Drug General Information (ID: DDIMKL7ZW4)
  Drug Name Methylene blue Drug Info Valbenazine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antidotes/Mao Inhibitors Vmat2 Inhibitors
  Structure

 Mechanism of Methylene blue-Valbenazine Interaction (Severity Level: Major)
     Additive serotonergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Methylene blue Valbenazine
      Mechanism Serotonergic effects
Monoamine oxidase non-selective  Inhibitor
Serotonergic effects
Vesicular monoamine transporter 2  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).
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      Key Mechanism Factor 2
Factor Name Synaptic vesicle amine transporter
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Structure Sequence
MALSELALVRWLQESRRSRKLILFIVFLALLLDNMLLTVVVPIIPSYLYSIKHEKNATEIQTARPVHTASISDSFQSIFSYYDNSTMVTGNATRDLTLHQTATQHMVTNASAVPSDCPSEDKDLLNENVQVGLLFASKATVQLITNPFIGLLTNRIGYPIPIFAGFCIMFVSTIMFAFSSSYAFLLIARSLQGIGSSCSSVAGMGMLASVYTDDEERGNVMGIALGGLAMGVLVGPPFGSVLYEFVGKTAPFLVLAALVLLDGAIQLFVLQPSRVQPESQKGTPLTTLLKDPYILIAAGSICFANMGIAMLEPALPIWMMETMCSRKWQLGVAFLPASISYLIGTNIFGILAHKMGRWLCALLGMIIVGVSILCIPFAKNIYGLIAPNFGVGFAIGMVDSSMMPIMGYLVDLRHVSVYGSVYAIADVAFCMGYAIGPSAGGAIAKAIGFPWLMTIIGIIDILFAPLCFFLRSPPAKEEKMAILMDHNCPIKTKMYTQNNIQSYPIGEDEESESD
Gene Name SLC18A2
Uniprot ID VMAT2_HUMAN
KEGG Pathway hsa:6571
Protein Family Major facilitator superfamily
Protein Function
Involved in the ATP-dependent vesicular transport of biogenic amine neurotransmitters. Pumps cytosolic monoamines including dopamine, norepinephrine, serotonin, and histamine into synaptic vesicles (PubMed:23363473). Requisite for vesicular amine storage prior to secretion via exocytosis.
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      Mechanism Description
  • Additive serotonergic effects by the combination of Methylene blue and Valbenazine 

Recommended Action
      Management The use of valbenazine with MAOIs should generally be avoided. If concomitant use is required, caution and close clinical and laboratory monitoring are recommended. alternative treatment may be required if an interaction is suspected.

References
1 Product Information. Ingrezza (valbenazine). Neurocrine Biosciences, Inc., San Diego, CA.
2 Product Information. Matulane (procarbazine). Roche Laboratories, Nutley, NJ.
3 Product Information. Zyvox (linezolid) Pharmacia and Upjohn, Kalamazoo, MI.