Details of Drug

Drug General Information (ID: D1285)
Drug Name	Physostigmine
Drug Type	Small molecule
Drug Synonymous	Xalieve; Acetylcholinesterase inhibitor (dry mouth), Calabar; Physostigmine (local acting gel, xerostomia); Physostigmine (buccal, xerostomia), Calabar; Physostigmine (local acting gel, xerostomia), Calabar Click to Show/Hide
Disease Class	DA02: Lips/oral mucosa miscellaneous disorder
Therapeutic Class	Ophthalmic Glaucoma Agents/Antidotes
Structure
Structure	3D Structure		2D Structure
Formula	C15H21N3O2
InChI	1S/C15H21N3O2/c1-15-7-8-17(3)13(15)18(4)12-6-5-10(9-11(12)15)20-14(19)16-2/h5-6,9,13H,7-8H2,1-4H3,(H,16,19)/t13-,15+/m1/s1
InChIKey	PIJVFDBKTWXHHD-HIFRSBDPSA-N
Canonical SMILES	CC12CCN(C1N(C3=C2C=C(C=C3)OC(=O)NC)C)C
External Link
	Pubchem ID	5983
	CAS Number	57-47-6
	CHEBI ID	27953
	TTD ID	D09JVV

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM037 Additive cholinergic effects BM045 Additive neuromuscular blocking effects BM049 Increased risk of atrioventricular block BM051 Increased risk of bradycardia BM069 Increased risk of lowers seizure threshold BM081 Increased risk of ventricular arrhythmias BM091 Antagonize the effect of cholinergic agents
Relation Graph

