Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI17V4DHM)
  Drug Name Donepezil Drug Info Physostigmine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Cholinesterase Inhibitors Ophthalmic Glaucoma Agents/Antidotes
  Structure

 Mechanism of Donepezil-Physostigmine Interaction (Severity Level: Moderate)
     Additive cholinergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Donepezil Physostigmine
      Mechanism Cholinergic effects
Acetylcholinesterase  Inhibitor 		Cholinergic effects
Acetylcholinesterase  Inhibitor
      Key Mechanism Factor 1
Factor Name Acetylcholinesterase
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Structure Sequence
MRPPQCLLHTPSLASPLLLLLLWLLGGGVGAEGREDAELLVTVRGGRLRGIRLKTPGGPVSAFLGIPFAEPPMGPRRFLPPEPKQPWSGVVDATTFQSVCYQYVDTLYPGFEGTEMWNPNRELSEDCLYLNVWTPYPRPTSPTPVLVWIYGGGFYSGASSLDVYDGRFLVQAERTVLVSMNYRVGAFGFLALPGSREAPGNVGLLDQRLALQWVQENVAAFGGDPTSVTLFGESAGAASVGMHLLSPPSRGLFHRAVLQSGAPNGPWATVGMGEARRRATQLAHLVGCPPGGTGGNDTELVACLRTRPAQVLVNHEWHVLPQESVFRFSFVPVVDGDFLSDTPEALINAGDFHGLQVLVGVVKDEGSYFLVYGAPGFSKDNESLISRAEFLAGVRVGVPQVSDLAAEAVVLHYTDWLHPEDPARLREALSDVVGDHNVVCPVAQLAGRLAAQGARVYAYVFEHRASTLSWPLWMGVPHGYEIEFIFGIPLDPSRNYTAEEKIFAQRLMRYWANFARTGDPNEPRDPKAPQWPPYTAGAQQYVSLDLRPLEVRRGLRAQACAFWNRFLPKLLSATDTLDEAERQWKAEFHRWSSYMVHWKNQFDHYSKQDRCSDL
Gene Name ACHE
Uniprot ID ACES_HUMAN
KEGG Pathway hsa:43
Protein Family Type-B carboxylesterase/lipase family
Protein Function
Hydrolyzes rapidly the acetylcholine neurotransmitter released into the synaptic cleft allowing to terminate the signal transduction at the neuromuscular junction. Role in neuronal apoptosis.
    Click to Show/Hide
      Mechanism Description
  • Additive cholinergic effects by the combination of Donepezil and Physostigmine 

Recommended Action
      Management Monitoring for excessive cholinergic effects and seizure activity is recommended. Patients should be advised to notify their physician if they experience nausea, vomiting, diarrhea, abdominal pain, increased salivation, cold sweats, slow or irregular heartbeat, muscle weakness or cramps, dizziness, headache, seizures, or respiratory distress.

References
1 Product Information. Aricept (donepezil). Pfizer US Pharmaceuticals, New York, NY.
2 Product Information. Cognex (tacrine). Parke-Davis, Morris Plains, NJ.
3 Product Information. Reminyl (galantamine) Janssen Pharmaceuticals, Titusville, NJ.