Drug General Information (ID: DDIM7JGINB)
  Drug Name Tranylcypromine Drug Info Ondansetron Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antidepressants Antiemetics
  Structure

 Mechanism of Tranylcypromine-Ondansetron Interaction (Severity Level: Major)
     Additive serotonergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Tranylcypromine Ondansetron
      Mechanism Serotonergic effects
Monoamine oxidase non-selective  Inhibitor
Serotonergic effects
5-HT 3 receptor  Antagonist
      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 5-HT 3 receptor Structure Sequence
Protein Family Ligand-gated ion channel (TC 1.A.9) family
Protein Function
This is one of the several different receptors for 5-hydroxytryptamine (serotonin), a biogenic hormone that functions as a neurotransmitter, a hormone, and a mitogen. This receptor is a ligand-gated ion channel, which when activated causes fast, depolarizing responses in neurons. It is a cation-specific, but otherwise relatively nonselective, ion channel.
    Click to Show/Hide
      Mechanism Description
  • Additive serotonergic effects by the combination of Tranylcypromine and Ondansetron 

Recommended Action
      Management Caution is advised if 5-HT3 receptor antagonists are prescribed with other agents that affect the serotonergic neurotransmitter system. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is warranted when initiating or increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is typically recommended following use of fluoxetine and 2 weeks following use of MAOIs before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary.

References
1 Canadian Pharmacists Association.
2 Cerner Multum, Inc. "Australian Product Information.".
3 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4 Product Information. Akynzeo (netupitant-palonosetron). Eisai Inc, Woodcliff Lake, NJ.
5 Product Information. Aloxi (palonosetron). MGI Pharma Inc, Minnetonka, MN.
6 Product Information. Anzemet (dolasetron). Hoechst Marion-Roussel Inc, Kansas City, MO.
7 Product Information. Sancuso (granisetron). ProStrakan Group, Bedminster, NJ.