lidocaine
generic
Drug Interactions .
Overview
lidocaine
antiarrhythmic, class Ib
- CYP1A2 substrate
- CYP3A4 substrate
- methemoglobinemia
Contraindicated
- dronedarone
- morphine liposomal
Contraindicated
lidocaine + dronedarone
contraindicated: combo may incr. lidocaine levels, risk of adverse effects, including QT prolongation, cardiac arrhythmias (hepatic metab. inhibited, additive prolonged QT)
Contraindicated
lidocaine + morphine liposomal
contraindicated w/in 48h of morphine liposomal use if also epidural local anesthetic use: combo may decr. efficacy, incr. risk of adverse effects (potential incompatibility in epidural space)
Avoid/Use Alternative
- acetaminophen
- amiodarone
- butalbital
- chloroquine
- dapsone
- disopyramide
- fosphenytoin
- isosorbide dinitrate
- isosorbide mononitrate
- nitrofurantoin
- nitroglycerin
- nitroprusside
- phenobarbital
- phenytoin
- primaquine
- sodium oxybate
- sulfadiazine
- sulfadoxine
- sulfamethoxazole
- sulfasalazine
- sulfisoxazole
Avoid/Use Alternative
lidocaine + acetaminophen
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + amiodarone
weigh risk/benefit; monitor levels, BP, toxicity: combo may incr. lidocaine levels, risk of adverse effects, including QT prolongation, cardiac arrhythmias (hepatic metab. inhibited; additive effects)
Avoid/Use Alternative
lidocaine + butalbital
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + chloroquine
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + dapsone
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + disopyramide
weigh risk/benefit: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects)
Avoid/Use Alternative
lidocaine + fosphenytoin
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + isosorbide dinitrate
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + isosorbide mononitrate
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + nitrofurantoin
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + nitroglycerin
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + nitroprusside
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + phenobarbital
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + phenytoin
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + primaquine
avoid combo or use alternative: combo may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + sodium oxybate
avoid combo: combo may incr. risk of CNS and resp. depression, other adverse effects (additive effects)
Avoid/Use Alternative
lidocaine + sulfadiazine
avoid combo or use alternative: combo w/ sulfonamides may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + sulfadoxine
avoid combo or use alternative: combo w/ sulfonamides may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + sulfamethoxazole
avoid combo or use alternative: combo w/ sulfonamides may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + sulfasalazine
avoid combo or use alternative: combo w/ sulfonamides may incr. risk of methemoglobinemia (additive effects)
Avoid/Use Alternative
lidocaine + sulfisoxazole
avoid combo or use alternative: combo w/ sulfonamides may incr. risk of methemoglobinemia (additive effects)
Monitor/Modify Tx
- adalimumab
- atazanavir
- boceprevir
- certolizumab pegol
- chloramphenicol
- cimetidine
- ciprofloxacin
- clarithromycin
- cobicistat
- conivaptan
- cyclosporine
- darunavir
- delavirdine
- erythromycin
- etanercept
- fluconazole
- fluvoxamine
- fosamprenavir
- golimumab
- imatinib
- indinavir
- infliximab
- itraconazole
- ketoconazole
- lopinavir/ritonavir
- nelfinavir
- nevirapine
- posaconazole
- propranolol
- ritonavir
- saquinavir
- sevelamer
- telaprevir
- telithromycin
- tipranavir
- tocilizumab
- ustekinumab
- voriconazole
Monitor/Modify Tx
lidocaine + adalimumab
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; TNF blockers may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + atazanavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + boceprevir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + certolizumab pegol
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; TNF blockers may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + chloramphenicol
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + cimetidine
monitor levels: combo may incr. lidocaine levels, risk of adverse effects (mechanism unknown, hepatic metab. possibly inhibited)
Monitor/Modify Tx
lidocaine + ciprofloxacin
monitor levels: combo may incr. lidocaine levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + clarithromycin
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + cobicistat
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + conivaptan
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + cyclosporine
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + darunavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + delavirdine
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + erythromycin
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + etanercept
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; TNF blockers may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + fluconazole
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + fluvoxamine
monitor levels: combo may incr. lidocaine levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + fosamprenavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + golimumab
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; TNF blockers may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + imatinib
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + indinavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + infliximab
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; TNF blockers may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + itraconazole
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + ketoconazole
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + lopinavir/ ritonavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + nelfinavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + nevirapine
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. induced)
Monitor/Modify Tx
lidocaine + posaconazole
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + propranolol
monitor levels: combo may incr. lidocaine levels, risk of adverse effects (clearance decreased)
Monitor/Modify Tx
lidocaine + ritonavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + saquinavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + sevelamer
give antiarrhythmic 1h before or 3h after, monitor efficacy: combo may decr. antiarrhythmic level, efficacy (absorption possibly decreased)
Monitor/Modify Tx
