Lidocaine + Epinephrine interactions

Checked as Lidocaine + Epinephrine in this data source.

Full monograph for Lidocaine + Epinephrine Check it against another medicine

Medicines

649 documented

Severity

Mechanism

Medicines documented to interact with Lidocaine + Epinephrine, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Amitriptyline Hydrochloridevia Epinephrine, Lidocaine	Major	Synergy · Unknown	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…2 documented mechanisms	11 sources — open the full entry
Amitriptyline Hydrochloride + Chlordiazepoxidevia Epinephrine, Lidocaine	Major	Synergy · Unknown	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…3 documented mechanisms	18 sources — open the full entry
Bimatoprost + Timololvia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Brimonidine Tartrate + Timolol Maleatevia Epinephrine, Lidocaine	Major	Metabolism · Synergy · Unknown	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…3 documented mechanisms	35 sources — open the full entry
Brinzolamide + Timololvia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Bupivacaine Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	Additive toxicities may occur when bupivacaine is coadministered with other local anesthetics. The potential for increased risk of systemic toxicities such as…2 documented mechanisms	3 sources — open the full entry
Bupivacaine Hydrochloride + Dextrosevia Lidocaine, Epinephrine	Major	Synergy · Unknown	Additive toxicities may occur when bupivacaine is coadministered with other local anesthetics. The potential for increased risk of systemic toxicities such as…2 documented mechanisms	3 sources — open the full entry
Bupropion Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin…2 documented mechanisms	19 sources — open the full entry
Carvedilolvia Lidocaine, Epinephrine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Chloroquine Phosphatevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Clomipramine Hydrochloridevia Epinephrine	Major	Synergy	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…	11 sources — open the full entry
Dapsonevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Dextromethorphan + Bupropionvia Lidocaine, Epinephrine	Major	Synergy · Unknown	The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin…2 documented mechanisms	19 sources — open the full entry
Dorzolamide + Timololvia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Doxepin (Oral)via Lidocaine, Epinephrine	Major	Synergy · Unknown	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…2 documented mechanisms	11 sources — open the full entry
Ergometrine Maleatevia Epinephrine	Major	Synergy	Additive or synergistic increases in blood pressure and/or ischemic response may occur when ergot alkaloids are combined with peripheral or central…	38 sources — open the full entry
Fluphenazine + Nortriptylinevia Epinephrine, Lidocaine	Major	Antagonism · Synergy · Unknown	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…4 documented mechanisms	35 sources — open the full entry
Flutamidevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Halothanevia Epinephrine	Major	Others	Rarely, the combination of epinephrine and some anesthetics has resulted in ventricular irritability, serious cardiac arrhythmias, or death. The halogenated…	20 sources — open the full entry
Hydroxyureavia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Ifosfamidevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Imipramine Hydrochloridevia Epinephrine	Major	Synergy	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…	11 sources — open the full entry
Iohexolvia Lidocaine	Major	Synergy	Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of…	5 sources — open the full entry
Iopamidolvia Lidocaine	Major	Synergy	Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of…	5 sources — open the full entry
Isofluranevia Lidocaine, Epinephrine	Major	Others · Unknown	Rarely, the combination of epinephrine and some anesthetics has resulted in ventricular irritability, serious cardiac arrhythmias, or death. The halogenated…2 documented mechanisms	20 sources — open the full entry
