Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI6I5CSAL)
  Drug Name Zolmitriptan Drug Info Milnacipran Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antimigraine Agents Antidepressants
  Structure

 Mechanism of Zolmitriptan-Milnacipran Interaction (Severity Level: Major)
     Additive serotonergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Zolmitriptan Milnacipran
      Mechanism Serotonergic effects
5-HT 1 receptor  Agonist 		Serotonergic effects
Serotonin transporter  Inhibitor
      Key Mechanism Factor 1
Factor Name 5-HT 1 receptor Structure Sequence
Protein Family G-protein coupled receptor 1 family
Protein Function
G-protein coupled receptor for 5-hydroxytryptamine (serotonin). Also functions as a receptor for various drugs and psychoactive substances. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down-stream effectors, such as adenylate cyclase. Beta-arrestin family members inhibit signaling via G proteins and mediate activation of alternative signaling pathways. Signaling inhibits adenylate cyclase activity and activates a phosphatidylinositol-calcium second messenger system that regulates the release of Ca(2+) ions from intracellular stores. Plays a role in the regulation of 5-hydroxytryptamine release and in the regulation of dopamine and 5-hydroxytryptamine metabolism. Plays a role in the regulation of dopamine and 5-hydroxytryptamine levels in the brain, and thereby affects neural activity, mood and behavior. Plays a role in the response to anxiogenic stimuli.
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      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.
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      Mechanism Description
  • Additive serotonergic effects by the combination of Zolmitriptan and Milnacipran 

Recommended Action
      Management In general, the use of milnacipran in combination with other serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life.

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58 Product Information. Brintellix (vortioxetine). Takeda Pharmaceuticals America, Lincolnshire, IL.
59 Product Information. Celexa (citalopram). Forest Pharmaceuticals, St. Louis, MO.
60 Product Information. Cymbalta (duloxetine). Lilly, Eli and Company, Indianapolis, IN.
61 Product Information. D.H.E. 45 (dihydroergotamine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
62 Product Information. Effexor (venlafaxine). Wyeth-Ayerst Laboratories, Philadelphia, PA.
63 Product Information. Fetzima (levomilnacipran). Forest Pharmaceuticals, St. Louis, MO.
64 Product Information. Flexeril (cyclobenzaprine). Merck & Co, Inc, West Point, PA.
65 Product Information. Imitrex (sumatriptan). Glaxo Wellcome, Research Triangle Park, NC.
66 Product Information. Lexapro (escitalopram). Forest Pharmaceuticals, St. Louis, MO.
67 Product Information. Luvox (fluvoxamine). Solvay Pharmaceuticals Inc, Marietta, GA.
68 Product Information. Maxalt (rizatriptan). Merck & Co, Inc, West Point, PA.
69 Product Information. Meridia (sibutramine). Knoll Pharmaceutical Company, Whippany, NJ.
70 Product Information. Nucynta (tapentadol). PriCara Pharmaceuticals, Raritan, NJ.
71 Product Information. Oleptro (traZODone). Labopharm Inc, Laval, AL.
72 Product Information. Paxil (paroxetine). GlaxoSmithKline, Research Triangle Park, NC.
73 Product Information. Pristiq (desvenlafaxine). Wyeth Laboratories, Philadelphia, PA.
74 Product Information. Prozac (fluoxetine). Dista Products Company, Indianapolis, IN.
75 Product Information. Savella (milnacipran). Forest Pharmaceuticals, St. Louis, MO.
76 Product Information. Viibryd (vilazodone). Trovis Pharmaceuticals LLC, New Haven, CT.
77 Product Information. Zoloft (sertraline). Roerig Division, New York, NY.
78 Product Information. Zomig (zolmitriptan). Zeneca Pharmaceuticals, Wilmington, DE.
79 Product Information. Zyvox (linezolid) Pharmacia and Upjohn, Kalamazoo, MI.
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