Skip to Content

Lidocaine / potassium chloride Disease Interactions

There are 14 disease interactions with lidocaine / potassium chloride:

Major

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Cardiovascular Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Hypotension

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.

References

  1. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
  2. 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
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 17 references
Major

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Proarrhythmic Effects

Severe Potential Hazard, High plausibility

Applies to: Arrhythmias

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.

References

  1. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  2. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  3. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
View all 62 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Hepatic Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

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.

References

  1. 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
  2. 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
  3. 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
View all 13 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

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.

References

  1. 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
  2. Jacobi J, McGory RW, McCoy H, Matzke GR "Hemodialysis clearance of total and unbound lidocaine." Clin Pharm 2 (1983): 54-7
  3. 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
View all 8 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Seizures

Severe Potential Hazard, High plausibility

Applies to: Seizures

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.

References

  1. 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
  2. Crampton RS, Oriscello RG "Petit and grand mal convulsions during lidocaine hydrochloride treatment of ventricular tachycardia." JAMA 204 (1968): 109-12
  3. Fortuna A, Fortuna AO "Convulsion during lignocaine infiltration." Anaesth Intensive Care 21 (1993): 483
View all 7 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Sinus/Av Node Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Heart Block

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.

References

  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
View all 4 references
Major

Potassium Chloride (Includes Lidocaine/potassium chloride) ↔ Dehydration/Diarrhea

Severe Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea

Potassium chloride liquid suspension contains the stool softener, docusate sodium, as a dispersing agent. Clinical studies with potassium chloride liquid suspension indicate that minor changes in stool consistency may be common though usually well tolerated. However, patients may rarely experience diarrhea or cramping abdominal pain. Patients with severe or chronic diarrhea or who are dehydrated ordinarily should not be prescribed potassium chloride liquid suspension.

References

  1. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Dehydration

Severe Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea

Administration of potassium salts in severe dehydration may predispose to renal impairment. Therapy with potassium salts should be administered cautiously in patients with acute dehydration (e.g., due to severe or prolonged diarrhea or heat stress). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
View all 4 references
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Familial Periodic Paralysis

Severe Potential Hazard, High plausibility

Applies to: Familial Periodic Paralysis

Administration of potassium salts may precipitate attacks in familial hyperkalemic periodic paralysis or paramyotonia congenita. Therapy with potassium preparations should be administered cautiously in patients with these conditions.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Hyperkalemia

Severe Potential Hazard, High plausibility

Applies to: Acidosis, Hyperkalemia, Adrenal Insufficiency, Burns - External, Diabetes Mellitus, Hemolytic Anemia

The use of potassium salts is contraindicated in patients with hyperkalemia, since a further increase in serum potassium concentration in such patients can lead to cardiac arrhythmias or arrest. Potassium therapy should be administered cautiously in patients with conditions predisposing to hyperkalemia, such as chronic renal failure, systemic acidosis, acute dehydration, hypoaldosteronism (e.g., due to primary adrenal insufficiency or congenital adrenal enzyme deficiency), uncontrolled diabetes mellitus, and extensive tissue breakdown (e.g., due to severe burns, intravascular hemolysis, tumor lysis syndrome, or rhabdomyolysis). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. Perez GO, Oster JR, Pelleya R, Caralis PV, Kem DC "Hyperkalemia from single small oral doses of potassium chloride." Nephron 36 (1984): 270-1
  2. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  3. Saxena K "Death from potassium chloride overdose." Postgrad Med 84 (1988): 97-8,101-2
View all 19 references
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The use of potassium salts is contraindicated in patients with severe renal impairment characterized by oliguria, anuria, or azotemia. Since potassium is excreted by the kidney, the administration of potassium salts in such patients, particularly by the intravenous route, may produce hyperkalemia and cardiac arrhythmias or arrest. Therapy with potassium salts should be administered cautiously in patients with diminished renal function or other conditions which impairs potassium excretion (e.g. adrenal insufficiency). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  2. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  3. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
View all 5 references
Major

Potassium Salts (Oral) (Includes Lidocaine/potassium chloride) ↔ Gi Irritation

Severe Potential Hazard, High plausibility

Applies to: Gastrointestinal Obstruction, Peptic Ulcer, Gastrointestinal Hemorrhage, History - Peptic Ulcer, Duodenitis/Gastritis, Gastrointestinal Perforation, Esophageal Disease

The use of all solid oral formulations of potassium is contraindicated in patients with arrested or delayed gastrointestinal (GI) transit, whether due to structural, pathological, or pharmacological causes. Potassium is irritating to the GI mucosa and may cause ulcerative and/or stenotic lesions during prolonged physical contact. Based on spontaneous adverse reaction reports, the frequency of small bowel lesions associated with enteric-coated preparations of potassium chloride is 40 to 50 per 100,000 patient-years, while that for wax matrix controlled-release formulations is less than one per 100,000 patient years. Esophageal ulceration has also been reported following administration of controlled-release formulations of potassium chloride in cardiac patients with esophageal compression due to enlarged left atrium. Potassium supplementation should be administered as a liquid preparation or as an aqueous suspension in patients with esophageal obstruction and/or delayed gastrointestinal transit time.

Because of ulcerogenic effects, oral potassium should be administered cautiously in patients with peptic ulcers or other upper gastrointestinal diseases associated with inflammation, bleeding, or perforation. Patients should be advised not to crush, chew, or break potassium tablets or capsules, and to take them with meals and a full glass of water or other liquid. Potassium liquids should be diluted prior to consumption.

References

  1. Leijonmarck CE, Fenyo G, Raf L "Nontraumatic perforation of the small intestine." Acta Chir Scand 150 (1984): 405-11
  2. Jacobs E, Pringot J "Gastric ulcers due to the intake of potassium chloride." Am J Dig Dis 18 (1973): 289-94
  3. Delaney T, Hoxworth PI "Enteric-coated potassium chloride enteropathy." Surg Gynecol Obstet 127 (1968): 76-80
View all 73 references
Moderate

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Electrolyte Imbalance

Moderate Potential Hazard, High plausibility

Applies to: Hypokalemia, Hyperkalemia, Magnesium Imbalance

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 torsades 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.

References

  1. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  2. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
View all 13 references
Moderate

Potassium Chloride (Includes Lidocaine/potassium chloride) ↔ Acidosis

Moderate Potential Hazard, High plausibility

Applies to: Acidosis

Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing potassium salt (i.e. acetate, bicarbonate, citrate, or gluconate) rather than potassium chloride, since alkali therapy helps to promote cellular uptake of potassium. Close monitoring of acid-base balance, serum electrolytes, electrocardiogram, and clinical status is recommended.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  2. Leiter LA, Josse RG, West ML, Halperin ML "Severe metabolic acidosis induced in a patient during fasting by KCl administration." Clin Invest Med 11 (1988): 266-70
  3. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.

lidocaine / potassium chloride drug Interactions

There are 654 drug interactions with lidocaine / potassium chloride

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide