Drug General Information (ID: DDI23PQC46)
  Drug Name Triamterene Drug Info Apraclonidine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Diuretics Ophthalmic Glaucoma Agents
  Structure

 Mechanism of Triamterene-Apraclonidine Interaction (Severity Level: Moderate)
     Additive hypotensive effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Triamterene Apraclonidine
      Mechanism Antihypertensive agent
Amiloride-sensitive sodium channel  Blocker
Hypotensive effects
Alpha-2 adrenergic receptor  Agonist
      Key Mechanism Factor 1
Factor Name Amiloride-sensitive sodium channel Structure Sequence
Protein Family Amiloride-sensitive sodium channel (TC 1.A.6) family
Protein Function
Sodium permeable non-voltage-sensitive ion channel inhibited by the diuretic amiloride. Mediates the electrodiffusion of the luminal sodium (and water, which follows osmotically) through the apical membrane of epithelial cells. Plays an essential role in electrolyte and blood pressure homeostasis, but also in airway surface liquid homeostasis, which is important for proper clearance of mucus. Controls the reabsorption of sodium in kidney, colon, lung and eccrine sweat glands. Also plays a role in taste perception.
    Click to Show/Hide
      Key Mechanism Factor 2
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.
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      Mechanism Description
  • Additive hypotensive effects by the combination of Triamterene and Apraclonidine 

Recommended Action
      Management Blood pressure and pulse rate should be monitored regularly when topical alpha-2 adrenergic receptor agonists are prescribed in combination with cardiovascular drugs. Patients should be advised to notify their physician if they experience slow pulse, irregular heartbeat, dizziness, lightheadedness, or syncope.

References
1 Product Information. Alphagan (brimonidine ophthalmic). Allergan Inc, Irvine, CA.
2 Product Information. Mirvaso (brimonidine topical). Galderma Laboratories Inc, Cranbury, NJ.
3 Walters TR "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol 41 ( Suppl (1996): s19-26