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Omapatrilat is an experimental antihypertensive agent developed for the treatment of hypertension and congestive heart failure. It is a vasopeptidase inhibitor that simultaneously inhibits both angiotensin-converting enzyme (ACE) and neprilysin (neutral endopeptidase, NEP). By inhibiting ACE, it reduces the production of angiotensin II, leading to vasodilation and decreased blood pressure. Inhibition of NEP increases levels of natriuretic peptides, promoting natriuresis, diuresis, vasodilation, and reductions in cardiac preload and ventricular remodeling. Omapatrilat demonstrated greater blood pressure reduction than standard ACE inhibitors in clinical trials but was associated with a higher risk of angioedema due to its dual mechanism affecting bradykinin metabolism. The drug was never marketed because development was discontinued after clinical trials revealed an unacceptable incidence of angioedema[1][2][8].
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