Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDIMCZQEB7)
  Drug Name Zolmitriptan Drug Info Methylene blue Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antimigraine Agents Antidotes/Mao Inhibitors
  Structure

 Mechanism of Zolmitriptan-Methylene blue Interaction (Severity Level: Major)
     Non-CYP450 enzyme inhibition Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Zolmitriptan Methylene blue
      Mechanism Monoamine oxidase substrate Monoamine oxidase inhibitor
      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
      Mechanism Description
  • Decreased metabolism of Zolmitriptan caused by Methylene blue mediated inhibition of non-CYP450 enzyme

Recommended Action
      Management Concomitant use of rizatriptan, sumatriptan, or zolmitriptan 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 5-HT1 receptor agonists. If concurrent therapy is necessary, almotriptan, frovatriptan and naratriptan may be preferred due to the lack of a significant pharmacokinetic interaction with MAOIs. However, patients should be closely monitored for adverse effects related to excessive serotonergic activity.

References
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