Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIRMQFX50)
Drug Name			Clonidine		Drug Info		Dapagliflozin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antidiabetic Agents
Structure

Mechanism of Clonidine-Dapagliflozin Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph

Drug Name		Clonidine				Dapagliflozin
Mechanism 1		Antihypertensive agent Alpha-2 adrenergic receptor Agonist				Antihypertensive agent
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
Mechanism Description		Additive hypotensive effects by the combination of Clonidine and Dapagliflozin
Mechanism 2		Antihypertensive agent Alpha-2 adrenergic receptor Agonist				Hypotensive effects
Key Mechanism Factor 2
		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
Mechanism Description		Additive hypotensive effects by the combination of Clonidine and Dapagliflozin

Recommended Action
Management		Caution is advised if SGLT-2 inhibitors are coadministered with diuretics and other hypotensive agents, particularly in the elderly and patients with impaired renal function. Prior to initiating SGLT-2 inhibitors, volume status should be assessed and corrected, if necessary. Clinical and laboratory monitoring are recommended during therapy, including electrolytes, fluid status, renal function, and blood pressure. If volume depletion occurs, treatment with SGLT-2 inhibitors should be interrupted until the condition is corrected.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Jardiance (empagliflozin). Boehringer Ingelheim, Ridgefield, CT.