Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI9IS30QZ)
  Drug Name Doxylamine Drug Info Methylene blue Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anxiolytics/Sedatives/Hypnotics Antidotes/Mao Inhibitors
  Structure

 Mechanism of Doxylamine-Methylene blue Interaction (Severity Level: Major)
     Additive anticholinergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Doxylamine Methylene blue
      Mechanism 1 Anticholinergic effects
Muscarinic acetylcholine receptor  Antagonist 		Anticholinergic effects
Monoamine oxidase non-selective  Inhibitor
      Key Mechanism Factor 1
Factor Name Muscarinic acetylcholine receptor M Structure Sequence
Protein Family G-protein coupled receptor 1 family
Protein Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Primary transducing effect is Pi turnover.
    Click to Show/Hide
      Key Mechanism Factor 2
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
      Mechanism Description
  • Additive anticholinergic effects by the combination of Doxylamine and Methylene blue 
     Additive CNS depression effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Doxylamine Methylene blue
      Mechanism 2 CNS depression effects CNS depression effects
      Key Mechanism Factor 3
Factor Name CNS depression effects
Factor Description CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
      Mechanism Description
  • Additive CNS depression effects by the combination of Doxylamine and Methylene blue 

Recommended Action
      Management The use of doxylamine in combination with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine) is considered contraindicated. At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with doxylamine.

References
1 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2 Product Information. Diclectin (doxylamine-pyridoxine). Duchesnay Inc, Laval, IN.
3 Product Information. Diclegis (doxylamine-pyridoxine). Duchesnay USA Inc, Rosemont, PA.
4 Skop BP, Finkelstein JA, Mareth TR, Magoon MR, Brown TM "The serotonin syndrome associated wtih paroxetine, an over-the-counter cold remedy, and vascular disease." Am J Emerg Med 12 (1994): 642-4. [PMID: 7945606]