Details of Drug Interaction | MecDDI

Drug General Information (ID: DDI0LR836X)
Drug Name			Dexmedetomidine		Drug Info		Isosorbide mononitrate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anxiolytics/Sedatives/Hypnotics				Vasodilator Agents
Structure

Mechanism of Dexmedetomidine-Isosorbide mononitrate Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph

Drug Name		Dexmedetomidine				Isosorbide mononitrate
Mechanism		Hypotensive effects Alpha-2 adrenergic receptor Agonist				Hypotensive effects Guanylate cyclase Agonist
Key Mechanism Factor 1
		Factor Name		Adrenergic receptor alpha-2				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		Alpha-2 adrenergic receptors mediate the catecholamine-induced inhibition of adenylate cyclase through the action of G proteins. The rank order of potency for agonists of this receptor is oxymetazoline > clonidine > epinephrine > norepinephrine > phenylephrine > dopamine > p-synephrine > p-tyramine > serotonin = p-octopamine. For antagonists, the rank order is yohimbine > phentolamine = mianserine > chlorpromazine = spiperone = prazosin > propanolol > alprenolol = pindolol. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions. Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Dexmedetomidine and Isosorbide mononitrate

Recommended Action
Management		Caution and monitoring of the patient's hemodynamic status are recommended during coadministration.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
3	Product Information. Precedex (dexmedetomidine) Abbott Pharmaceutical, Abbott Park, IL.