Details of Drug Interaction | MecDDI

Drug General Information (ID: DDII2U6WT1)
Drug Name			Minoxidil		Drug Info		Alimemazine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antihistamines
Structure

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

Drug Name		Minoxidil				Alimemazine
Mechanism		Hypotensive effects ATP-sensitive inward rectifier potassium channel Inducer				Hypotensive effects Alpha-1 adrenergic receptor Antagonist
Key Mechanism Factor 1
		Factor Name		Inward rectifier potassium channel				Structure Sequence
		Protein Family		Inward rectifier-type potassium channel (TC 1.A.2.1) family
		Protein Function		This receptor is controlled by G proteins. Inward rectifier potassium channels are characterized by a greater tendency to allow potassium to flow into the cell rather than out of it. Their voltage dependence is regulated by the concentration of extracellular potassium; as external potassium is raised, the voltage range of the channel opening shifts to more positive voltages. The inward rectification is mainly due to the blockage of outward current by internal magnesium. Can be blocked by extracellular barium (By similarity). Subunit of ATP-sensitive potassium channels (KATP). Can form cardiac and smooth muscle-type KATP channels with ABCC9. KCNJ11 forms the channel pore while ABCC9 is required for activation and regulation. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Adrenergic receptor alpha-1				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		This alpha-adrenergic receptor mediates its action by association with G proteins that activate a phosphatidylinositol-calcium second messenger system. Its effect is mediated by G(q) and G(11) proteins. Nuclear ADRA1A-ADRA1B heterooligomers regulate phenylephrine(PE)-stimulated ERK signaling in cardiac myocytes. Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Minoxidil and Alimemazine

Recommended Action
Management		Close clinical monitoring for development of hypotension is recommended if phenothiazines or neuroleptic agents are used in patients receiving antihypertensive medications or vasodilators. A lower starting dosage and slower titration of the phenothiazine or neuroleptic may be appropriate, especially in the elderly. 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. Patients should also avoid driving or operating hazardous machinery.

References
1	Product Information. Clozaril (clozapine). Novartis Pharmaceuticals, East Hanover, NJ.
2	Product Information. Rexulti (brexpiprazole). Otsuka American Pharmaceuticals Inc, Rockville, MD.
3	Product Information. Seroquel (quetiapine). Zeneca Pharmaceuticals, Wilmington, DE.