Isosorbide Dinitrate + Hydralazine Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms	5 sources — open the full entry
Isosorbide Mononitratevia Lidocaine, Epinephrine	Major	Synergy · Unknown	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms	5 sources — open the full entry
Labetalol Hydrochloridevia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Latanoprost + Timololvia Epinephrine, Lidocaine	Major	Metabolism · Synergy · Unknown	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…3 documented mechanisms	35 sources — open the full entry
Lidocaine + Prilocainevia Lidocaine	Major	Synergy	Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…2 documented mechanisms	13 sources — open the full entry
Linezolidvia Epinephrine, Lidocaine	Major	Synergy · Unknown	Linezolid may potentiate the pressor response to sympathomimetic agents. Linezolid is a reversible, nonselective monoamine oxidase inhibitor (MAOI) and, as…2 documented mechanisms	24 sources — open the full entry
Methylergonovine Maleatevia Epinephrine	Major	Synergy	Additive or synergistic increases in blood pressure and/or ischemic response may occur when ergot alkaloids are combined with peripheral or central…	38 sources — open the full entry
Metoclopramide Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms	5 sources — open the full entry
Nitrofurantoinvia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Nitrofurantoin + Nitrofurantoin Microcrystalsvia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Nitroglycerinbase IV Infusion Ointmentvia Lidocaine, Epinephrine	Major	Synergy · Unknown	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms	5 sources — open the full entry
Nortriptylinevia Epinephrine, Lidocaine	Major	Synergy · Unknown	Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing…2 documented mechanisms	11 sources — open the full entry
Paracetamol + Tramadol Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	The risk of seizures may be increased during coadministration of tramadol with any substance that can reduce the seizure threshold, such as selective serotonin…3 documented mechanisms	8 sources — open the full entry
Primaquine Phosphatevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Propranolol Hydrochloridevia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Quinine Sulfatevia Lidocaine	Major	Synergy	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…	5 sources — open the full entry
Sevofluranevia Lidocaine, Epinephrine	Major	Others · Unknown	Rarely, the combination of epinephrine and some anesthetics has resulted in ventricular irritability, serious cardiac arrhythmias, or death. The halogenated…2 documented mechanisms	20 sources — open the full entry
Sotalol Hydrochloridevia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Sulphamethoxazole + Trimethoprimvia Lidocaine	Major	Synergy · Unknown	Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms	5 sources — open the full entry
Timolol Maleatevia Epinephrine, Lidocaine	Major	Metabolism · Synergy	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…2 documented mechanisms	35 sources — open the full entry
Tramadol Hydrochloridevia Lidocaine, Epinephrine	Major	Synergy · Unknown	The risk of seizures may be increased during coadministration of tramadol with any substance that can reduce the seizure threshold, such as selective serotonin…2 documented mechanisms	8 sources — open the full entry
Travoprost + Timolol Maleatevia Epinephrine, Lidocaine	Major	Metabolism · Synergy · Unknown	Noncardioselective beta-blockers can significantly enhance the pressor response to epinephrine. The mechanism involves blockade of beta-2 adrenergic receptors…3 documented mechanisms	35 sources — open the full entry
Abametapirvia Lidocaine	Moderate	Metabolism	Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450…	1 sources — open the full entry
Acarbosevia Epinephrine	Moderate	Antagonism	The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics…	95 sources — open the full entry
Aclidinium Bromide + Formoterol Fumaratevia Epinephrine	Moderate	Synergy	Coadministration of beta-2 adrenergic agonists with other adrenergic agents may potentiate the risk of cardiovascular side effects. Beta-2 adrenergic agonists…	11 sources — open the full entry

