Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIJO7LKIA)
Drug Name			Triamterene		Drug Info		Tranylcypromine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Diuretics				Antidepressants
Structure

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

Drug Name		Triamterene				Tranylcypromine
Mechanism		Hypotensive effects Amiloride-sensitive sodium channel Inhibitor				Hypotensive effects Monoamine oxidase non-selective Inhibitor
Key Mechanism Factor 1
		Factor Name		Amiloride-sensitive sodium channel				Structure Sequence
		Protein Family		Amiloride-sensitive sodium channel (TC 1.A.6) family
		Protein Function		Sodium permeable non-voltage-sensitive ion channel inhibited by the diuretic amiloride. Mediates the electrodiffusion of the luminal sodium (and water, which follows osmotically) through the apical membrane of epithelial cells. Plays an essential role in electrolyte and blood pressure homeostasis, but also in airway surface liquid homeostasis, which is important for proper clearance of mucus. Controls the reabsorption of sodium in kidney, colon, lung and eccrine sweat glands. Also plays a role in taste perception. 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 hypotensive effects by the combination of Triamterene and Tranylcypromine

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
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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]