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Epinephrine / lidocaine / tetracaine topical Disease Interactions

There are 7 disease interactions with epinephrine / lidocaine / tetracaine topical:

Major

Lidocaine (applies to epinephrine/lidocaine/tetracaine topical) teething pain

Major Potential Hazard, Moderate plausibility. Applicable conditions: Teething Syndrome

Topical lidocaine is not recommended to be used in teething infants and young children, as its ingestion is dangerous and potentially fatal. Ingestion of the drug has shown to result in seizures, severe brain injury, and heart problems in children.

Major

Lidocaine topical (applies to epinephrine/lidocaine/tetracaine topical) cardiovascular dysfunction

Major Potential Hazard, Moderate plausibility. Applicable conditions: Heart Block, Shock

Lidocaine is absorbed through intact skin and mucosal membranes following topical administration. Prolonged exposure, large doses, frequent applications and/or use on compromised skin or mucosa can produce systemic effects. At high plasma levels, lidocaine can cause hypotension, bradycardia, and cardiovascular collapse. Therapy with lidocaine topical should be administered cautiously in patients with shock, sinus bradyarrhythmia, or severe heart block. The recommended dosage should not be exceeded. Children and debilitated, elderly, or acutely ill patients should be given reduced dosages commensurate with their age, weight, and physical condition.

Major

Lidocaine topical (applies to epinephrine/lidocaine/tetracaine topical) hepatic dysfunction

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Lidocaine 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 lidocaine. 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. The pharmacokinetic disposition of lidocaine is altered by changes in hepatic function, including hepatic blood flow. Therapy with lidocaine topical should be administered cautiously and dosing modified for patients with compromised hepatic function.

Major

Lidocaine topical (applies to epinephrine/lidocaine/tetracaine topical) renal dysfunction

Major Potential Hazard, Moderate plausibility.

Lidocaine 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 lidocaine. 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. Serum concentrations of lidocaine and the active metabolites are increased and the half-life prolonged in patients with renal impairment. Therapy with lidocaine topical should be administered cautiously and dosing modified for repeated doses in patients with compromised renal function.

Major

Lidocaine topical (applies to epinephrine/lidocaine/tetracaine topical) seizures

Major Potential Hazard, Moderate plausibility.

Lidocaine 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 lidocaine. Seizures can occur as a result of accumulation of active metabolites. Therapy with lidocaine topical should be administered cautiously to patients with or predisposed to seizure disorders.

Major

Sympathomimetics (applies to epinephrine/lidocaine/tetracaine topical) dehydration

Major Potential Hazard, High plausibility.

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.

References

  1. "Product Information. Adrenalin Chloride Solution (epinephrine)." Parke-Davis, Morris Plains, NJ.
  2. "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Epifrin Sterile Ophthalmic Solution (epinephrine)." Allergan Inc, Irvine, CA.
  4. "Product Information. Levophed Bitartrate (norepinephrine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 4 references
Moderate

Sympathomimetics (applies to epinephrine/lidocaine/tetracaine topical) acidosis

Moderate Potential Hazard, High plausibility.

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.

References

  1. "Product Information. Adrenalin Chloride Solution (epinephrine)." Parke-Davis, Morris Plains, NJ.
  2. "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Epifrin Sterile Ophthalmic Solution (epinephrine)." Allergan Inc, Irvine, CA.
  4. "Product Information. Levophed Bitartrate (norepinephrine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 4 references

Epinephrine / lidocaine / tetracaine topical drug interactions

There are 100 drug interactions with epinephrine / lidocaine / tetracaine topical

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.