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Ilepatril is a small molecule vasopeptidase inhibitor that was developed by Sanofi-Aventis for the treatment of cardiovascular and renal diseases, including hypertension and diabetic nephropathy. It functions as a dual inhibitor of angiotensin-converting enzyme (ACE) and neprilysin (neutral endopeptidase, NEP). By inhibiting ACE, it prevents the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, while inhibition of neprilysin prevents the degradation of natriuretic peptides, which promote vasodilation and natriuresis. This dual mechanism was intended to provide superior blood pressure control and organ protection compared to ACE inhibitors alone. However, development was discontinued during Phase II clinical trials, largely due to concerns regarding the risk of angioedema, a side effect observed with other drugs in the vasopeptidase inhibitor class.
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