Details of Drug-Drug Interaction
| Drug General Information (ID: DDIKMJN02O) | |||||||||
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| Drug Name | Brimonidine (ophthalmic) | Drug Info | Isosorbide | Drug Info | |||||
| Drug Type | Small molecule | Small molecule | |||||||
| Therapeutic Class | Ophthalmic Glaucoma Agents | Antianginal Agents | |||||||
| Structure | |||||||||
| Mechanism of Brimonidine (ophthalmic)-Isosorbide Interaction (Severity Level: Moderate) | |||||||||
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| Additive hypotensive effects Click to Show/Hide Mechanism Graph | |||||||||
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| Drug Name | Brimonidine (ophthalmic) | Isosorbide | |||||||
| Mechanism |
Hypotensive effects Alpha-2 adrenergic receptor Agonist |
Antihypertensive agent Guanylate cyclase Agonist |
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| Key Mechanism Factor 1 | |||||||||
| Factor Name | Adrenergic receptor alpha-2 | Structure Sequence | |||||||
| Protein Family | G-protein coupled receptor 1 family | ||||||||
| Protein Function |
Alpha-2 adrenergic receptors mediate the catecholamine-induced inhibition of adenylate cyclase through the action of G proteins. The rank order of potency for agonists of this receptor is oxymetazoline > clonidine > epinephrine > norepinephrine > phenylephrine > dopamine > p-synephrine > p-tyramine > serotonin = p-octopamine. For antagonists, the rank order is yohimbine > phentolamine = mianserine > chlorpromazine = spiperone = prazosin > propanolol > alprenolol = pindolol.
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| Key Mechanism Factor 2 | |||||||||
| Factor Name | Guanylate cyclase soluble | Structure Sequence | |||||||
| Protein Family | Adenylyl cyclase class-4/guanylyl cyclase family | ||||||||
| Protein Function |
There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions.
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| Mechanism Description |
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| Recommended Action | |||||||||
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| Management | Blood pressure and pulse rate should be monitored regularly when topical alpha-2 adrenergic receptor agonists are prescribed in combination with cardiovascular drugs. Patients should be advised to notify their physician if they experience slow pulse, irregular heartbeat, dizziness, lightheadedness, or syncope. | ||||||||