Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDISPT2H1U)
  Drug Name Guanidine Drug Info Amifampridine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Cholinergic Muscle Stimulants Cholinergic Muscle Stimulants
  Structure

 Mechanism of Guanidine-Amifampridine Interaction (Severity Level: Moderate)
     Additive cholinergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Guanidine Amifampridine
      Mechanism Cholinergic effects
Acetylcholinesterase  Inhibitor 		Cholinergic effects
      Key Mechanism Factor 1
Factor Name Acetylcholinesterase
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Structure Sequence
MRPPQCLLHTPSLASPLLLLLLWLLGGGVGAEGREDAELLVTVRGGRLRGIRLKTPGGPVSAFLGIPFAEPPMGPRRFLPPEPKQPWSGVVDATTFQSVCYQYVDTLYPGFEGTEMWNPNRELSEDCLYLNVWTPYPRPTSPTPVLVWIYGGGFYSGASSLDVYDGRFLVQAERTVLVSMNYRVGAFGFLALPGSREAPGNVGLLDQRLALQWVQENVAAFGGDPTSVTLFGESAGAASVGMHLLSPPSRGLFHRAVLQSGAPNGPWATVGMGEARRRATQLAHLVGCPPGGTGGNDTELVACLRTRPAQVLVNHEWHVLPQESVFRFSFVPVVDGDFLSDTPEALINAGDFHGLQVLVGVVKDEGSYFLVYGAPGFSKDNESLISRAEFLAGVRVGVPQVSDLAAEAVVLHYTDWLHPEDPARLREALSDVVGDHNVVCPVAQLAGRLAAQGARVYAYVFEHRASTLSWPLWMGVPHGYEIEFIFGIPLDPSRNYTAEEKIFAQRLMRYWANFARTGDPNEPRDPKAPQWPPYTAGAQQYVSLDLRPLEVRRGLRAQACAFWNRFLPKLLSATDTLDEAERQWKAEFHRWSSYMVHWKNQFDHYSKQDRCSDL
Gene Name ACHE
Uniprot ID ACES_HUMAN
KEGG Pathway hsa:43
Protein Family Type-B carboxylesterase/lipase family
Protein Function
Hydrolyzes rapidly the acetylcholine neurotransmitter released into the synaptic cleft allowing to terminate the signal transduction at the neuromuscular junction. Role in neuronal apoptosis.
    Click to Show/Hide
      Mechanism Description
  • Additive cholinergic effects by the combination of Guanidine and Amifampridine 

Recommended Action
      Management Patients should be apprised of the potential for increased cholinergic effects when amifampridine is coadministered with other drugs that have cholinergic effects such as cholinesterase inhibitors.

References
1 EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
2 Product Information. Firdapse (amifampridine). Catalyst Pharmaceuticals, Inc., Coral Gables, FL.