Ketanserin

Summary

Ketanserin (CHEMBL51) is an approved small-molecule α-adrenergic antagonist (ATC C02KD01) targeting HTR2A; indicated across 3 conditions including hypertensive disorder and acute kidney injury.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: C02KD01
• Targets: 1 (HTR2A)
• Indications: 3 conditions
• Clinical trials: 7
• Chemistry: 395.4 Da · C22H22FN3O3

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL51
Name	Ketanserin
Type	Small molecule
Max phase	4
FDA approved	no
PubChem CID	3822
ChEBI	CHEBI:6123
ATC	C02KD01
Molecular formula	C22H22FN3O3
Molecular weight	395.4
InChIKey	FPCCSQOGAWCVBH-UHFFFAOYSA-N

SMILES: C1CN(CCC1C(=O)C2=CC=C(C=C2)F)CCN3C(=O)C4=CC=CC=C4NC3=O

IUPAC name: 3-[2-[4-(4-fluorobenzoyl)piperidin-1-yl]ethyl]-1H-quinazoline-2,4-dione

ChEBI definition: A member of the class of quinazolines that is quinazoline-2,4(1H,3H)-dione which is substituted at position 3 by a 2-[4-(p-fluorobenzoyl)piperidin-1-yl]ethyl group.

Pharmacological roles (ChEBI): α-adrenergic antagonist, serotonergic antagonist, antihypertensive agent, cardiovascular drug, EC 3.4.21.26 (prolyl oligopeptidase) inhibitor.

Also known as: Ketanserin, Ketanserin tartrate, Ketanserina, Ketanserine, KJK 945, NSC-758959, Perketan, R 49945, R-41,468, R-41468, R-49945, Serepress

Parent form; salt/anhydrous children: CHEMBL1256709, CHEMBL1628637, CHEMBL1724541, CHEMBL2062337, CHEMBL4303471, CHEMBL5198816

Patent coverage: 8,519 distinct patent families (20,018 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 19,792 (99%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

Gene	Target	Action	pAffinity	Cancer dependency	UniProt
HTR2A	5-HT2A receptor	Antagonist	9.7	0%	P28223

Broader ChEMBL bioactivity targets: 44 (assay-derived). Sample: Microtubule-associated protein tau, Prelamin-A/C, 15-hydroxyprostaglandin dehydrogenase [NAD(+)], 5-hydroxytryptamine receptor 2B, Synaptic vesicular amine transporter, 5-hydroxytryptamine receptor 1B, Adrenergic receptor alpha-1, Alpha-2C adrenergic receptor, Alpha-2B adrenergic receptor, 5-hydroxytryptamine receptor 1D.

Bioactivity

ChEMBL activities: 129 potent at pChembl ≥ 5 of 143 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
HTR2A	9.64	Ki	0.23	nM	CHEMBL_ACT_2478049
HTR2A	9.55	Ki	0.28	nM	CHEMBL_ACT_17995194
P14842	9.55	Kd	0.28	nM	CHEMBL_ACT_61992
HTR2A	9.55	Ki	0.28	nM	CHEMBL_ACT_6317044
HTR2A	9.52	Ki	0.3	nM	CHEMBL_ACT_14738652
HTR2A	9.52	Ki	0.3	nM	CHEMBL_ACT_15187885
HTR2A	9.46	IC50	0.35	nM	CHEMBL_ACT_16501795
HTR2A	9.46	IC50	0.35	nM	CHEMBL_ACT_16838453
HTR2A	9.46	Ki	0.35	nM	CHEMBL_ACT_26333258
P08909	9.4	Ki	0.4	nM	CHEMBL_ACT_236671
HTR2A	9.4	Ki	0.4	nM	CHEMBL_ACT_2478023
P08909	9.38	Kd	0.42	nM	CHEMBL_ACT_903225
HTR2A	9.35	Ki	0.45	nM	CHEMBL_ACT_19226342
P14842	9.33	Ki	0.47	nM	CHEMBL_ACT_13457835
HTR2A	9.31	Ki	0.49	nM	CHEMBL_ACT_13341981
P14842	9.31	Ki	0.49	nM	CHEMBL_ACT_1991177
HTR2A	9.28	IC50	0.52	nM	CHEMBL_ACT_17995179
HTR2A	9.2	IC50	0.63	nM	CHEMBL_ACT_26333203
P08909	9.18	Ki	0.66	nM	CHEMBL_ACT_202536
HTR2A	9.11	IC50	0.77	nM	CHEMBL_ACT_13336169
HTR2A	9.09	IC50	0.82	nM	CHEMBL_ACT_19226343
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_16471367
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_16571355
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_18454531
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_2943953
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_6228087
P14842	9.07	Ki	0.85	nM	CHEMBL_ACT_7966789
HTR2A	9.05	IC50	0.9	nM	CHEMBL_ACT_13342053
SIGMAR1	9	IC50	1	nM	CHEMBL_ACT_1147646
P08909	9	Ki	1	nM	CHEMBL_ACT_236670