Conditions

Conditions in which Lidocaine + Epinephrine needs care, as documented in this source.

Arrhythmias, Cardiac
Major
Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.
62 sources
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2. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
3. Strasberg B, Sclarovsky S, Erdberg A, et al. "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
4. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
5. Lo KS, Gantz KB, Stetson PL, et al. "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
6. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
7. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
8. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7
Show all 62 sourcesShow fewer sources
1. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
2. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
3. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
4. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
5. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
6. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
7. Damle R, Levine J, Matos J, et al. "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
8. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
9. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
10. Hii JT, Wyse DG, Gillis AM, et al. "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
11. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
12. Bauman JL, Bauernfeind RA, Hoff JV, et al. "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
13. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
14. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
15. Au PK, Bhandari AK, Bream R, et al. "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
16. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
17. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
18. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
19. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
20. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
21. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
22. "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
23. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
24. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
25. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals (2002):
26. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
27. "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
28. "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
29. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
30. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
31. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
32. "Product Information. Adenocard (adenosine)." Fujisawa (2001):
33. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):
34. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
35. "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
36. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
37. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
38. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7
39. "Product Information. Norpace (disopyramide)." Searle (2001):
40. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
41. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
42. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
43. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
44. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
45. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
46. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
47. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
48. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
49. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
50. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
51. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
52. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
53. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
54. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
Cardiomyopathies
Major
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
17 sources
1. Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
2. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
3. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
4. Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
5. Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
6. Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
7. Prescott LF, Adjepon-Yamoah KK, Talbot RG "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J 1 (1976): 939-41
8. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
Show all 17 sourcesShow fewer sources
1. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
2. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
3. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
4. "Product Information. Adenocard (adenosine)." Fujisawa (2001):
5. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
6. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
7. Singh SN, Fletcher RD, Fisher SG, et al. "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med 333 (1995): 77-82
8. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
9. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
Cardiovascular Diseases
Major
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
58 sources
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2. Mariani PJ "Pseudoephedrine-induced hypertensive emergency: treatment with labetalol." Am J Emerg Med 4 (1986): 141-2
