Overview
| Generic Names: | Amoxepine |
|---|---|
| Trade Names: | Ascendin; Asendis; Defanyl; Demolox; Moxadil |
| PharmGKB Accession Id: | PA448405 |
Description
The N-demethylated derivative of the antipsychotic agent loxapine that works by blocking the reuptake of norepinephrine, serotonin, or both. It also blocks dopamine receptors. PubChem (source: Drug Bank)
Indication
For the relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions. Also for depression accompanied by anxiety or agitation. (source: Drug Bank)
ATC Therapeutic Category
- N06AA:Non-selective monoamine reuptake inhibitors
Pharmacology, Interactions, and Contraindications
Mechanism Of Action
Amoxapine acts by decreasing the reuptake of norepinephrine and serotonin (5-HT). (source: Drug Bank)
Pharmacology
Amoxapine is a tricyclic antidepressant of the dibenzoxazepine class, chemically distinct from the dibenzodiazepines, dibenzocycloheptenes, and dibenzoxepines. It has a mild sedative component to its action. The mechanism of its clinical action in man is not well understood. In animals, amoxapine reduced the uptake of nor-epinephirine and serotonin and blocked the response of dopamine receptors to dopamine Amoxapine is not a monoamine oxidase inhibitor. Clinical studies have demonstrated that amoxapine has a more rapid onset of action than either amitriptyline or imipramine (source: Drug Bank)
Food Interactions
Avoid alcohol.
Take with food to reduce irritation.
(source:
Drug Bank)
Absorption, Distribution, Metabolism, Elimination & Toxicity
Biotransformation
Amoxapine is almost completely metabolized, producing the major metabolite 8-hydroxyamoxapine. (source: Drug Bank)
Protein Binding
In vitro tests show that amoxapine binding to human serum is approximately 90%. (source: Drug Bank)
Absorption
Absorbed rapidly and reaches peak blood levels approximately 90 minutes after ingestion (source: Drug Bank)
Toxicity
Toxic manifestations of amoxapine overdosage differ significantly from those of other tricyclic antidepressants. Serious cardiovascular effects are seldom if ever observed. However, CNS effects, particularly grand mal convulsions, occur frequently, and treatment should be directed primarily toward prevention or control of seizures. Status epilepticus may develop and constitutes a neurologic emergency. Coma and acidosis are other serious complications of substantial amoxapine overdosage in some cases. Renal failure may develop two to five days after toxic overdose in patients who may appear otherwise recovered. Acute tubular necrosis with rhabdomuolysis and myolobinurla is the most common renal complication in such cases. This reaction probably occurs in less than 5% of overdose cases, and typically in those who have experienced multiple seizures. (source: Drug Bank)
Isomeric SMILES Code:
c1ccc2c(c1)N=C(c3cc(ccc3O2)Cl)N4CCNCC4 (source: Drug Bank)
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
| Gene | Description | |
|---|---|---|
| SLC6A2 |
|
(source: Drug Bank) |
| SLC6A4 |
|
(source: Drug Bank) |
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| altretamine |
|
Risk of severe hypotension (source: Drug Bank) |
| atazanavir |
|
Atazanavir increases the efect and toxicity of tricyclics (source: Drug Bank) |
| cimetidine |
|
Cimetidine increases the effect of tricyclic agent (source: Drug Bank) |
| cisapride |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| clonidine |
|
The tricyclic decreases the effect of clonidine (source: Drug Bank) |
| dobutamine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| donepezil |
|
Possible antagonism of action (source: Drug Bank) |
| dopamine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| ephedra |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| ephedrine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| epinephrine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| fenoterol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| fluoxetine |
|
Fluoxetine increases the effect and toxicity of tricyclics (source: Drug Bank) |
| fluvoxamine |
|
Fluvoxamine increases the effect and toxicity of tricyclics (source: Drug Bank) |
| galantamine |
|
Possible antagonism of action (source: Drug Bank) |
| grepafloxacin |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| guanethidine |
|
The tricyclic decreases the effect of guanethidine (source: Drug Bank) |
| isocarboxazid |
|
Possibility of severe adverse effects (source: Drug Bank) |
| isoproterenol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| mephentermine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| metaraminol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| methoxamine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| moclobemide |
|
Possible severe adverse reaction with this combination (source: Drug Bank) |
| norepinephrine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| orciprenaline |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| phenelzine |
|
Possibility of severe adverse effects (source: Drug Bank) |
| phenylephrine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| phenylpropanolamine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| pirbuterol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| procaterol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| pseudoephedrine |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| rasagiline |
|
Possibility of severe adverse effects (source: Drug Bank) |
| rifabutin |
|
The rifamycin decreases the effect of tricyclics (source: Drug Bank) |
| rifampin |
|
The rifamycin decreases the effect of tricyclics (source: Drug Bank) |
| ritonavir |
|
Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank) |
| rivastigmine |
|
Possible antagonism of action (source: Drug Bank) |
| salbutamol |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| sibutramine |
|
Increased risk of CNS adverse effects (source: Drug Bank) |
| sparfloxacin |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| terbutaline |
|
The tricyclic increases the sympathomimetic effect (source: Drug Bank) |
| terfenadine |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| tranylcypromine |
|
Possibility of severe adverse effects (source: Drug Bank) |
Non-Curated Information
A list of non-curated publications that mention this drug along with other diseases is available.
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
LinkOuts
Common Searches
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Non-Curated Publications
A list of non-curated publications that mention this drug is available.