Target pathways

Aggregated over 1 target gene(s): HTR2A.

Top Reactome pathways

8 total, by targets touching each:

Pathway	Targets	Genes
Signal Transduction	1	HTR2A
Signaling by GPCR	1	HTR2A
Class A/1 (Rhodopsin-like receptors)	1	HTR2A
Amine ligand-binding receptors	1	HTR2A
GPCR downstream signalling	1	HTR2A
Serotonin receptors	1	HTR2A
G alpha (q) signalling events	1	HTR2A
GPCR ligand binding	1	HTR2A

Dominant GO biological processes

GO term	Targets
temperature homeostasis	1
positive regulation of cytokine production involved in immune response	1
glycolytic process	1
intracellular calcium ion homeostasis	1
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messenger	1
positive regulation of cytosolic calcium ion concentration	1
phospholipase C-activating serotonin receptor signaling pathway	1
serotonin receptor signaling pathway	1
chemical synaptic transmission	1
memory	1
positive regulation of cell population proliferation	1
response to xenobiotic stimulus	1
positive regulation of phosphatidylinositol biosynthetic process	1
regulation of dopamine secretion	1
artery smooth muscle contraction	1

Indications & clinical

Indications

3 indications (1 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
hypertensive disorder	4	MONDO:0005044	EFO:0000537
acute kidney injury	3	MONDO:0002492	HP:0001919

1 further indication record had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 7.

Phase distribution

Phase	Trials
PHASE3	2
PHASE1	2
PHASE4	1
PHASE1/PHASE2	1
Not specified	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT03646318	PHASE4	UNKNOWN	Ketanserin Effects on Peripheral Temperature and Lactate
NCT00557219	PHASE3	TERMINATED	Fenoldopam and Ketanserin for Acute Kidney Failure Prevention After Cardiac Surgery
NCT01329887	PHASE3	COMPLETED	The Effect of Ketanserin on the Microcirculation in Sepsis
NCT02632877	PHASE1/PHASE2	COMPLETED	Efficacy of Pirfenidone Plus MODD in Diabetic Foot Ulcers
NCT03289949	PHASE1	RECRUITING	The Neurobiological Effect of 5-HT2AR Modulation
NCT04558294	PHASE1	COMPLETED	Effect of Ketanserin After LSD Administration
NCT02451072	Not specified	COMPLETED	The Role of 5-HT2A Receptor in the Perception of Self and Personal Meaning in Healthy Volunteers

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline, but PharmGKB curates 1 clinical and 1 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

387 molecules share ≥1 primary target. Top 60 by shared-target count:

Molecule	Source	Status	Shared targets
DIHYDROERGOTAMINE	ChEMBL + PubChem	Phase 4 (approved)	HTR2A
FIDAXOMICIN	ChEMBL + PubChem	Phase 4 (approved)	HTR2A
PIMAVANSERIN	ChEMBL + PubChem	Phase 4 (approved)	HTR2A
PROPOXYPHENE	ChEMBL + PubChem	Phase 4 (approved)	HTR2A
ABEMACICLIB	ChEMBL	Phase 4 (approved)	HTR2A
ACETOPHENAZINE	ChEMBL	Phase 4 (approved)	HTR2A
ACYCLOVIR	ChEMBL	Phase 4 (approved)	HTR2A
ALMOTRIPTAN	ChEMBL	Phase 4 (approved)	HTR2A
ALOSETRON	ChEMBL	Phase 4 (approved)	HTR2A
AMIODARONE	ChEMBL	Phase 4 (approved)	HTR2A
AMISULPRIDE	ChEMBL	Phase 4 (approved)	HTR2A
AMITRIPTYLINE	ChEMBL	Phase 4 (approved)	HTR2A
AMLODIPINE	ChEMBL	Phase 4 (approved)	HTR2A
AMOXAPINE	ChEMBL	Phase 4 (approved)	HTR2A
APOMORPHINE	ChEMBL	Phase 4 (approved)	HTR2A
ARIPIPRAZOLE	ChEMBL	Phase 4 (approved)	HTR2A
ASENAPINE	ChEMBL	Phase 4 (approved)	HTR2A
ASTEMIZOLE	ChEMBL	Phase 4 (approved)	HTR2A
ATOMOXETINE	ChEMBL	Phase 4 (approved)	HTR2A
AZATADINE	ChEMBL	Phase 4 (approved)	HTR2A
AZELASTINE	ChEMBL	Phase 4 (approved)	HTR2A
BAZEDOXIFENE	ChEMBL	Phase 4 (approved)	HTR2A
BEDAQUILINE	ChEMBL	Phase 4 (approved)	HTR2A
BENFLUOREX	ChEMBL	Phase 4 (approved)	HTR2A
BENPERIDOL	ChEMBL	Phase 4 (approved)	HTR2A
BENZBROMARONE	ChEMBL	Phase 4 (approved)	HTR2A
BENZPHETAMINE	ChEMBL	Phase 4 (approved)	HTR2A
BENZQUINAMIDE	ChEMBL	Phase 4 (approved)	HTR2A
BENZTROPINE	ChEMBL	Phase 4 (approved)	HTR2A
BEPRIDIL	ChEMBL	Phase 4 (approved)	HTR2A
BIFONAZOLE	ChEMBL	Phase 4 (approved)	HTR2A
BLONANSERIN	ChEMBL	Phase 4 (approved)	HTR2A
BOSUTINIB	ChEMBL	Phase 4 (approved)	HTR2A
BREXPIPRAZOLE	ChEMBL	Phase 4 (approved)	HTR2A
BROMOCRIPTINE	ChEMBL	Phase 4 (approved)	HTR2A
BROMPERIDOL	ChEMBL	Phase 4 (approved)	HTR2A
BUSPIRONE	ChEMBL	Phase 4 (approved)	HTR2A
BUTENAFINE	ChEMBL	Phase 4 (approved)	HTR2A
BUTRIPTYLINE	ChEMBL	Phase 4 (approved)	HTR2A
CABERGOLINE	ChEMBL	Phase 4 (approved)	HTR2A
CABOZANTINIB	ChEMBL	Phase 4 (approved)	HTR2A
CANDESARTAN CILEXETIL	ChEMBL	Phase 4 (approved)	HTR2A
CANNABIDIOL	ChEMBL	Phase 4 (approved)	HTR2A
CAPTOPRIL	ChEMBL	Phase 4 (approved)	HTR2A
CARBENOXOLONE	ChEMBL	Phase 4 (approved)	HTR2A
CARIPRAZINE	ChEMBL	Phase 4 (approved)	HTR2A
CARVEDILOL	ChEMBL	Phase 4 (approved)	HTR2A
CETIRIZINE	ChEMBL	Phase 4 (approved)	HTR2A
CHLOPHEDIANOL	ChEMBL	Phase 4 (approved)	HTR2A
CHLORHEXIDINE	ChEMBL	Phase 4 (approved)	HTR2A
CHLORPHENIRAMINE	ChEMBL	Phase 4 (approved)	HTR2A
CHLORPHENTERMINE	ChEMBL	Phase 4 (approved)	HTR2A
CHLORPROMAZINE	ChEMBL	Phase 4 (approved)	HTR2A
CHLORPROPAMIDE	ChEMBL	Phase 4 (approved)	HTR2A
CINACALCET	ChEMBL	Phase 4 (approved)	HTR2A
CINNARIZINE	ChEMBL	Phase 4 (approved)	HTR2A
CISAPRIDE	ChEMBL	Phase 4 (approved)	HTR2A
CITALOPRAM	ChEMBL	Phase 4 (approved)	HTR2A
CLEMASTINE	ChEMBL	Phase 4 (approved)	HTR2A
CLINDAMYCIN	ChEMBL	Phase 4 (approved)	HTR2A