D0245		Canagliflozin	C24H25FO5S	24812758	Moderate		Inter Info	[36], [13], [37]
D0418		Dapagliflozin	C21H25ClO6	9887712	Moderate		Inter Info	[36], [13], [37]
D0565		Empagliflozin	C23H27ClO7	11949646	Moderate		Inter Info	[36], [13], [37]
D0864		Isoxsuprine	C18H23NO3	3783	Moderate		Inter Info	[5]
D1148		Nitrous acid	HNO2	24529	Moderate		Inter Info	[41], [42], [43]
D1211		Ozanimod	C23H24N4O3	52938427	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1408		Riociguat	C20H19FN8O2	11304743	Moderate		Inter Info	[44]
D1437		Safinamide	C17H19FN2O2	131682	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1457		Selexipag	C26H32N4O4S	9913767	Moderate		Inter Info	[13], [14], [15]
D1138		Nimodipine	C21H26N2O7	4497	Moderate		Inter Info	[5]
D1146		Nitroglycerin	C3H5N3O9	4510	Moderate		Inter Info	[5]
D1147		Nitroprusside	C5FeN6O	11953891	Moderate		Inter Info	[5]
D1223		Papaverine	C20H21NO4	4680	Moderate		Inter Info	[5]
D1251		Pentoxifylline	C13H18N4O3	4740	Moderate		Inter Info	[45]
D1256		Perindopril	C19H32N2O5	107807	Moderate		Inter Info	[11], [12], [5]
D1263		Phenelzine	C8H12N2	3675	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1345		Procarbazine	C12H19N3O	4915	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1369		Quinapril	C25H30N2O5	54892	Moderate		Inter Info	[11], [12], [5]
D1379		Ramipril	C23H32N2O5	5362129	Moderate		Inter Info	[11], [12], [5]
D1455		Selegiline	C13H17N	26757	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1465		Sildenafil	C22H30N6O4S	135398744	Moderate		Inter Info	[33], [34], [35]
D1602		Tolazoline	C10H12N2	5504	Moderate		Inter Info	[5]
D1618		Trandolapril	C24H34N2O5	5484727	Moderate		Inter Info	[11], [12], [5]
D1620		Tranylcypromine	C9H11N	19493	Moderate		Inter Info	[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [3], [26], [27]
D1625		Treprostinil	C23H34O5	6918140	Moderate		Inter Info	[13], [14], [15]
D1643		Trimethaphan	C22H25N2OS+	23576	Moderate		Inter Info	[5]
D1682		Vardenafil	C23H32N6O4S	135400189	Moderate		Inter Info	[33], [34], [35]
D0711		Garlic	NA	NA	Minor		Inter Info	[46], [47]
D1527		Tadalafil	C22H19N3O4	110635	Minor		Inter Info	[48], [49]
Pharmacodynamic antagonistic effects
	Antagonize the effect of antihypertensive agents					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0926		Licorice	C42H62O16Zn	163463	Moderate		Inter Info	[38], [39], [40]

