Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIOVER17G)
Drug Name			Botulinum Toxin Type B		Drug Info		Mepenzolate		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Antidystonic Agents				Parasympatholytics

Mechanism of Botulinum Toxin Type B-Mepenzolate Interaction (Severity Level: Moderate)
Additive anticholinergic effects Click to Show/Hide Mechanism Graph

Drug Name		Botulinum Toxin Type B				Mepenzolate
Mechanism		Anticholinergic effects Vesicle-associated membrane protein Inhibitor				Anticholinergic effects Muscarinic acetylcholine receptor Antagonist
Key Mechanism Factor 1
		Factor Name		Vesicle-associated membrane protein 2				× Structure Sequence MSATAATAPPAAPAGEGGPPAPPPNLTSNRRLQQTQAQVDEVVDIMRVNVDKVLERDQKLSELDDRADALQAGASQFETSAAKLKRKYWWKNLKMMIILGVICAIILIIIIVYFST
		Gene Name		VAMP2
		Uniprot ID		VAMP2_HUMAN
		KEGG Pathway		hsa:6844
		Protein Family		Synaptobrevin family
		Protein Function		Involved in the targeting and/or fusion of transport vesicles to their target membrane (By similarity). Major SNARE protein of synaptic vesicles which mediates fusion of synaptic vesicles to release neurotransmitters. Essential for fast vesicular exocytosis and activity-dependent neurotransmitter release as well as fast endocytosis that mediates rapid reuse of synaptic vesicles (By similarity) (PubMed:30929742). Modulates the gating characteristics of the delayed rectifier voltage-dependent potassium channel KCNB1. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Muscarinic acetylcholine receptor M				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Primary transducing effect is Pi turnover. Click to Show/Hide
Mechanism Description		Additive anticholinergic effects by the combination of Botulinum Toxin Type B and Mepenzolate

Recommended Action
Management		Patients should be advised that systemic anticholinergic side effects such as dry mouth, blurred vision, and urinary disorders may increase if agents with anticholinergic properties (e.g., sedating antihistamines antispasmodics neuroleptics phenothiazines skeletal muscle relaxants tricyclic antidepressants disopyramide) are used after administration of botulinum toxin.

References
1	Product Information. Botox (onabotulinumtoxin A). Allergan Inc, Irvine, CA.
2	Product Information. Myobloc (botulinum toxin type B) Elan Pharmaceuticals, S. San Francisco, CA.
3	Product Information. Xeomin (botulinum toxin type A (obsolete) (botulinum toxin type A)). Merz Pharmaceuticals, Greensboro, NC.