3. Rosen RA "Angina associated with pseudoephedrine ." Ann Emerg Med 10 (1981): 230-1
4. Wiener I, Tilkian AG, Palazzolo M "Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: temporal relationship to pseudoephedrine ingestion." Cathet Cardiovasc Diagn 20 (1990): 51-3
5. Gordon RD, Ballantine DM, Bachmann AW "Effects of repeated doses of pseudoephedrine on blood pressure and plasma catecholamines in normal subjects and in patients with phaeochromocytoma." Clin Exp Pharmacol Physiol 19 (1992): 287-90
6. Loizou LA, Hamilton JG, Tsementzis SA "Intracranial haemorrhage in association with pseudoephedrine overdose." J Neurol Neurosurg Psychiatry 45 (1982): 471-2
7. Dickerson J, Perrier D, Mayersohn M, Bressler R "Dose tolerance and pharmacokinetic studies of L (+) pseudoephedrine capsules in man." Eur J Clin Pharmacol 14 (1978): 253-9
8. Wooten MR, Khangure MS, Murphy MJ "Intracerebral hemorrhage and vasculitis related to ephedrine abuse." Ann Neurol 13 (1983): 337-40
Show all 58 sourcesShow fewer sources
1. To LB, Sangster JF, Rampling D, Cammens I "Ephedrine-induced cardiomyopathy." Med J Aust 2 (1980): 35-6
2. Bruno A, Nolte KB, Chapin J "Stroke associated with ephedrine use." Neurology 43 (1993): 1313-6
3. Stoessl AJ, Young GB, Feasby TE "Intracerebral haemorrhage and angiographic beading following ingestion of catecholaminergics." Stroke 16 (1985): 734-6
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5. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
6. Kizer KW "Intracranial hemorrhage associated with overdose of decongestant containing phenylpropanolamine" Am J Emerg Med 2 (1984): 180-1
7. Edwards M, Russo L, Harwood-Nuss A "Cerebral infarction with a single oral dose of phenylpropanolamine." Am J Emerg Med 5 (1987): 163-4
8. Lake CR, Gallant S, Masson E, Miller P "Adverse drug effects attributed to phenylpropanolamine: a review of 142 case reports." Am J Med 89 (1990): 195-208
9. Lake CR, Zaloga G, Bray J, Rosenberg D, Chernow B "Transient hypertension after two phenylpropanolamine diet aids and the effects of caffeine: a placebo-controlled follow-up study." Am J Med 86 (1989): 427-32
10. Lake CR, Zaloga G, Clymer R, Quirk RM, Chernow B "A double dose of phenylpropanolamine causes transient hypertension." Am J Med 85 (1988): 339-43
11. Bernstein E, Diskant BM "Phenylpropanolamine: a potentially hazardous drug." Ann Emerg Med 11 (1982): 311-5
12. Kroenke K, Omori DM, Simmons JO, Wood DR, Meier NJ "The safety of phenylpropanolamine in patients with stable hypertension." Ann Intern Med 111 (1989): 1043-4
13. Pentel PR, Mikell FL, Zavoral JH "Myocardial injury after phenylpropanolamine ingestion." Br Heart J 47 (1982): 51-4
14. Howrie DL, Wolfson JH "Phenylpropanolamine-induced hypertensive seizures." J Pediatr 102 (1983): 143-5
15. Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1
16. Johnson DA, Etter HS, Reeves DM "Stroke and phenylpropanolamine use" Lancet 2 (1983): 970
17. McEwen J "Phenylpropanolamine-associated hypertension after the use of "over- the-counter" appetite-suppressant products." Med J Aust 2 (1983): 71-3
18. Elliott CF, Whyte JC "Phenylpropanolamine and hypertension." Med J Aust 1 (1981): 715
19. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use" Neurology 37 (1987): 1686
20. Kase CS, Foster TE, Reed JE, Spatz EL, Girgis GN "Intracerebral hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 399-404
21. Kikta DG, Devereaux MW, Chandar K "Intracranial hemorrhages due to phenylpropanolamine." Stroke 16 (1985): 510-2
22. Clark JE, Simon WA "Cardiac arrhythmias after phenylpropanolamine ingestion." Drug Intell Clin Pharm 17 (1983): 737-8
23. Noble R "A controlled clinical trial of the cardiovascular and psychological effects of phenylpropanolamine and caffeine." Drug Intell Clin Pharm 22 (1988): 296-9
24. O'Connell MB, Gross CR "The effect of multiple doses of phenylpropanolamine on the blood pressure of patients whose hypertension was controlled with beta blockers." Pharmacotherapy 11 (1991): 376-81
25. O'Connell MB, Gross CR "The effect of single-dose phenylpropanolamine on blood pressure in patients with hypertension controlled by beta blockers." Pharmacotherapy 10 (1990): 85-91
26. Chin C, Choy M "Cardiomyopathy induced by phenylpropanolamine." J Pediatr 123 (1993): 825-7
27. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
28. Lee KY, Beilin LJ, Vandongen R "Severe hypertension after ingestion of an appetite suppressant (phenylpropanolamine) with indomethacin." Lancet 1 (1979): 1110-1
29. Gibson GJ, Warrell DA "Hypertensive crises and phenylpropanolamine." Lancet 2 (1972): 492-3
30. Frewin DB "Phenylpropanolamine. How safe is it?" Med J Aust 2 (1983): 54-5
31. Lee KY, Beilin LJ, Vandongen R "Severe hypertension after administration of phenylpropanolamine" Med J Aust 1 (1979): 525-6
32. Horowitz JD, McNeil JJ, Sweet B, Mendelsohn FA, Louis WJ "Hypertension and postural hypotension induced by phenylpropanolamine (Trimolets)." Med J Aust 1 (1979): 175-6
33. Frewin DB, Leonello PP, Frewin ME "Hypertension after ingestion of Trimolets." Med J Aust 2 (1978): 497-8
34. Teh AY "Phenylpropanolamine and hypertension" Med J Aust 2 (1979): 425-6
35. Shapiro SR "Hypertension due to anorectic agent." N Engl J Med 280 (1969): 1363
36. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 1886,1890
37. Fallis RJ, Fisher M "Cerebral vasculitis and hemorrhage associated with phenylpropanolamine." Neurology 35 (1985): 405-7