Full list of drugs interacting with Physostigmine
Pharmacodynamic additive effects
	Additive cholinergic effects					Drug Num: 10
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0516		Donepezil	C24H29NO3	3152	Moderate		Inter Info	[31], [32], [33]
D0707		Galantamine	C17H21NO3	9651	Moderate		Inter Info	[31], [32], [33]
D0746		Guanidine	CH5N3	3520	Moderate		Inter Info	[31], [32], [33]
D0052		Ambenonium	C28H42Cl2N4O2+2	2131	Moderate		Inter Info	[31], [32], [33]
D0054		Amifampridine	C5H7N3	5918	Moderate		Inter Info	[39], [40]
D0175		Bethanechol	C7H17N2O2+	2370	Moderate		Inter Info	[31], [32], [33]
D0552		Edrophonium	C10H16NO+	3202	Moderate		Inter Info	[31], [32], [33]
D1122		Neostigmine	C12H19N2O2+	4456	Moderate		Inter Info	[31], [32], [33]
D1418		Rivastigmine	C14H22N2O2	77991	Moderate		Inter Info	[31], [32], [33]
D1525		Tacrine	C13H14N2	1935	Moderate		Inter Info	[31], [32], [33]
	Additive neuromuscular blocking effects					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1510		Succinylcholine	C14H30N2O4+2	5314	Moderate		Inter Info	[61], [62], [63], [31], [33]
	Increased risk of bradycardia					Drug Num: 8
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1474		Siponimod	C29H35F3N2O3	44599207	Major		Inter Info	[21], [22]
D0031		Alectinib	C30H34N4O2	49806720	Moderate		Inter Info	[37], [38]
D0204		Brigatinib	C29H39ClN7O2P	68165256	Moderate		Inter Info	[41]
D0393		Crizotinib	C21H22Cl2FN5O	11626560	Moderate		Inter Info	[42], [43], [44]
D0661		Fingolimod	C19H33NO2	107970	Moderate		Inter Info	[45], [46]
D0868		Ivabradine	C27H36N2O5	132999	Moderate		Inter Info	[21], [55]
D0897		Lasmiditan	C19H18F3N3O2	11610526	Moderate		Inter Info	[56]
D1211		Ozanimod	C23H24N4O3	52938427	Moderate		Inter Info	[57]
	Increased risk of lowers seizure threshold					Drug Num: 9
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0220		Bupropion	C13H18ClNO	444	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]
D0833		Iohexol	C19H26I3N3O9	3730	Major		Inter Info	[16], [17], [18], [19], [20]
D0834		Iopamidol	C17H22I3N3O8	65492	Major		Inter Info	[16], [17], [18], [19], [20]
D1616		Tramadol	C16H25NO2	33741	Major		Inter Info	[23], [14], [13], [24]
D0932		Lindane	C6H6Cl6	727	Moderate		Inter Info	[34], [35], [36]
D0722		Ginkgo biloba	NA	NA	Moderate		Inter Info	[47], [48], [49], [50], [51], [52], [53], [54]
D1287		Picosulfuric acid	C18H15NO8S2	5243	Moderate		Inter Info	[58], [59], [42]
D1308		Polyethylene glycol (3350 with electrolytes)	C2H6O2	174	Moderate		Inter Info	[58], [59], [42]
D1488		Sodium sulfate	Na2O4S	24436	Moderate		Inter Info	[58], [59], [42]
	Increased risk of ventricular arrhythmias					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1569		Thalidomide	C13H10N2O4	5426	Moderate		Inter Info	[21], [42], [60]
Pharmacodynamic antagonistic effects
	Antagonize the effect of cholinergic agents					Drug Num: 91
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0068		Amitriptyline	C20H23N	2160	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0072		Amoxapine	C17H16ClN3O	2170	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0123		Atropine	C17H23NO3	174174	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0124		Atropine (ophthalmic)	C17H23NO3	174174	Moderate		Inter Info	[29], [31], [30]
D0135		Azatadine	C20H22N2	19861	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0160		Benzatropine	C21H25NO	1201549	Moderate		Inter Info	[29], [31], [30]
D0183		Biperiden	C21H29NO	2381	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0214		Brompheniramine	C16H19BrN2	6834	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0259		Carbinoxamine	C16H19ClN2O	2564	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0324		Chlorpromazine	C17H19ClN2S	2726	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0337		Cimetidine	C10H16N6S	2756	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0351		Clemastine	C21H26ClNO	26987	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0353		Clidinium	C22H26NO3+	2784	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0370		Clozapine	C18H19ClN4	135398737	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0398		Cyclobenzaprine	C20H21N	2895	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0399		Cyclopentolate (ophthalmic)	C17H25NO3	2905	Moderate		Inter Info	[29], [31], [30]
D0403		Cyproheptadine	C21H21N	2913	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0424		Darifenacin	C28H30N2O2	444031	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0456		Dexbrompheniramine	C16H19BrN2	16960	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0482		Dicyclomine	C19H35NO2	3042	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0508		Disopyramide	C21H29N3O	3114	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0532		Doxylamine	C17H22N2O	3162	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0678		Fluphenazine	C22H26F3N3OS	3372	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0750		Haloperidol	C21H23ClFNO2	3559	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0781		Hydroxyzine	C21H27ClN2O2	3658	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0782		Hyoscyamine	C17H23NO3	154417	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0795		Imipramine	C19H24N2	3696	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0947		Loperamide	C29H33ClN2O2	3955	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0957		Loxapine	C18H18ClN3O	3964	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0979		Maprotiline	C20H23N	4011	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1010		Mesoridazine	C21H26N2OS2	4078	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1019		Methdilazine	C18H20N2S	14677	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1158		Nortriptyline	C19H21N	4543	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1166		Olanzapine	C17H20N4S	135398745	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1257		Perphenazine	C21H26ClN3OS	4748	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0020		Acrivastine	C22H24N2O2	5284514	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0037		Alimemazine	C18H22N2S	5574	Moderate		Inter Info	[26], [27], [29]
D0105		Aripiprazole	C23H27Cl2N3O2	60795	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0154		Belladonna	C34H42N2O4	265028	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0202		Brexpiprazole	C25H27N3O2S	11978813	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0316		Chlorcyclizine	C18H21ClN2	2710	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0323		Chlorpheniramine	C16H19ClN2	2725	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0361		Clomipramine	C19H23ClN2	2801	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0397		Cyclizine	C18H22N2	6726	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0446		Desipramine	C18H22N2	2995	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0498		Dimenhydrinate	C24H28ClN5O3	10660	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0502		Diphenhydramine	C17H21NO	3100	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0525		Doxepin	C19H21NO	667477	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D0526		Doxepin (topical)	C19H21NO	667477	Moderate		Inter Info	[26], [27], [29]
D0662		Flavoxate	C24H25NO4	3354	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D0733		Glycopyrronium	C19H28NO3+	3494	Moderate		Inter Info	[29], [31], [30]
D0759		Homatropine	C16H21NO3	5282593	Moderate		Inter Info	[29], [31], [30]
D0760		Homatropine (ophthalmic)	C16H21NO3	5282593	Moderate		Inter Info	[29], [31], [30]
D0959		Lumateperone	C24H28FN3O	21302490	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1000		Mepenzolate	C21H26NO3+	4057	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1006		Mepyramine	C17H23N3O	4992	Moderate		Inter Info	[26], [27], [29]
D1026		Methotrimeprazine	C19H24N2OS	72287	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1031		Methscopolamine	C18H24NO4+	71183	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1084		Molindone	C16H24N2O2	23897	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1188		Orphenadrine	C18H23NO	4601	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1202		Oxybutynin	C22H31NO3	4634	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1264		Phenindamine	C19H19N	11291	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1282		Phenyltoloxamine	C17H21NO	7077	Moderate		Inter Info	[26], [27], [29]
D1292		Pimozide	C28H29F2N3O	16362	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1343		Procainamide	C13H21N3O	4913	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1352		Promethazine	C17H20N2S	4927	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1368		Quetiapine	C21H25N3O2S	5002	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1491		Solifenacin	C23H26N2O2	154059	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1576		Thiothixene	C23H29N3O2S2	941651	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1607		Tolterodine	C22H31NO	443879	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1346		Prochlorperazine	C20H24ClN3S	4917	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1347		Procyclidine	C19H29NO	4919	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1351		Promazine	C17H20N2S	4926	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1354		Propantheline	C23H30NO3+	4934	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1355		Propiomazine	C20H24N2OS	4940	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1361		Protriptyline	C19H21N	4976	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1371		Quinidine	C20H24N2O2	441074	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1381		Ranitidine	C13H22N4O3S	3001055	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1413		Risperidone	C23H27FN4O2	5073	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1451		Scopolamine (ophthalmic)	C17H21NO4	3000322	Moderate		Inter Info	[29], [31], [30]
D1572		Thiethylperazine	C22H29N3S2	5440	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1574		Thioridazine	C21H26N2S2	5452	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1637		Trifluoperazine	C21H24F3N3S	5566	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1638		Triflupromazine	C18H19F3N2S	5568	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1641		Trihexyphenidyl	C20H31NO	5572	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1647		Trimipramine	C20H26N2	5584	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1649		Tripelennamine	C16H21N3	5587	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1650		Triprolidine	C19H22N2	5282443	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]
D1655		Tropicamide (ophthalmic)	C17H20N2O2	5593	Moderate		Inter Info	[29], [31], [30]
D1656		Trospium	C25H30NO3+	5284632	Moderate		Inter Info	[25], [26], [27], [28], [29], [31], [32], [33], [30]
D1726		Ziprasidone	C21H21ClN4OS	60854	Moderate		Inter Info	[25], [26], [27], [28], [29], [30]

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