Details of the Drug Combination

General Information of Drug Combination (ID: DC5M9CK)

Drug Combination Name
Fentanyl Propofol
Indication
Disease Entry Status REF
C.Surgical Procedure; Cardiac Phase 4 [1]
Component Drugs Fentanyl   DM8WAHT Propofol   DMB4OLE
Small molecular drug Small molecular drug
2D MOL 2D MOL
3D MOL 3D MOL

Molecular Interaction Atlas of This Drug Combination

Molecular Interaction Atlas (MIA)
Indication(s) of Fentanyl
Disease Entry ICD 11 Status REF
Analgesia MB40.8 Approved [2]
Traumatic brain injury NA07.Z Approved [3]
Cancer related pain MG30 Phase 3 [4]
Pain MG30-MG3Z Phase 3 [5]
Chronic pain MG30 Phase 1 [6]
Fentanyl Interacts with 1 DTT Molecule(s)
DTT Name DTT ID UniProt ID Mode of Action REF
Opioid receptor mu (MOP) TTKWM86 OPRM_HUMAN Modulator [10]
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Fentanyl Interacts with 1 DTP Molecule(s)
DTP Name DTP ID UniProt ID Mode of Action REF
P-glycoprotein 1 (ABCB1) DTUGYRD MDR1_HUMAN Substrate [11]
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Fentanyl Interacts with 3 DME Molecule(s)
DME Name DME ID UniProt ID Mode of Action REF
Cytochrome P450 3A4 (CYP3A4) DE4LYSA CP3A4_HUMAN Metabolism [12]
Cytochrome P450 3A5 (CYP3A5) DEIBDNY CP3A5_HUMAN Metabolism [13]
Cytochrome P450 3A7 (CYP3A7) DERD86B CP3A7_HUMAN Metabolism [14]
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Fentanyl Interacts with 13 DOT Molecule(s)
DOT Name DOT ID UniProt ID Mode of Action REF
ATP-dependent translocase ABCB1 (ABCB1) OTEJROBO MDR1_HUMAN Increases Transport [15]
Mu-type opioid receptor (OPRM1) OT16AAT8 OPRM_HUMAN Increases Phosphorylation [16]
Phospholipase D2 (PLD2) OT86I3WH PLD2_HUMAN Increases Activity [17]
Pro-opiomelanocortin (POMC) OTV41F7T COLI_HUMAN Decreases Expression [18]
Interleukin-4 (IL4) OTOXBWAU IL4_HUMAN Increases Expression [17]
NF-kappa-B inhibitor alpha (NFKBIA) OTFT924M IKBA_HUMAN Increases Expression [19]
Mitogen-activated protein kinase 3 (MAPK3) OTCYKGKO MK03_HUMAN Increases Phosphorylation [17]
Mitogen-activated protein kinase 1 (MAPK1) OTH85PI5 MK01_HUMAN Increases Phosphorylation [17]
Beta-arrestin-2 (ARRB2) OTAEJZCI ARRB2_HUMAN Affects Localization [20]
Interleukin-2 (IL2) OTGI4NSA IL2_HUMAN Decreases Expression [17]
Potassium voltage-gated channel subfamily H member 2 (KCNH2) OTZX881H KCNH2_HUMAN Decreases Activity [21]
Opioid growth factor receptor (OGFR) OTROS6RJ OGFR_HUMAN Increases ADR [22]
Adenylate cyclase type 1 (ADCY1) OTSLLFZO ADCY1_HUMAN Increases ADR [22]
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⏷ Show the Full List of 13 DOT(s)
Indication(s) of Propofol
Disease Entry ICD 11 Status REF
Anaesthesia 9A78.6 Approved [7]
Leukemia N.A. Approved [8]
Traumatic brain injury NA07.Z Approved [8]
Coronavirus Disease 2019 (COVID-19) 1D6Y Investigative [9]
Propofol Interacts with 1 DTT Molecule(s)
DTT Name DTT ID UniProt ID Mode of Action REF
Fatty acid amide hydrolase (FAAH) TTDP1UC NOUNIPROTAC Inhibitor [25]
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Propofol Interacts with 14 DME Molecule(s)
DME Name DME ID UniProt ID Mode of Action REF
Cytochrome P450 3A4 (CYP3A4) DE4LYSA CP3A4_HUMAN Metabolism [26]
