DT-Web

DB01081 - Diphenoxylate


Identification
Name Diphenoxylate
Accession Number DB01081 (APRD00366)
Type small molecule
Description A meperidine congener used as an antidiarrheal, usually in combination with atropine. At high doses, it acts like morphine. Its unesterified metabolite difenoxin has similar properties and is used similarly. It has little or no analgesic activity. This medication is classified as a Schedule V under the Controlled Substances Act by the Food and Drug Administration (FDA) and the DEA in the United States when used in preparations. When diphenoxylate is used alone, it is classified as a Schedule II.
Structure
MOL SDF PDB SMILES InChI
Categories (*)
Molecular Weight 452.5873
Groups illicit
Monoisotopic Weight 452.246378278
Pharmacology
Indication For as adjunctive therapy in the management of diarrhea
Mechanism of action Diphenoxylate is an opiate receptor agonists that stimulate mu receptors in GI to decrease the peristalsis and constrict the sphincters. Diphenoxylate has a direct effect on circular smooth muscle of the bowel, that conceivably results in segmentation and prolongation of gastrointestinal transit time. The clinical antidiarrheal action of diphenoxylate may thus be a consequence of enhanced segmentation that allows increased contact of the intraluminal contents with the intestinal mucosa.
Absorption 90%
Protein binding 74-95%
Biotransformation Hepatic
Route of elimination Not Available
Toxicity Coma, dry skin and mucous membranes, enlarged pupils of the eyes, extremely high body temperature, flushing, involuntary eyeball movement, lower than normal muscle tone, pinpoint pupils, rapid heartbeat, restlessness, sluggishness, suppressed breathing
Affected organisms
  • Humans and other mammals
Interactions
Drug Interactions
Drug Mechanism of interaction
Alvimopan Increases levels by receptor binding competition. Discontinue opioid administration at least 7 days prior to administrating Alvimopan.
Donepezil Possible antagonism of action
Galantamine Possible antagonism of action
Food Interactions
  • Take with food.
  • Avoid alcohol.

Targets


Mu-type opioid receptor
Name Mu-type opioid receptor
Gene Name OPRM1
Pharmacological action yes
Actions agonist
References
  • Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. - Pubmed
  • Baker DE: Loperamide: a pharmacological review. Rev Gastroenterol Disord. 2007;7 Suppl 3:S11-8. - Pubmed
  • Corazziari E: Role of opioid ligands in the irritable bowel syndrome. Can J Gastroenterol. 1999 Mar;13 Suppl A:71A-75A. - Pubmed
  • Coupar IM: The peristaltic reflex in the rat ileum: evidence for functional mu- and delta-opiate receptors. J Pharm Pharmacol. 1995 Aug;47(8):643-6. - Pubmed
  • De Luca A, Coupar IM: Difenoxin and loperamide: studies on possible mechanisms of intestinal antisecretory action. Naunyn Schmiedebergs Arch Pharmacol. 1993 Feb;347(2):231-7. - Pubmed
DTHybrid score 0.7113
Delta-type opioid receptor
Name Delta-type opioid receptor
Gene Name OPRD1
Pharmacological action unknown
Actions agonist
References
  • Coupar IM: The peristaltic reflex in the rat ileum: evidence for functional mu- and delta-opiate receptors. J Pharm Pharmacol. 1995 Aug;47(8):643-6. - Pubmed
DTHybrid score 0.5698