38. Caperton E "Raynaud's phenomenon. Role of diet pills and cold remedies." Postgrad Med 73 (1983): 291-2
39. McDowell JR, LeBlanc HJ "Phenylpropanolamine and cerebral hemorrhage." West J Med 142 (1985): 688-91
40. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
41. Dowse R, Scherzinger SS, Kanfer I "Serum concentrations of phenylpropanolamine and associated effects on blood pressure in normotensive subjects: a pilot-study." Int J Clin Pharmacol Ther Toxicol 28 (1990): 205-10
42. Pentel PR, Aaron C, Paya C "Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure." Int J Obes 9 (1985): 115-9
43. Finton CK, Barton M, Chernow B "Possible adverse effects of phenylpropanolamine (diet pills) on sympathetic nervous system function--caveat emptor!" Mil Med 147 (1982): 1072
44. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
45. Leo PJ, Hollander JE, Shih RD, Marcus SM "Phenylpropanolamine and associated myocardial injury." Ann Emerg Med 28 (1996): 359-62
46. Gill ND, Shield A, Blazevich AJ, Zhou S, Weatherby RP "Muscular and cardiorespiratory effects of pseudoephedrine in human athletes." Br J Clin Pharmacol 50 (2000): 205-13
47. Haller CA, Benowitz NL "Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids." N Engl J Med 343 (2000): 1833-8
48. Mansoor GA "Herbs and alternative therapies in the hypertension clinic." Am J Hypertens 14(9 Pt 1) (2001): 971-5
49. Samenuk D, Link MS, Homoud MK, et al. "Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine." Mayo Clin Proc 77 (2002): 12-6
50. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
Dehydration
Major
The use of sympathomimetic amines has been infrequently associated with significant hypotension especially in dehydrated patients secondary to the drug's beta-2 mediated vasodilation. Hypovolemia should be corrected, if possible, before administering sympathomimetic amines. Blood pressure and ECG should be monitored at regular intervals. Monitoring of cardiac output and pulmonary wedge pressure may also be desired.
4 sources
1. "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals (2001):
2. "Product Information. Epifrin (EPINEPHrine ophthalmic)." Allergan Inc (2022):
3. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
4. "Product Information. Levophed Bitartrate (norepinephrine)." Sanofi Winthrop Pharmaceuticals (2001):
Kidney Diseases
Major
Lidocaine is primarily eliminated by the kidney. Less than 10% is eliminated unchanged in the urine. Two active metabolites (MEGX and GX) have been identified that exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. Serum concentrations of lidocaine and the active metabolites are increased and the half-life prolonged in patients with renal impairment. Therapy with lidocaine should be administered cautiously and dosing modified for repeated or maintenance doses in patients with compromised renal function. Clinical monitoring of cardiac function (continual ECG) is required and serum metabolite concentrations and monitoring renal function are recommended.
8 sources
1. Eriksson E, Granberg P-O, Ortengren B "Study of renal excretion of prilocaine and lidocaine." Acta Chem Scand 358 (1966): 55-69
2. Thomson PD, Rowland M, Melmon KL "The influence of heart failure, liver disease, and renal failure on the disposition of lidocaine in man." Am Heart J 82 (1971): 417-21
3. Collinsworth KA, Strong JM, Atkinson AJ Jr, et al. "Pharmacokinetics and metabolism of lidocaine in patients with renal failure." Clin Pharmacol Ther 18 (1975): 59-64
4. Jacobi J, McGory RW, McCoy H, Matzke GR "Hemodialysis clearance of total and unbound lidocaine." Clin Pharm 2 (1983): 54-7
5. Vaziri ND, Saiki JK, Hughes W "Clearance of lidocaine by hemodialysis." South Med J 72 (1979): 1567-8
6. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
7. Grossman S, Davis D, Kitchell B, Shand D, Routledge P "Diazepam and lidocaine plasma protein binding in renal disease." Clin Pharmacol Ther 31 (1982): 350-7
8. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
Liver Diseases
Major
Lidocaine is rapidly and extensively metabolized by the liver. Less than 10% is eliminated unchanged in the urine. Several inactive and two active forms (MEGX and GX) have been identified. MEGX and GX exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. The pharmacokinetic disposition of lidocaine is altered by changes in hepatic function, including hepatic blood flow. Therapy with lidocaine should be administered cautiously and dosing modifications for repeated or loading and maintenance doses may be necessary. Clinical monitoring of cardiac (continuous ECG) is required and serum metabolite concentrations and monitoring hepatic function are recommended.
13 sources
1. Williams RL, Blaschke TF, Meffin PJ, et al. "Influence of viral hepatitis on the disposition of two compounds with high hepatic clearance: lidocaine and indocyanine green." Clin Pharmacol Ther 20 (1976): 290-9
2. Huet P-M, LeLorier J "Effects of smoking and chronic hepatitis B on lidocaine and indocyanine green kinetics." Clin Pharmacol Ther 28 (1980): 208-15
3. Bauer LA, Brown T, Gibaldi M, et al. "Influence of long-term infusions on lidocaine kinetics." Clin Pharmacol Ther 31 (1982): 433-7
4. Barry M, Keeling PW, Weir D, Feely J "Severity of cirrhosis and the relationship of a1-acid glycoprotein concentration to plasma protein binding of lidocaine." Clin Pharmacol Ther 47 (1990): 366-70