Cytochrome P450 1A2 (CYP1A2) DEJGDUW CP1A2_HUMAN Metabolism [27]
UDP-glucuronosyltransferase 1A1 (UGT1A1) DEYGVN4 UD11_HUMAN Metabolism [28]
Cytochrome P450 2A6 (CYP2A6) DEJVYAZ CP2A6_HUMAN Metabolism [29]
Cytochrome P450 2D6 (CYP2D6) DECB0K3 CP2D6_HUMAN Metabolism [30]
Cytochrome P450 2E1 (CYP2E1) DEVDYN7 CP2E1_HUMAN Metabolism [27]
Cytochrome P450 2C18 (CYP2C18) DEZMWRE CP2CI_HUMAN Metabolism [29]
Cytochrome P450 2C8 (CYP2C8) DES5XRU CP2C8_HUMAN Metabolism [29]
Cytochrome P450 2C9 (CYP2C9) DE5IED8 CP2C9_HUMAN Metabolism [26]
Cytochrome P450 2B6 (CYP2B6) DEPKLMQ CP2B6_HUMAN Metabolism [31]
Mephenytoin 4-hydroxylase (CYP2C19) DEGTFWK CP2CJ_HUMAN Metabolism [29]
UDP-glucuronosyltransferase 1A9 (UGT1A9) DE85D2P UD19_HUMAN Metabolism [32]
UDP-glucuronosyltransferase 1A6 (UGT1A6) DESD26P UD16_HUMAN Metabolism [33]
Oleamide hydrolase 1 (FAAH) DEUM1EX FAAH1_HUMAN Metabolism [34]
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⏷ Show the Full List of 14 DME(s)
Propofol Interacts with 58 DOT Molecule(s)
DOT Name DOT ID UniProt ID Mode of Action REF
Carbonic anhydrase 1 (CA1) OTNFBVVQ CAH1_HUMAN Decreases Activity [35]
Carbonic anhydrase 2 (CA2) OTJRMUAG CAH2_HUMAN Decreases Activity [35]
Catalase (CAT) OTHEBX9R CATA_HUMAN Decreases Activity [36]
Cellular tumor antigen p53 (TP53) OTIE1VH3 P53_HUMAN Increases Expression [36]
Cyclin-dependent kinase 1 (CDK1) OTW1SC2N CDK1_HUMAN Decreases Expression [36]
Apoptosis regulator Bcl-2 (BCL2) OT9DVHC0 BCL2_HUMAN Decreases Expression [36]
G2/mitotic-specific cyclin-B1 (CCNB1) OT19S7E5 CCNB1_HUMAN Decreases Expression [36]
G1/S-specific cyclin-D1 (CCND1) OT8HPTKJ CCND1_HUMAN Increases Expression [36]
Caspase-3 (CASP3) OTIJRBE7 CASP3_HUMAN Increases Cleavage [36]
Caspase-9 (CASP9) OTD4RFFG CASP9_HUMAN Increases Cleavage [36]
Apoptosis regulator BAX (BAX) OTAW0V4V BAX_HUMAN Increases Expression [36]
Leucine-rich colipase-like protein 1 (LRCOL1) OTDXBZF8 LRCL1_HUMAN Decreases Expression [24]
Glutamate dehydrogenase 1, mitochondrial (GLUD1) OTXKOCUH DHE3_HUMAN Decreases Expression [37]
Progonadoliberin-1 (GNRH1) OTH8A44K GON1_HUMAN Increases Expression [38]
Prolactin (PRL) OTWFQGX7 PRL_HUMAN Increases Secretion [39]
Interleukin-1 beta (IL1B) OT0DWXXB IL1B_HUMAN Decreases Expression [38]
Interleukin-2 receptor subunit alpha (IL2RA) OT0MWCHG IL2RA_HUMAN Decreases Secretion [40]
Fibronectin (FN1) OTB5ZN4Q FINC_HUMAN Increases Expression [38]
Guanine nucleotide-binding protein G(i) subunit alpha-2 (GNAI2) OTTLGRGH GNAI2_HUMAN Decreases Expression [24]
Insulin-like growth factor I (IGF1) OTIIZR61 IGF1_HUMAN Increases Expression [38]
Interleukin-6 (IL6) OTUOSCCU IL6_HUMAN Decreases Expression [41]
72 kDa type IV collagenase (MMP2) OT5NIWA2 MMP2_HUMAN Decreases Expression [38]
Hepatocyte growth factor receptor (MET) OT7K55MU MET_HUMAN Increases Expression [38]
Small ribosomal subunit protein uS2 (RPSA) OTJZHEGT RSSA_HUMAN Increases Expression [38]
Matrilysin (MMP7) OTVT3SEJ MMP7_HUMAN Increases Expression [38]
Solute carrier family 2, facilitated glucose transporter member 1 (SLC2A1) OTA675TJ GTR1_HUMAN Decreases Expression [37]
Proliferating cell nuclear antigen (PCNA) OTHZ1RIA PCNA_HUMAN Decreases Expression [24]
