Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI417AV8E)
  Drug Name Tranylcypromine Drug Info Dexfenfluramine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antidepressants Appetite Depressants
  Structure

 Mechanism of Tranylcypromine-Dexfenfluramine Interaction (Severity Level: Major)
     Additive serotonergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Tranylcypromine Dexfenfluramine
      Mechanism Serotonergic effects
Monoamine oxidase non-selective  Inhibitor 		Serotonergic effects
Serotonin transporter  Inhibitor
      Key Mechanism Factor 1
Factor Name Monoamine oxidase Structure Sequence
Protein Family Flavin monoamine oxidase family
Protein Function
Catalyzes the oxidative deamination of primary and some secondary amine such as neurotransmitters, with concomitant reduction of oxygen to hydrogen peroxide and has important functions in the metabolism of neuroactive and vasoactive amines in the central nervous system and peripheral tissues (PubMed:20493079, PubMed:8316221, PubMed:18391214, PubMed:24169519). Preferentially oxidizes serotonin (PubMed:20493079, PubMed:24169519). Also catalyzes the oxidative deamination of kynuramine to 3-(2-aminophenyl)-3-oxopropanal that can spontaneously condense to 4-hydroxyquinoline (By similarity).
    Click to Show/Hide
      Key Mechanism Factor 2
Factor Name Serotonin transporter
×
Structure Sequence
METTPLNSQKQLSACEDGEDCQENGVLQKVVPTPGDKVESGQISNGYSAVPSPGAGDDTRHSIPATTTTLVAELHQGERETWGKKVDFLLSVIGYAVDLGNVWRFPYICYQNGGGAFLLPYTIMAIFGGIPLFYMELALGQYHRNGCISIWRKICPIFKGIGYAICIIAFYIASYYNTIMAWALYYLISSFTDQLPWTSCKNSWNTGNCTNYFSEDNITWTLHSTSPAEEFYTRHVLQIHRSKGLQDLGGISWQLALCIMLIFTVIYFSIWKGVKTSGKVVWVTATFPYIILSVLLVRGATLPGAWRGVLFYLKPNWQKLLETGVWIDAAAQIFFSLGPGFGVLLAFASYNKFNNNCYQDALVTSVVNCMTSFVSGFVIFTVLGYMAEMRNEDVSEVAKDAGPSLLFITYAEAIANMPASTFFAIIFFLMLITLGLDSTFAGLEGVITAVLDEFPHVWAKRRERFVLAVVITCFFGSLVTLTFGGAYVVKLLEEYATGPAVLTVALIEAVAVSWFYGITQFCRDVKEMLGFSPGWFWRICWVAISPLFLLFIICSFLMSPPQLRLFQYNYPYWSIILGYCIGTSSFICIPTYIAYRLIITPGTFKERIIKSITPETPTEIPCGDIRLNAV
Gene Name SLC6A4
Uniprot ID SC6A4_HUMAN
KEGG Pathway hsa:6532
Protein Family Sodium:neurotransmitter symporter (SNF) (TC 2.A.22) family
Protein Function
Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into the pre-synaptic terminal for re-utilization. Plays a key role in mediating regulation of the availability of serotonin to other receptors of serotonergic systems. Terminates the action of serotonin and recycles it in a sodium-dependent manner.
    Click to Show/Hide
      Mechanism Description
  • Additive serotonergic effects by the combination of Tranylcypromine and Dexfenfluramine 

Recommended Action
      Management In general, serotonergic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with serotonergic agents.

References
1 Graber MA, Hoehns TB, Perry PJ "Sertraline-phenelzine drug interaction: a serotonin syndrome reaction." Ann Pharmacother 28 (1994): 732-5. [PMID: 7919561]
2 Klysner R, Larsen JK, Sorensen P, Hyllested M, Pedersen BD "Toxic interaction of venlafaxine and isocarboxazide." Lancet 346 (1995): 1298-9. [PMID: 7475741]
3 Levy AB, Bucher P, Votolato N "Myoclonus, hyperreflexia and diaphoresis in patients on phenelzine- tryptophan combination treatment." Can J Psychiatry 30 (1985): 434-6. [PMID: 4063940]