Predictions


Id Partner name Gene Name Score
696 Kappa-type opioid receptor OPRK1 0.4329
4512 Cytochrome P450 3A4 CYP3A4 0.0783
1716 Tripartite motif-containing protein 13 TRIM13 0.0748
4119 Cytochrome P450 2D6 CYP2D6 0.0726
1262 Corticotropin-lipotropin POMC 0.0542
6107 Cytochrome P450 3A7 CYP3A7 0.0435
1588 Multidrug resistance protein 1 ABCB1 0.0325
4118 Cytochrome P450 3A5 CYP3A5 0.0323
4137 Nociceptin receptor OPRL1 0.0253
4924 Cytochrome P450 2C8 CYP2C8 0.0243
319 Opioid receptor, sigma 1 OPRS1 0.0223
4757 Cytochrome P450 2C9 CYP2C9 0.0219
6018 UDP-glucuronosyltransferase 1-9 UGT1A9 0.0189
6180 UDP-glucuronosyltransferase 2B4 UGT2B4 0.0187
6178 UDP-glucuronosyltransferase 2B7 UGT2B7 0.0181
6030 Cytochrome P450 2B6 CYP2B6 0.0163
6022 UDP-glucuronosyltransferase 1-1 UGT1A1 0.0161
174 Sigma 1-type opioid receptor SIGMAR1 0.0153
824 Sodium-dependent serotonin transporter SLC6A4 0.0119
540 Sodium-dependent noradrenaline transporter SLC6A2 0.0118
1291 cAMP response element-binding protein CREB1 0.0108
706 Glutamate [NMDA] receptor subunit 3A GRIN3A 0.0107
6016 Cytochrome P450 2C19 CYP2C19 0.0104
4210 Toll-like receptor 4 TLR4 0.0097
341 5-hydroxytryptamine 3 receptor HTR3A 0.0093
392 Voltage-dependent P/Q-type calcium channel subunit alpha-1A CACNA1A 0.0089
6106 Cytochrome P450 2C18 CYP2C18 0.0084
587 Serum albumin ALB 0.0084
5878 Alpha-7 nicotinic cholinergic receptor subunit CHRFAM7A 0.0082
3811 Cytochrome P450 19A1 CYP19A1 0.0079
4200 Cytochrome P450 1A2 CYP1A2 0.0078
6181 UDP-glucuronosyltransferase 1-8 UGT1A8 0.0077
20 Prostaglandin G/H synthase 1 PTGS1 0.0065
6078 Neuronal acetylcholine receptor subunit beta-4 CHRNB4 0.0065
465 Calmodulin CALM1 0.0063
4120 NADPH--cytochrome P450 reductase POR 0.006
51 Muscarinic acetylcholine receptor M3 CHRM3 0.0059
6176 UDP-glucuronosyltransferase 1-3 UGT1A3 0.0058
6079 Neuronal acetylcholine receptor subunit alpha-3 CHRNA3 0.0058
458 Neuronal acetylcholine receptor subunit alpha-10 CHRNA10 0.0055
6145 Solute carrier family 22 member 1 SLC22A1 0.0055
590 5-hydroxytryptamine 2C receptor HTR2C 0.0053
136 Estrogen receptor ESR1 0.0053
6139 Solute carrier organic anion transporter family member 1A2 SLCO1A2 0.0051
1181 Alpha-1-acid glycoprotein 1 ORM1 0.005
94 5-hydroxytryptamine 4 receptor HTR4 0.0035
5718 Cytochrome P450 2A6 CYP2A6 0.0034
1732 ATP-binding cassette sub-family G member 2 ABCG2 0.0033
320 5-hydroxytryptamine 1A receptor HTR1A 0.0033
6013 Cytochrome P450 2E1 CYP2E1 0.0027
885 5-hydroxytryptamine 1B receptor HTR1B 0.0025
6100 BDNF/NT-3 growth factors receptor NTRK2 0.0022
1618 High affinity nerve growth factor receptor NTRK1 0.0017
6098 Potassium voltage-gated channel subfamily D member 2 KCND2 0.0017
6099 Potassium voltage-gated channel subfamily D member 3 KCND3 0.0017
1086 Potassium voltage-gated channel subfamily KQT member 2 KCNQ2 0.0017
858 Potassium voltage-gated channel subfamily A member 1 KCNA1 0.0013
789 Alpha-1D adrenergic receptor ADRA1D 0.0011
274 Muscarinic acetylcholine receptor M5 CHRM5 0.0011
450 Muscarinic acetylcholine receptor M4 CHRM4 0.0011
318 Alpha-2A adrenergic receptor ADRA2A 0.001
617 Muscarinic acetylcholine receptor M2 CHRM2 0.001
502 5-hydroxytryptamine 2A receptor HTR2A 0.0009
103 Muscarinic acetylcholine receptor M1 CHRM1 0.0009
556 Alpha-1A adrenergic receptor ADRA1A 0.0009
492 Histamine H1 receptor HRH1 0.0009
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