Details of Drug Interaction | MecDDI

Drug General Information (ID: DDI850DL12)
Drug Name			Phenelzine		Drug Info		Aliskiren		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidepressants				Antihypertensive Agents
Structure

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

Drug Name		Phenelzine				Aliskiren
Mechanism		Hypotensive effects Monoamine oxidase non-selective Inhibitor				Antihypertensive agent Angiotensinogenase 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		Angiotensinogenase renin				× Structure Sequence MDGWRRMPRWGLLLLLWGSCTFGLPTDTTTFKRIFLKRMPSIRESLKERGVDMARLGPEWSQPMKRLTLGNTTSSVILTNYMDTQYYGEIGIGTPPQTFKVVFDTGSSNVWVPSSKCSRLYTACVYHKLFDASDSSSYKHNGTELTLRYSTGTVSGFLSQDIITVGGITVTQMFGEVTEMPALPFMLAEFDGVVGMGFIEQAIGRVTPIFDNIISQGVLKEDVFSFYYNRDSENSQSLGGQIVLGGSDPQHYEGNFHYINLIKTGVWQIQMKGVSVGSSTLLCEDGCLALVDTGASYISGSTSSIEKLMEALGAKKRLFDYVVKCNEGPTLPDISFHLGGKEYTLTSADYVFQESYSSKKLCTLAIHAMDIPPPTGPTWALGATFIRKFYTEFDRRNNRIGFALAR
		Gene Name		REN
		Uniprot ID		RENI_HUMAN
		KEGG Pathway		hsa:5972
		Protein Family		Peptidase A1 family
		Protein Function		Renin is a highly specific endopeptidase, whose only known function is to generate angiotensin I from angiotensinogen in the plasma, initiating a cascade of reactions that produce an elevation of blood pressure and increased sodium retention by the kidney. Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Phenelzine and Aliskiren

Recommended Action
Management		Caution is advised during coadministration of MAOIs and other medications with hypotensive effects, especially during the first few weeks of treatment. Close monitoring for development of hypotension is recommended. Ambulatory patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References
1	Ban TA "Drug interactions with psychoactive drugs." Dis Nerv Syst 36 (1975): 164-6. [PMID: 1116424]
2	De Vita VT, Hahn MA, Oliverio VT "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med 120 (1965): 561-5. [PMID: 4379192]
3	Goldberg LI "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA 190 (1964): 456-62. [PMID: 14197995]
4	Golwyn DH, Sevlie CP "Monoamine oxidase inhibitor hypertensive crisis headache and orthostatic hypotension." J Clin Psychopharmacol 13 (1993): 77-8. [PMID: 8486823]
5	Kronig MH, Roose SP, Walsh BT, Woodring S, Glassman AH "Blood pressure effects of phenelzine." J Clin Psychopharmacol 3 (1983): 307-10. [PMID: 6630590]
6	Pettinger WA, Soyangco FG, Oates JA "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther 9 (1968): 442-7. [PMID: 5655478]
7	Product Information. Marplan (isocarboxazid) Roche Laboratories, Nutley, NJ.
8	Product Information. Matulane (procarbazine). Roche Laboratories, Nutley, NJ.
9	Product Information. Nardil (phenelzine). Parke-Dvis, Morris Plains, NJ.
10	Product Information. Parnate (tranylcypromine). SmithKline Beecham, Philadelphia, PA.
11	Product Information. Xatral (alfuzosin). Sanofi-Synthelabo Canada Inc, Markham, ON.
12	Reggev A, Vollhardt BR "Bradycardia induced by an interaction between phenelzine and beta blockers." Psychosomatics 30 (1992): 106-8. [PMID: 2913594]
13	Schulz R, Antonin KH, Hoffmann E, et al "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther 46 (1989): 528-36. [PMID: 2510962]