Proto-oncogene tyrosine-protein kinase Src (SRC) OTETYX40 SRC_HUMAN Increases Expression [38]
Metalloproteinase inhibitor 2 (TIMP2) OT8S1RRP TIMP2_HUMAN Increases Expression [38]
Interleukin-10 (IL10) OTIRFRXC IL10_HUMAN Increases Expression [41]
Mitogen-activated protein kinase 3 (MAPK3) OTCYKGKO MK03_HUMAN Decreases Phosphorylation [37]
Mitogen-activated protein kinase 1 (MAPK1) OTH85PI5 MK01_HUMAN Decreases Phosphorylation [37]
Ephrin type-B receptor 2 (EPHB2) OT8VZ6C5 EPHB2_HUMAN Increases Expression [38]
3-oxo-5-alpha-steroid 4-dehydrogenase 2 (SRD5A2) OTTG0NFD S5A2_HUMAN Decreases Expression [24]
RAC-alpha serine/threonine-protein kinase (AKT1) OT8H2YY7 AKT1_HUMAN Decreases Phosphorylation [24]
Macrosialin (CD68) OTOYEY3J CD68_HUMAN Increases Expression [38]
Carbonic anhydrase 5A, mitochondrial (CA5A) OTP9M7VW CAH5A_HUMAN Decreases Expression [24]
Pigment epithelium-derived factor (SERPINF1) OTWZH98J PEDF_HUMAN Increases Expression [37]
Serine/threonine-protein kinase mTOR (MTOR) OTHH8KU7 MTOR_HUMAN Decreases Phosphorylation [24]
Proliferation marker protein Ki-67 (MKI67) OTA8N1QI KI67_HUMAN Decreases Expression [37]
Stromal cell-derived factor 1 (CXCL12) OT2QX5LL SDF1_HUMAN Decreases Expression [37]
Phosphatidylinositol 3,4,5-trisphosphate 3-phosphatase and dual-specificity protein phosphatase PTEN (PTEN) OTOWDUNT PTEN_HUMAN Increases Expression [24]
C-X-C chemokine receptor type 4 (CXCR4) OTUFSBX2 CXCR4_HUMAN Decreases Expression [37]
Protein SET (SET) OTGYYQJO SET_HUMAN Decreases Expression [38]
RNA-binding protein EWS (EWSR1) OT7SRHV3 EWS_HUMAN Increases Expression [38]
Alpha-1,6-mannosylglycoprotein 6-beta-N-acetylglucosaminyltransferase A (MGAT5) OTU4DD4G MGT5A_HUMAN Increases Expression [38]
Interleukin-18 (IL18) OTBB2A8O IL18_HUMAN Increases Expression [38]
Mothers against decapentaplegic homolog 2 (SMAD2) OTC6VB4K SMAD2_HUMAN Decreases Expression [38]
Hypoxia-inducible factor 1-alpha (HIF1A) OTADSC03 HIF1A_HUMAN Decreases Expression [37]
Transmembrane channel-like protein 6 (TMC6) OTKH50J4 TMC6_HUMAN Increases Expression [24]
Polycystin-1-like protein 3 (PKD1L3) OTQMYNOW PK1L3_HUMAN Decreases Expression [24]
Uncharacterized protein C10orf67, mitochondrial (C10ORF67) OTX24W0H CJ067_HUMAN Increases Expression [24]
Sodium-coupled neutral amino acid transporter 3 (SLC38A3) OTCHH25G S38A3_HUMAN Decreases Expression [24]
Oxidoreductase HTATIP2 (HTATIP2) OT9MZ4QO HTAI2_HUMAN Increases Expression [38]
Pinin (PNN) OT0HXICH PININ_HUMAN Decreases Expression [38]
Protein turtle homolog B (IGSF9B) OTNOMYYQ TUTLB_HUMAN Decreases Expression [24]
Heparanase (HPSE) OTPTK5VS HPSE_HUMAN Increases Expression [38]
Mitochondrial pyruvate carrier 1 (MPC1) OT6DYFUO MPC1_HUMAN Decreases Expression [37]
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⏷ Show the Full List of 58 DOT(s)

Test Results of This Drug Combination in Other Disease Systems

Indication DrugCom ID Cell Line Status REF
Intubation, Intratracheal DCBE5BH N. A. Phase 4 [42]
Mechanical Ventilation DCBYVR4 N. A. Phase 4 [43]
Opioid Use DCCPQTH N. A. Phase 4 [44]
Patient Satisfaction DCTXB3E N. A. Phase 4 [45]
Breast Cancer DCSB3HE N. A. Phase 3 [46]
General Anaesthesia DCZXTLI N. A. Phase 3 [47]
