Lidocaine + Prilocaine interactions
Checked as Lidocaine + Prilocaine in this data source.
Full monograph for Lidocaine + PrilocaineCheck it against another medicine
Medicines
568 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Benzocaine + Butamben + Tetracaine Hydrochloridevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…4 documented mechanisms | 20 sources — open the full entry |
| Bupivacaine Hydrochloridevia Lidocaine, Prilocaine | Major | Synergy | Additive toxicities may occur when bupivacaine is coadministered with other local anesthetics. The potential for increased risk of systemic toxicities such as…3 documented mechanisms | 16 sources — open the full entry |
| Bupivacaine Hydrochloride + Dextrosevia Lidocaine, Prilocaine | Major | Synergy | Additive toxicities may occur when bupivacaine is coadministered with other local anesthetics. The potential for increased risk of systemic toxicities such as…3 documented mechanisms | 16 sources — open the full entry |
| Bupropion Hydrochloridevia Lidocaine | Major | Synergy | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin… | 19 sources — open the full entry |
| Chloroquine Phosphatevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 18 sources — open the full entry |
| Cinchocaine + Hydrocortisone + Framycetin + Esculinvia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…5 documented mechanisms | 21 sources — open the full entry |
| Cinchocaine + Hydrocortisone + Neomycin + Esculinvia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…5 documented mechanisms | 21 sources — open the full entry |
| Cyclophosphamidevia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…2 documented mechanisms | 7 sources — open the full entry |
| Dapsonevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 18 sources — open the full entry |
| Dextromethorphan + Bupropionvia Lidocaine | Major | Synergy | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin… | 19 sources — open the full entry |
| Flutamidevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 18 sources — open the full entry |
| Hydroxyureavia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 12 sources — open the full entry |
| Ibuprofen + Paracetamolvia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…2 documented mechanisms | 6 sources — open the full entry |
| Ifosfamidevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 12 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 |
| Isosorbide Dinitrate + Hydralazine Hydrochloridevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 18 sources — open the full entry |
| Isosorbide Mononitratevia Lidocaine, Prilocaine | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 18 sources — open the full entry |
| Lidocaine Hydrochloride (Jelly)via Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 21 sources — open the full entry |
| Light kaolin + Silver sulfadiazine + Calcium gluconate + Butane propellantvia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 12 sources — open the full entry |
| Metoclopramide Hydrochloridevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| Nitrofurantoinvia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| Nitrofurantoin + Nitrofurantoin Microcrystalsvia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| NitroglycerinbaseIV InfusionOintmentvia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| Paracetamolvia Prilocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce… | 6 sources — open the full entry |
| Paracetamol + Caffeinevia Prilocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce… | 6 sources — open the full entry |
| Paracetamol + Tramadol Hydrochloridevia Lidocaine, Prilocaine | Major | Synergy | 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 | 14 sources — open the full entry |
| Phenobarbitalvia Prilocaine, Lidocaine | Major | Metabolism · Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 16 sources — open the full entry |
| Phenytoin Sodiumvia Lidocaine, Prilocaine | Major | Metabolism · Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 31 sources — open the full entry |
| Primaquine Phosphatevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| Quinine Sulfatevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 18 sources — open the full entry |
| Ropivacaine Hydrochloridevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 14 sources — open the full entry |
| Silver Sulfadiazinevia Prilocaine, Lidocaine | Major | Synergy | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 12 sources — open the full entry |
| Sulfasalazinevia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…3 documented mechanisms | 13 sources — open the full entry |
| Sulphadoxine + Pyrimethaminevia Prilocaine | 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 |
| Sulphamethoxazole + Trimethoprimvia Prilocaine, Lidocaine | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…5 documented mechanisms | 25 sources — open the full entry |
| Tramadol Hydrochloridevia Lidocaine | Major | Synergy | The risk of seizures may be increased during coadministration of tramadol with any substance that can reduce the seizure threshold, such as selective serotonin… | 8 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 |
| Adalimumabvia Lidocaine | Moderate | Metabolism | Plasma concentrations of drugs that are CYP450 substrates may decrease following the initiation of interleukin (IL) inhibitors, tumor necrosis factor (TNF)… | 19 sources — open the full entry |
| Alprazolamvia Prilocaine, Lidocaine | Moderate | Synergy | The concomitant use of local anesthetics and benzodiazepines may have additive CNS-depressant effects. Both types of drugs are CNS depressants.2 documented mechanisms | 7 sources — open the full entry |
| Amiodarone Hydrochloridevia Lidocaine, Prilocaine | Moderate | Metabolism · Synergy | Limited data suggest additive depressive effects of amiodarone and lidocaine on the sinoatrial node. The proposed mechanism is amiodarone inhibition of…2 documented mechanisms | 9 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxidevia Prilocaine, Lidocaine | Moderate | Synergy · Unknown | The concomitant use of local anesthetics and benzodiazepines may have additive CNS-depressant effects. Both types of drugs are CNS depressants.3 documented mechanisms | 7 sources — open the full entry |