5. Thomson AH, Elliott HL, Kelman AW, et al. "The pharmacokinetics and pharmacodynamics of lignocaine and MEGX in healthy subjects." J Pharmacokinet Biopharm 15 (1987): 101-15
6. Forrest JA, Finlayson ND, Adjepon-Yamoah KK, Prescott LF "Antipyrine, paracetamol, and lignocaine elimination in chronic liver disease." Br Med J 1 (1977): 1384-7
7. Colli A, Buccino G, Cocciolo M, et al. "Disposition of a flow-limited drug (lidocaine) and a metabolic capacity-limited drug (theophylline) in liver cirrhosis." Clin Pharmacol Ther 44 (1988): 642-9
8. Villeneuve JP, Thibeault MJ, Ampelas M, et al. "Drug disposition in patients with HBsAg-positive chronic liver disease." Dig Dis Sci 32 (1987): 710-4
Show all 13 sourcesShow fewer sources
1. Huet PM, Villeneuve JP "Determinants of drug disposition in patients with cirrhosis." Hepatology 3 (1983): 913-8
2. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
3. Huang YS, Lee SD, Deng JF, Wu JC, Lu RH, Lin YF, Wang YJ, Lo KJ "Measuring lidocaine metabolite - monoethylglycinexylidide as a quantitative index of hepatic function in adults with chronic hepatitis and cirrhosis." J Hepatol 19 (1993): 140-7
4. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
5. Shiffman ML, Luketic VA, Sanyal AJ, Duckworth PF, Purdum PP, Contos MJ, Mills AS, Edinboro LE, Poklis A "Hepatic lidocaine metabolism and liver histology in patients with chronic hepatitis and cirrhosis." Hepatology 19 (1994): 933-40
Seizures
Major
Seizures have occurred during lidocaine therapy and have been associated with the rapid administration of a large intravenous doses or accumulation of active metabolites with maintenance therapy. Therapy with lidocaine should be administered cautiously to patients with or predisposed to seizure disorders. Clinical monitoring of cardiac (continuous ECG) is required, and serum metabolite concentrations are recommended.
7 sources
1. Crampton RS, Oriscello RG "Petit and grand mal convulsions during lidocaine hydrochloride treatment of ventricular tachycardia." JAMA 204 (1968): 109-12
2. Sundaram MB "Seizures after intraurethral instillation of lidocaine." Can Med Assoc J 137 (1987): 219-20
3. Pelter MA, Vollmer TA, Blum RL "Seizure-like reaction associated with subcutaneous lidocaine injection ." Clin Pharm 8 (1989): 767-8
4. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
5. Fortuna A, Fortuna AO "Convulsion during lignocaine infiltration." Anaesth Intensive Care 21 (1993): 483
6. Ryan CA, Robertson M, Coe JY "Seizures due to lidocaine toxicity in a child during cardiac catheterization." Pediatr Cardiol 14 (1993): 116-8
7. Wu FL, Razzaghi A, Souney PF "Seizure after lidocaine for bronchoscopy: case report and review of the use of lidocaine in airway anesthesia." Pharmacotherapy 13 (1993): 72-8
Sick Sinus Syndrome
Major
The use of lidocaine is contraindicated in patients with Stokes-Adam syndrome, Wolff-Parkinson White syndrome, or second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation.
4 sources
1. Tagliente TM, Jayagopal S "Transient left bundle branch block following lidocaine." Anesth Analg 69 (1989): 545-7
2. Hilleman DE, Mohiuddin SM, Destache CJ "Lidocaine-induced second-degree mobitz type II heart block." Drug Intell Clin Pharm 19 (1985): 669-73
3. Keidar S, Grenadier E, Palant A "Sinoatrial arrest due to lidocaine injection in sick sinus syndrome during amiodarone administration." Am Heart J 104 (1982): 1384-5
4. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
Acidosis
Moderate
Acidosis, hypoxia, and hypercapnia may reduce the effectiveness of sympathomimetic amines in raising blood pressure. These conditions should be corrected before initiating therapy with sympathomimetic amines, if possible. Monitoring the patients acid-base balance, carbon dioxide levels, and oxygen saturation is recommended.
4 sources
1. "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals (2001):
2. "Product Information. Epifrin (EPINEPHrine ophthalmic)." Allergan Inc (2022):
3. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
4. "Product Information. Levophed Bitartrate (norepinephrine)." Sanofi Winthrop Pharmaceuticals (2001):
Diabetes Mellitus
Moderate
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
6 sources
1. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
4. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
5. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
6. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
Parkinson Disease
Moderate
Epinephrine should be administered with caution to patients with Parkinson's disease as these patients may experience psychomotor agitation or notice a temporary worsening of symptoms.
1 source
1. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
Water-Electrolyte Imbalance
Moderate
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
13 sources
1. "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
2. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
4. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
5. "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
6. "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
7. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
8. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):
Show all 13 sourcesShow fewer sources
1. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
2. "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
3. "Product Information. Norpace (disopyramide)." Searle (2001):
4. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
5. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):