Obesity, Morbid DC4CHW4 N. A. Phase 1 [48]
Ventricular Tachycardia DCUJDNK N. A. Phase 1 [49]
Hip Fractures DC6Q8SQ N. A. Phase 1 [50]
Urinary Bladder Neoplasms DCA9P4G N. A. Phase 1 [51]
Renal Failure DCKIRKQ N. A. Phase 1 [52]
Cirrhosis DCIATZ5 N. A. Phase 1 [53]
Traumatic Brain Injury DCKD511 N. A. Phase 1 [54]
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⏷ Show the Full List of 13 DrugCom(s)

References

1 ClinicalTrials.gov (NCT02119806) Decreasing the Incidence of Delirium After Cardiac Surgery
2 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
3 Fentanyl FDA Label
4 ClinicalTrials.gov (NCT00822614) Safety of Fentanyl TAIFUN Treatment. U.S. National Institutes of Health.
5 A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain. Curr Med Res Opin. 2006 Aug;22(8):1493-501.
6 Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
7 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 5464).
8 Propofol FDA Label
9 Propofol and sedation in patients with coronavirus disease. Am J Emerg Med. 2020 Jun 18;S0735-6757(20)30512-X.
10 The ChEMBL database in 2017. Nucleic Acids Res. 2017 Jan 4;45(D1):D945-D954.
11 Mammalian drug efflux transporters of the ATP binding cassette (ABC) family in multidrug resistance: A review of the past decade. Cancer Lett. 2016 Jan 1;370(1):153-64.
12 Three-dimensional-quantitative structure activity relationship analysis of cytochrome P-450 3A4 substrates. J Pharmacol Exp Ther. 1999 Oct;291(1):424-33.
13 Pharmacogenomics as molecular autopsy for forensic toxicology: genotyping cytochrome P450 3A4*1B and 3A5*3 for 25 fentanyl cases. J Anal Toxicol. 2005 Oct;29(7):590-8.
14 Drug Interactions Flockhart Table
15 P-Glycoprotein on Blood-Brain Barrier Plays a Vital Role in Fentanyl Brain Exposure and Respiratory Toxicity in Rats. Toxicol Sci. 2018 Jul 1;164(1):353-362. doi: 10.1093/toxsci/kfy093.
16 A G protein-biased ligand at the ?-opioid receptor is potently analgesic with reduced gastrointestinal and respiratory dysfunction compared with morphine. J Pharmacol Exp Ther. 2013 Mar;344(3):708-17.
17 opioid receptor agonist-selective regulation of interleukin-4 in T lymphocytes. J Neuroimmunol. 2013 Oct 15;263(1-2):35-42. doi: 10.1016/j.jneuroim.2013.07.012. Epub 2013 Jul 25.
18 Serum beta-endorphin response to stress before and after operation under fentanyl anesthesia in neonates, infants and preschool children. Eur J Pediatr Surg. 2010 Mar;20(2):106-10. doi: 10.1055/s-0029-1243620. Epub 2010 Jan 18.
19 Mechanisms of the inhibition of nuclear factor-B by morphine in neuronal cells. Mol Pharmacol. 2012 Apr;81(4):587-97. doi: 10.1124/mol.111.076620. Epub 2012 Jan 18.
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23 Effects of beta-estradiol and propofol on the 4-methylumbelliferone glucuronidation in recombinant human UGT isozymes 1A1, 1A8 and 1A9. Biopharm Drug Dispos. 2004 Nov;25(8):339-44.
24 Propofol suppresses proliferation, migration, invasion, and tumor growth of liver cancer cells via suppressing cancer susceptibility candidate 9/phosphatase and tensin homolog/AKT serine/threonine kinase/mechanistic target of rapamycin kinase axis. Hum Exp Toxicol. 2022 Jan-Dec;41:9603271211065972. doi: 10.1177/09603271211065972.