| Amlodipine Besilate + Atenololvia Lidocaine | Moderate | Metabolism · Synergy · Unknown | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic…2 documented mechanisms | 10 sources — open the full entry |
| Aprepitantvia Lidocaine | Moderate | Metabolism | Coadministration with aprepitant or its prodrug, fosaprepitant, may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4… | 2 sources — open the full entry |
| Atenololvia Lidocaine | Moderate | Metabolism · Synergy | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic… | 10 sources — open the full entry |
| Atenolol + Chlorthalidonevia Lidocaine | Moderate | Metabolism · Synergy · Unknown | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic…2 documented mechanisms | 10 sources — open the full entry |
| Atracurium Besilatevia Lidocaine | Moderate | Synergy | Lidocaine may enhance the effect of neuromuscular blocking agents. The mechanism is not known, but may include inhibition of acetylcholine release from… | 6 sources — open the full entry |
| Betaxolol Hydrochloridevia Lidocaine | Moderate | Metabolism · Synergy | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic… | 10 sources — open the full entry |
| Bimatoprost + Timololvia Lidocaine | Moderate | Metabolism · Synergy | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic… | 10 sources — open the full entry |
| Bisoprolol Fumaratevia Lidocaine | Moderate | Metabolism · Synergy | Some beta-blockers may increase lidocaine levels and risk of toxicity. The proposed mechanism is enzyme inhibition and/or decreased cardiac output and hepatic… | 10 sources — open the full entry |
Conditions
Conditions in which Lidocaine + Prilocaine needs care, as documented in this source.
Arrhythmias, Cardiac
MajorAntiarrhythmic 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
- Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
- Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
- Strasberg B, Sclarovsky S, Erdberg A, et al. "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
- Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
- Lo KS, Gantz KB, Stetson PL, et al. "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
- Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
- Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
- 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
- Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
- Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
- Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
- Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
- Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
- Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
- 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
- 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
- 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
- Hii JT, Wyse DG, Gillis AM, et al. "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
- Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
- 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
- Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
- 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
- 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
- Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
- 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
- Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
- Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
- Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
- 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
- "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
- "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
- "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals (2002):
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
- "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
- Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
- Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
- Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
- "Product Information. Adenocard (adenosine)." Fujisawa (2001):
- "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):
- "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
- "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
- Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
- 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
- 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
- "Product Information. Norpace (disopyramide)." Searle (2001):
- Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
- Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
- 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
- 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
- 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
- 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
- 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
- "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
- 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
- "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
- Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
- 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
- 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
- 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
- Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
Cardiomyopathies
MajorAntiarrhythmic 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
- 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
- Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
- 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
- Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
- Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
- Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
- 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