References
1	Product Information. Zanaflex (tizanidine). Acorda Therapeutics, Hawthorne, NY.
2	Bailey DG, Dresser GK "Natural products and adverse drug interactions." Can Med Assoc J 170 (2004): 1531-2. [PMID: 15136542]
3	Product Information. Xatral (alfuzosin). Sanofi-Synthelabo Canada Inc, Markham, ON.
4	Product Information. Ethyol (amifostine). Alza, Palo Alto, CA.
5	Product Information. Natrecore (nesiritide) Scios Inc, Sunnyvale, CA.
6	Ho PC, Ghose K, Saville D, Wanwimolruk S "Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers." Eur J Clin Pharmacol 56 (2000): 693-8. [PMID: 11214778]
7	Product Information. Apokyn (apomorphine). Mylan Pharmaceuticals Inc, Morgantown, WV.
8	Product Information. Alphagan (brimonidine ophthalmic). Allergan Inc, Irvine, CA.
9	Product Information. Mirvaso (brimonidine topical). Galderma Laboratories Inc, Cranbury, NJ.
10	Walters TR "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol 41 ( Suppl (1996): s19-26
11	Ray K, Dorman S, Watson R "Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction." J Hum Hypertens 13 (1999): 717-20. [PMID: 10516744]
12	Product Information. Vasotec (enalapril). Merck &amp Co, Inc, West Point, PA.
13	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
14	Product Information. Flolan (epoprostenol). Glaxo Wellcome, Research Triangle Park, NC.
15	Product Information. Remodulin (treprostinil). United Therapeutics Corp, Silver Spring, MD.
16	Ban TA "Drug interactions with psychoactive drugs." Dis Nerv Syst 36 (1975): 164-6. [PMID: 1116424]
17	De Vita VT, Hahn MA, Oliverio VT "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med 120 (1965): 561-5. [PMID: 4379192]
18	Goldberg LI "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA 190 (1964): 456-62. [PMID: 14197995]
19	Golwyn DH, Sevlie CP "Monoamine oxidase inhibitor hypertensive crisis headache and orthostatic hypotension." J Clin Psychopharmacol 13 (1993): 77-8. [PMID: 8486823]
20	Kronig MH, Roose SP, Walsh BT, Woodring S, Glassman AH "Blood pressure effects of phenelzine." J Clin Psychopharmacol 3 (1983): 307-10. [PMID: 6630590]
21	Pettinger WA, Soyangco FG, Oates JA "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther 9 (1968): 442-7. [PMID: 5655478]
22	Product Information. Marplan (isocarboxazid) Roche Laboratories, Nutley, NJ.
23	Product Information. Matulane (procarbazine). Roche Laboratories, Nutley, NJ.
24	Product Information. Nardil (phenelzine). Parke-Dvis, Morris Plains, NJ.
25	Product Information. Parnate (tranylcypromine). SmithKline Beecham, Philadelphia, PA.
26	Reggev A, Vollhardt BR "Bradycardia induced by an interaction between phenelzine and beta blockers." Psychosomatics 30 (1992): 106-8. [PMID: 2913594]
27	Schulz R, Antonin KH, Hoffmann E, et al "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther 46 (1989): 528-36. [PMID: 2510962]
28	Leenen FH, Smith DL, Unger WP "Topical minoxidil: cardiac effects in bald men." Br J Clin Pharmacol 26 (1988): 481-5. [PMID: 3191000]
29	Product Information. Rogaine (minoxidil topical). Johnson and Johnson/McNeil Consumer, Fort Washington, PA.
30	Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
31	Product Information. Serzone (nefazodone). Bristol-Myers Squibb, Princeton, NJ.
32	Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7. [PMID: 3725002]
33	Product Information. Levitra (vardenafil). Bayer, West Haven, CT.
34	Product Information. Stendra (avanafil). Vivus Inc, Mountain View, CA.
35	Product Information. Viagra (sildenafil). Pfizer US Pharmaceuticals, New York, NY.
36	Cerner Multum, Inc. "Australian Product Information.".
37	Product Information. Jardiance (empagliflozin). Boehringer Ingelheim, Ridgefield, CT.
38	Stewart PM, Wallace AM, Valentino R, Burt D, Shackleton CH, Edwards CR "Mineralocorticoid activity of liquorice: 11-beta-hydroxysteroid dehydrogenase deficiency comes of age." Lancet 2 (1987): 821-4. [PMID: 2889032]
39	Cumming AM "Metabolic effects of licorice." Br Med J 1 (1977): 906
40	Epstein MT, Espiner EA, Donald RA, Hughes H "Effect of eating liquorice on the renin-angiotensin aldosterone axis in normal subjects." Br Med J 1 (1977): 488-90
41	Fuhr U, Maier-Bruggemann A, Blume H, et al. "Grapefruit juice increases oral nimodipine bioavailability." Int J Clin Pharmacol Ther 36 (1998): 126-32. [PMID: 9562227]
42	Gunston GD, Mehta U "Potentially serious drug interactions with grapefruit juice." S Afr Med J 90 (2000): 41. [PMID: 10721388]
43	Product Information. Sodium Nitrite (sodium nitrite). Hope Pharmaceuticals, Scottsdale, AZ.
44	Product Information. Adempas (riociguat). Bayer Pharmaceutical Inc, West Haven, CT.
45	Product Information. Trental (pentoxifylline). Hoechst Marion-Roussel Inc, Kansas City, MO.
46	Tattelman E "Health effects of garlic." Am Fam Physician 72 (2005): 103-6
47	Richard CL, Jurgens TM "Effects of natural health products on blood pressure." Ann Pharmacother 39 (2005): 712-20
48	Product Information. Cialis (tadalafil). Lilly, Eli and Company, Indianapolis, IN.
49	Product Information. Rapaflo (silodosin). Watson Pharmaceuticals, Corona, CA.

Details of Drug

Details of Drug

Cite MecDDI

About MecDDI

Correspondence