lidocaine + telaprevir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + telithromycin
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + tipranavir
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Monitor/Modify Tx
lidocaine + tocilizumab
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. altered; tocilizumab may inhibit inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)
Monitor/Modify Tx
lidocaine + ustekinumab
monitor levels: combo may decr. lidocaine levels, efficacy (hepatic metab. possibly altered; ustekinumab may normalize hepatic enzyme formation suppressed by incr. cytokine levels)
Monitor/Modify Tx
lidocaine + voriconazole
monitor levels: combo may incr. lidocaine or active metabolite levels, risk of adverse effects (hepatic metab. inhibited)
Caution Advised
- alfentanil
- atracurium
- belatacept
- benzocaine topical
- buprenorphine
- butamben topical
- butorphanol
- butorphanol nasal
- cisatracurium
- clonidine
- cocaine topical
- codeine
- desflurane
- dihydrocodeine
- enflurane
- epinephrine
- fentanyl
- flecainide
- hydrocodone
- hydromorphone
- isoflurane
- levorphanol
- lidocaine topical
- meperidine
- methadone
- morphine
- nalbuphine
- nitrite
- oxycodone
- oxymorphone
- pancuronium
- pentazocine
- prilocaine topical
- propafenone
- remifentanil
- rocuronium
- sevoflurane
- sotalol
- succinylcholine
- sufentanil
- tetracaine topical
- vecuronium
Caution Advised
lidocaine + alfentanil
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + atracurium
caution advised: combo may potentiate neuromuscular blockade (synergistic effects)
Caution Advised
lidocaine + belatacept
caution advised: combo may decr. lidocaine levels, efficacy (hepatic metab. possibly altered; belatacept may normalize hepatic enzyme formation suppressed by incr. cytokine levels)
Caution Advised
lidocaine + benzocaine topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo w/ topical anesthetics may incr. risk of methemoglobinemia, other adverse effects (additive effects)
Caution Advised
lidocaine + buprenorphine
caution advised: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + butamben topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo w/ topical anesthetics may incr. risk of methemoglobinemia, other adverse effects (additive effects)
Caution Advised
lidocaine + butorphanol
caution advised: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + butorphanol nasal
caution advised: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + cisatracurium
caution advised: combo may potentiate neuromuscular blockade (synergistic effects)
Caution Advised
lidocaine + clonidine
caution advised w/ epidural clonidine, may use for therapeutic advantage: combo may prolong epidural local anesthetic effects, incl. sensory and motor blockade (additive effects)
Caution Advised
lidocaine + cocaine topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo may incr. risk of adverse effects (additive effects)
Caution Advised
lidocaine + codeine
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + desflurane
caution advised: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + dihydrocodeine
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + enflurane
caution advised: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + epinephrine
caution advised, use for therapeutic advantage: combo may prolong anesthesia, and may decr. systemic toxicity and burning w/ injection of local anesthetic (absorption decreased via vasoconstriction)
Caution Advised
lidocaine + fentanyl
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + flecainide
caution advised: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + hydrocodone
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + hydromorphone
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + isoflurane
caution advised: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + levorphanol
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + lidocaine topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo w/ topical anesthetics may incr. risk of methemoglobinemia, other adverse effects (additive effects)
Caution Advised
lidocaine + meperidine
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + methadone
caution advised, consider opioid dose reduction: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + morphine
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + nalbuphine
caution advised: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + nitrite
caution advised: combo w/ nitrites may incr. risk of methemoglobinemia (additive effects)
Caution Advised
lidocaine + oxycodone
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + oxymorphone
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + pancuronium
caution advised: combo may potentiate neuromuscular blockade (synergistic effects)
Caution Advised
lidocaine + pentazocine
caution advised: combo may incr. risk of CNS and resp. depression (additive effects)
Caution Advised
lidocaine + prilocaine topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo w/ topical anesthetics may incr. risk of methemoglobinemia, other adverse effects (additive effects)
Caution Advised
lidocaine + propafenone
caution advised, if possible withhold antiarrhythmics for 2-3 half-lives before initiating new antiarrhythmic: combo may incr. risk of CNS adverse effects (additive effects)
Caution Advised
lidocaine + remifentanil
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + rocuronium
caution advised: combo may potentiate neuromuscular blockade (synergistic effects)
Caution Advised
lidocaine + sevoflurane
caution advised: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + sotalol
caution advised, if possible withhold antiarrhythmics for 2-3 half-lives before initiating new antiarrhythmic: combo may incr. risk of cardiac arrhythmias (additive effects)
Caution Advised
lidocaine + succinylcholine
caution advised: combo may potentiate, prolong neuromuscular blockade (mechanism unknown)
Caution Advised
lidocaine + sufentanil
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression; opioid anesthestics used w/ high levels of epidural or spinal anesthesia may also have incr. risk of hypotension, bradycardia (additive effects)
Caution Advised
lidocaine + tetracaine topical
caution advised, consider cumulative doses/potential systemic exposure from all topical or local anesthetic formulations used concurrently: combo w/ topical anesthetics may incr. risk of methemoglobinemia, other adverse effects (additive effects)
Caution Advised
lidocaine + vecuronium
caution advised: combo may potentiate neuromuscular blockade (synergistic effects)