- "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
Show all 17 sourcesShow fewer sources
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
- "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
- "Product Information. Adenocard (adenosine)." Fujisawa (2001):
- "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
- 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
- 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
- "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
- "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
Kidney Diseases
MajorLidocaine 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
- Eriksson E, Granberg P-O, Ortengren B "Study of renal excretion of prilocaine and lidocaine." Acta Chem Scand 358 (1966): 55-69
- 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
- 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
- Jacobi J, McGory RW, McCoy H, Matzke GR "Hemodialysis clearance of total and unbound lidocaine." Clin Pharm 2 (1983): 54-7
- Vaziri ND, Saiki JK, Hughes W "Clearance of lidocaine by hemodialysis." South Med J 72 (1979): 1567-8
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- 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
- 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
MajorLidocaine 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
- 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
- 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
- Bauer LA, Brown T, Gibaldi M, et al. "Influence of long-term infusions on lidocaine kinetics." Clin Pharmacol Ther 31 (1982): 433-7
- 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
- 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
- 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
- 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
- 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
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- Huet PM, Villeneuve JP "Determinants of drug disposition in patients with cirrhosis." Hepatology 3 (1983): 913-8
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- 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
- 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
- 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
Methemoglobinemia
MajorPrilocaine has induced methemoglobinemia resulting in respiratory distress and cyanosis. Therapy with prilocaine topical should be administered cautiously to patients with or predisposed to methemoglobinemia. If life-threatening or severe methemoglobinemia develops, methylene blue infused at a dosage of 1 to 2 mg/kg body weight will rapidly reverse or improve the condition, except in G-6-PD-deficient patients.
1 source
- "Product Information. Citanest Plain (prilocaine)." Astra-Zeneca Pharmaceuticals (2001):
Seizures
MajorSeizures 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
- Crampton RS, Oriscello RG "Petit and grand mal convulsions during lidocaine hydrochloride treatment of ventricular tachycardia." JAMA 204 (1968): 109-12
- Sundaram MB "Seizures after intraurethral instillation of lidocaine." Can Med Assoc J 137 (1987): 219-20
- Pelter MA, Vollmer TA, Blum RL "Seizure-like reaction associated with subcutaneous lidocaine injection ." Clin Pharm 8 (1989): 767-8
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- Fortuna A, Fortuna AO "Convulsion during lignocaine infiltration." Anaesth Intensive Care 21 (1993): 483
- Ryan CA, Robertson M, Coe JY "Seizures due to lidocaine toxicity in a child during cardiac catheterization." Pediatr Cardiol 14 (1993): 116-8
- 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
MajorThe 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
- Tagliente TM, Jayagopal S "Transient left bundle branch block following lidocaine." Anesth Analg 69 (1989): 545-7
- Hilleman DE, Mohiuddin SM, Destache CJ "Lidocaine-induced second-degree mobitz type II heart block." Drug Intell Clin Pharm 19 (1985): 669-73
- 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
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
Liver Failure
ModeratePrilocaine topical is absorbed through intact skin and mucosal membranes. Prolonged exposure, large doses, and/or application to compromised skin or mucosa can result in elevated plasma concentrations of prilocaine. Prilocaine is metabolized by the liver and to some extent by the kidney. The pharmacokinetic disposition of prilocaine is altered by changes in hepatic and renal function. Therapy with prilocaine topical should be administered cautiously and dosing modified for patients with compromised hepatic and renal function.
1 source
- "Product Information. Citanest Plain (prilocaine)." Astra-Zeneca Pharmaceuticals (2001):
Water-Electrolyte Imbalance
ModerateElectrolyte 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
- "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
- "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
- "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
- "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
- "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
- "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
- "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):
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- "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
- "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
- "Product Information. Norpace (disopyramide)." Searle (2001):
- "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
- "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
Therapeutic duplication
Drug classes that overlap with Lidocaine + Prilocaine, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
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): Bupivacaine/lidocaine/triamcinolone
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): Scandonest l
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): 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
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
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/lidocaine