Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIZPCXD3I)
Drug Name			Fenfluramine		Drug Info		Oxitriptan		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Cns Stimulants				Antidepressants
Structure

Mechanism of Fenfluramine-Oxitriptan Interaction (Severity Level: Major)
Additive serotonergic effects Click to Show/Hide Mechanism Graph

Drug Name		Fenfluramine				Oxitriptan
Mechanism		Serotonergic effects 5-HT 2 receptor Agonist				Serotonergic effects 5-HT receptor Agonist
Key Mechanism Factor 1
		Factor Name		5-HT 2 receptor				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		G-protein coupled receptor for 5-hydroxytryptamine (serotonin) (PubMed:1330647, PubMed:18703043, PubMed:19057895). Also functions as a receptor for various drugs and psychoactive substances, including mescaline, psilocybin, 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) and lysergic acid diethylamide (LSD) (PubMed:28129538). Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down-stream effectors (PubMed:28129538). Beta-arrestin family members inhibit signaling via G proteins and mediate activation of alternative signaling pathways (PubMed:28129538). Signaling activates phospholipase C and a phosphatidylinositol-calcium second messenger system that modulates the activity of phosphatidylinositol 3-kinase and promotes the release of Ca(2+) ions from intracellular stores (PubMed:18703043, PubMed:28129538). Affects neural activity, perception, cognition and mood (PubMed:18297054). Plays a role in the regulation of behavior, including responses to anxiogenic situations and psychoactive substances. Plays a role in intestinal smooth muscle contraction, and may play a role in arterial vasoconstriction. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		5-HT receptor				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		G-protein coupled receptor for 5-hydroxytryptamine (serotonin) (PubMed:1330647, PubMed:18703043, PubMed:19057895). Also functions as a receptor for various drugs and psychoactive substances, including mescaline, psilocybin, 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) and lysergic acid diethylamide (LSD) (PubMed:28129538). Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down-stream effectors (PubMed:28129538). Beta-arrestin family members inhibit signaling via G proteins and mediate activation of alternative signaling pathways (PubMed:28129538). Signaling activates phospholipase C and a phosphatidylinositol-calcium second messenger system that modulates the activity of phosphatidylinositol 3-kinase and promotes the release of Ca(2+) ions from intracellular stores (PubMed:18703043, PubMed:28129538). Affects neural activity, perception, cognition and mood (PubMed:18297054). Plays a role in the regulation of behavior, including responses to anxiogenic situations and psychoactive substances. Plays a role in intestinal smooth muscle contraction, and may play a role in arterial vasoconstriction. Click to Show/Hide
Mechanism Description		Additive serotonergic effects by the combination of Fenfluramine and Oxitriptan

Recommended Action
Management		The concomitant use of serotonin reuptake inhibitors and tryptophan should be avoided.

References
1	Product Information. Cymbalta (duloxetine). Lilly, Eli and Company, Indianapolis, IN.
2	Product Information. Luvox (fluvoxamine). Solvay Pharmaceuticals Inc, Marietta, GA.
3	Product Information. Paxil (paroxetine). GlaxoSmithKline, Research Triangle Park, NC.