Drug General Information (ID: DDISJE156Z)
  Drug Name Altretamine Drug Info Clomipramine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antineoplastics Antidepressants
  Structure

 Mechanism of Altretamine-Clomipramine Interaction (Severity Level: Moderate)
     Additive hypotensive effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Altretamine Clomipramine
      Mechanism Hypotensive effects Hypotensive effects
Serotonin transporter  Inhibitor
      Key Mechanism Factor 1
Factor Name Serotonin transporter
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Structure Sequence
METTPLNSQKQLSACEDGEDCQENGVLQKVVPTPGDKVESGQISNGYSAVPSPGAGDDTRHSIPATTTTLVAELHQGERETWGKKVDFLLSVIGYAVDLGNVWRFPYICYQNGGGAFLLPYTIMAIFGGIPLFYMELALGQYHRNGCISIWRKICPIFKGIGYAICIIAFYIASYYNTIMAWALYYLISSFTDQLPWTSCKNSWNTGNCTNYFSEDNITWTLHSTSPAEEFYTRHVLQIHRSKGLQDLGGISWQLALCIMLIFTVIYFSIWKGVKTSGKVVWVTATFPYIILSVLLVRGATLPGAWRGVLFYLKPNWQKLLETGVWIDAAAQIFFSLGPGFGVLLAFASYNKFNNNCYQDALVTSVVNCMTSFVSGFVIFTVLGYMAEMRNEDVSEVAKDAGPSLLFITYAEAIANMPASTFFAIIFFLMLITLGLDSTFAGLEGVITAVLDEFPHVWAKRRERFVLAVVITCFFGSLVTLTFGGAYVVKLLEEYATGPAVLTVALIEAVAVSWFYGITQFCRDVKEMLGFSPGWFWRICWVAISPLFLLFIICSFLMSPPQLRLFQYNYPYWSIILGYCIGTSSFICIPTYIAYRLIITPGTFKERIIKSITPETPTEIPCGDIRLNAV
Gene Name SLC6A4
Uniprot ID SC6A4_HUMAN
KEGG Pathway hsa:6532
Protein Family Sodium:neurotransmitter symporter (SNF) (TC 2.A.22) family
Protein Function
Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into the pre-synaptic terminal for re-utilization. Plays a key role in mediating regulation of the availability of serotonin to other receptors of serotonergic systems. Terminates the action of serotonin and recycles it in a sodium-dependent manner.
    Click to Show/Hide
      Mechanism Description
  • Additive hypotensive effects by the combination of Altretamine and Clomipramine 

Recommended Action
      Management Caution is advised if altretamine must be used with a MAOI or tricyclic antidepressant, particularly in elderly patients. All patients receiving the combination should be advised to avoid rising abruptly from a sitting or lying position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting.

References
1 Bruckner HW, Schleifer SJ "Orthostatic hypotension as a complication of hexamethylmelamine antidepressant interaction." Cancer Treat Rep 67 (1983): 516. [PMID: 6406063]
2 Product Information. Hexalen Capsules (altretamine). US Bioscience, West Conshohoken, PA.