Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDINT8YGCW)
  Drug Name Brimonidine (topical) Drug Info Mecamylamine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Ophthalmic Glaucoma Agents Antihypertensive Agents
  Structure

 Mechanism of Brimonidine (topical)-Mecamylamine Interaction (Severity Level: Moderate)
     Additive hypotensive effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Brimonidine (topical) Mecamylamine
      Mechanism Hypotensive effects
Alpha-2 adrenergic receptor  Agonist 		Hypotensive effects
Neuronal acetylcholine receptor  Antagonist
      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.
    Click to Show/Hide
      Key Mechanism Factor 2
Factor Name Neuronal acetylcholine receptor Structure Sequence
Protein Family Ligand-gated ion channel (TC 1.A.9) family
Protein Function
After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.
    Click to Show/Hide
      Mechanism Description
  • Additive hypotensive effects by the combination of Brimonidine (topical) and Mecamylamine 

Recommended Action
      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.

References
1 Product Information. Alphagan (brimonidine ophthalmic). Allergan Inc, Irvine, CA.
2 Product Information. Mirvaso (brimonidine topical). Galderma Laboratories Inc, Cranbury, NJ.
3 Walters TR "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol 41 ( Suppl (1996): s19-26