Details of Drug Interaction | MecDDI

Drug General Information (ID: DDI38M9W2D)
Drug Name			Cyclandelate		Drug Info		Empagliflozin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasodilator Agents				Antidiabetic Agents
Structure

Mechanism of Cyclandelate-Empagliflozin Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph

Drug Name		Cyclandelate				Empagliflozin
Mechanism 1		Antihypertensive agent Voltage-gated calcium channel Blocker				Antihypertensive agent
Key Mechanism Factor 1
		Factor Name		Voltage-dependent L-type calcium channel				Structure Sequence
		Protein Family		Calcium channel beta subunit family
		Protein Function		Regulatory subunit of L-type calcium channels (PubMed:1309651, PubMed:8107964, PubMed:15615847). Regulates the activity of L-type calcium channels that contain CACNA1A as pore-forming subunit (By similarity). Regulates the activity of L-type calcium channels that contain CACNA1C as pore-forming subunit and increases the presence of the channel complex at the cell membrane (PubMed:15615847). Required for functional expression L-type calcium channels that contain CACNA1D as pore-forming subunit (PubMed:1309651). Regulates the activity of L-type calcium channels that contain CACNA1B as pore-forming subunit (PubMed:8107964). Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Cyclandelate and Empagliflozin
Mechanism 2		Antihypertensive agent Voltage-gated calcium channel Blocker				Hypotensive effects
Key Mechanism Factor 2
		Factor Name		Voltage-dependent L-type calcium channel				Structure Sequence
		Protein Family		Calcium channel beta subunit family
		Protein Function		Regulatory subunit of L-type calcium channels (PubMed:1309651, PubMed:8107964, PubMed:15615847). Regulates the activity of L-type calcium channels that contain CACNA1A as pore-forming subunit (By similarity). Regulates the activity of L-type calcium channels that contain CACNA1C as pore-forming subunit and increases the presence of the channel complex at the cell membrane (PubMed:15615847). Required for functional expression L-type calcium channels that contain CACNA1D as pore-forming subunit (PubMed:1309651). Regulates the activity of L-type calcium channels that contain CACNA1B as pore-forming subunit (PubMed:8107964). Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Cyclandelate and Empagliflozin

Recommended Action
Management		Caution is advised if SGLT-2 inhibitors are coadministered with diuretics and other hypotensive agents, particularly in the elderly and patients with impaired renal function. Prior to initiating SGLT-2 inhibitors, volume status should be assessed and corrected, if necessary. Clinical and laboratory monitoring are recommended during therapy, including electrolytes, fluid status, renal function, and blood pressure. If volume depletion occurs, treatment with SGLT-2 inhibitors should be interrupted until the condition is corrected.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Jardiance (empagliflozin). Boehringer Ingelheim, Ridgefield, CT.