Therapeutic duplication

Drug classes that overlap with Lidocaine + Epinephrine, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Olodaterol/tiotropium
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Wixela inhub
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Formoterol/mometasone
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Glycopyrrolate/indacaterol
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Trelegy ellipta
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Fluticasone/vilanterol
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Symbicort
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Duaklir pressair
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Albuterol/ipratropium
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Anoro ellipta
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Albuterol/budesonide
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Formoterol/glycopyrrolate
local injectable anesthetics
The recommended maximum number of medicines in the 'local injectable anesthetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'local injectable anesthetics' category.
Example product in the source data (US market): Epinephrine/prilocaine
local injectable anesthetics
The recommended maximum number of medicines in the 'local injectable anesthetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'local injectable anesthetics' category.
Example product in the source data (US market): Vivacaine
local injectable anesthetics
The recommended maximum number of medicines in the 'local injectable anesthetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'local injectable anesthetics' category.
Example product in the source data (US market): Zynrelef
sympathomimetic amines
The recommended maximum number of medicines in the 'sympathomimetic amines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'sympathomimetic amines' category.
Example product in the source data (US market): Guaifenex
sympathomimetic amines
The recommended maximum number of medicines in the 'sympathomimetic amines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'sympathomimetic amines' category.
Example product in the source data (US market): Promethazine vc with codeine
sympathomimetic amines
The recommended maximum number of medicines in the 'sympathomimetic amines' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'sympathomimetic amines' category.
Example product in the source data (US market): Phenylephrine/promethazine

Medicines

Conditions

Arrhythmias, Cardiac

Cardiomyopathies

Cardiovascular Diseases

Dehydration

Kidney Diseases

Liver Diseases

Seizures

Sick Sinus Syndrome

Acidosis

Diabetes Mellitus

Parkinson Disease

Water-Electrolyte Imbalance

Therapeutic duplication

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

local injectable anesthetics

local injectable anesthetics

local injectable anesthetics

sympathomimetic amines

sympathomimetic amines

sympathomimetic amines