Drug A,Drug B,Interaction Level,Notes,similarity_score (2-D structural similarity)
Mescasermin,Baclofen,Moderate - Baclofen can decrease the therapeutic efficacy of rhIGF-1,"IGF-1 analogs restore MECP2-down-stream trophic signalling (improved synaptic maturation in RTT). Baclofen’s GABA_B activation may blunt IGF-1’s downstream Akt/ERK activity, so co-administration could dampen gains; monitor clinical end-points closely.",0.02 (essentially no chemical similarity)
Minocycline,Baclofen,Moderate - Minocycline potentiates CNS-depressant effects of Baclofen,"Minocycline’s anti-inflammatory, MMP-9–lowering actions may synergise with Baclofen’s GABA_B rescue of inhibitory tone, but additive sedation/ataxia is a practical safety concern.",0.13 (low)
Baclofen,Memantine,Moderate - Baclofen may reduce renal clearance of Memantine and both are CNS depressants,"The pair jointly shifts E/I balance (GABA_B agonism + NMDA antagonism) which conceptually fits RTT pathophysiology, but dose-titration is needed to avoid over-suppression of neuronal activity",0.15 (low)
Minocycline,Memantine,Minor/unknown,Mechanistically complementary: Minocycline’s microglia-modulating and BDNF-boosting properties may augment Memantine’s protection against glutamate-mediated excitotoxicity suggested for RTT. No pharmacokinetic clashes reported to date.,0.10 (low)
Mescasermin,Minocycline,None documented,Potentially attractive combination: trophic (IGF-1) + anti-inflammatory (minocycline). No PK interaction signals seen in DrugBank.,0.03 (very low)
Mescasermin,Memantine,None documented,Could address two core RTT mechanisms simultaneously (synaptic growth & excitotoxicity). No PK interaction signals seen in DrugBank.,0.02 (very low)