25 Glutamate- and GABA-based CNS therapeutics. Curr Opin Pharmacol. 2006 Feb;6(1):7-17.
26 Cytochrome P-450 2B6 is responsible for interindividual variability of propofol hydroxylation by human liver microsomes. Anesthesiology. 2001 Jan;94(1):110-9.
27 Inhibition of cytochrome P450 2E1 by propofol in human and porcine liver microsomes. Biochem Pharmacol. 2002 Oct 1;64(7):1151-6.
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29 Possible involvement of multiple human cytochrome P450 isoforms in the liver metabolism of propofol. Br J Anaesth. 1998 Jun;80(6):788-95.
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31 Involvement of human cytochrome P450 2B6 in the omega- and 4-hydroxylation of the anesthetic agent propofol. Xenobiotica. 2007 Jul;37(7):717-24.
32 Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675.
33 Pharmacokinetics of propofol and extrahepatic UGT1A6 gene expression in anhepatic rats. Pharmacology. 2009;84(4):219-26.
34 Update of TTD: therapeutic target database. Nucleic Acids Res. 2010 Jan;38(Database issue):D787-91.
35 Carbonic anhydrase inhibitors. Inhibition of human erythrocyte isozymes I and II with a series of antioxidant phenols bioorg. Med Chem. 2009 Apr 15;17(8):3207-11.
36 Evaluation of cytotoxicity of propofol and its related mechanism in glioblastoma cells and astrocytes. Environ Toxicol. 2017 Dec;32(12):2440-2454.
37 Sevoflurane but not propofol enhances ovarian cancer cell biology through regulating cellular metabolic and signaling mechanisms. Cell Biol Toxicol. 2023 Aug;39(4):1395-1411. doi: 10.1007/s10565-022-09766-6. Epub 2022 Oct 8.
38 The differential cancer growth associated with anaesthetics in a cancer xenograft model of mice: mechanisms and implications of postoperative cancer recurrence. Cell Biol Toxicol. 2023 Aug;39(4):1561-1575. doi: 10.1007/s10565-022-09747-9. Epub 2022 Aug 12.
39 Propofol withdrawal seizures (or not). Seizure. 2008 Oct;17(7):665-7. doi: 10.1016/j.seizure.2008.03.004. Epub 2008 May 14.
40 Effects of different anaesthetic agents on immune cell function in vitro. Eur J Anaesthesiol. 2005 Aug;22(8):616-23. doi: 10.1017/s0265021505001031.
41 The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth. 2006 Dec;97(6):825-31. doi: 10.1093/bja/ael270. Epub 2006 Oct 9.
42 ClinicalTrials.gov (NCT04872881) Comparison of Effectiveness of Different Airway Management Methods During Percutaneous Tracheostomy
43 ClinicalTrials.gov (NCT01059929) Dexmedetomidine Versus Propofol in the Medical Intensive Care Unit (MICU)
44 ClinicalTrials.gov (NCT03732469) Rectal Acetaminophen Use During Oocyte Retrievals to Reduce Post-Operative Opioid Utilization
45 ClinicalTrials.gov (NCT03803449) Patient Satisfaction and Safety With Propofol Based Sedation With or Without Fentanyl for Gastrointestinal Endoscopy
46 ClinicalTrials.gov (NCT00542542) Evaluate the Use of Paravertebral Block in Reconstructive Breast Surgery
47 ClinicalTrials.gov (NCT03669484) Comparative Clinical Study of Efficacy and Safety of Remimazolam and Propofol in Patients Undergoing Elective Surgery Under General Anaesthesia
48 ClinicalTrials.gov (NCT03009877) Preoxygenation With Optiflow?in Morbidly Obese Patients is Superior to Face Mask
49 ClinicalTrials.gov (NCT02419547) Inducibility and Stability of Ventricular Tachycardia Inpatients Undergoing VT Ablation Under General Anesthesia
50 ClinicalTrials.gov (NCT02604459) Does Optimized General Anesthesia Care Reduce Postoperative Delirium?
51 ClinicalTrials.gov (NCT02534623) Postoperative Quality of Recovery After Transurethral Resection of the Bladder
52 ClinicalTrials.gov (NCT02037802) Caudal Epidural Catheterization in Pediatric Renal Transplant: Effect on Hemodynamics and Pain After Surgery
53 ClinicalTrials.gov (NCT00906139) Propofol and Fentanyl Versus Midazolam and Fentanyl for Endoscopy Sedation in Cirrhotic Patients
54 ClinicalTrials.gov (NCT01007773) Safety of Dexmedetomidine in Severe Traumatic Brain Injury