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Can you take Acalabrutinib with Lidodextrapine?

1 drug interaction and 15 additional warnings found for the following 2 drugs:

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Drug interactions

Minor drug interactions

Minor:

menthol topical acalabrutinib

Applies to: Lidodextrapine (lidocaine / menthol topical) and acalabrutinib

Coadministration with orally administered menthol may decrease plasma concentrations of drugs that are substrates of the CYP450 3A4 and/or CYP450 2C9 isoenzymes. The proposed mechanism is increased clearance due to menthol-mediated induction of CYP450 3A4 and CYP450 2C9. In vivo data suggests that concomitant administration of oral menthol reduced the systemic exposure (AUC) of triazolam (a CYP450 3A4 substrate) by 40%, and phenytoin (a CYP450 2C9 substrate) by 20%. Until further data are available, no specific precautions are recommended.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

acalabrutinib Food/Lifestyle

Applies to: acalabrutinib

Acalabrutinib may be taken with or without food. However, consumption of grapefruit and grapefruit juice can increase the blood levels of acalabrutinib.

This may increase side effects such as:

  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • hemorrhage
  • development of other cancers
  • abnormal heart rhythm
  • impaired bone marrow function resulting in low numbers of different types of blood cells

You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts.

You should avoid the consumption of grapefruit and grapefruit juice during treatment with acalabrutinib.

Be sure to take the medication at approximately the same time(s) every day to maintain consistent blood levels and effects.

Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Minor food/lifestyle interactions

Minor:

lidocaine topical Food/Lifestyle

Applies to: Lidodextrapine (lidocaine / menthol topical)

Theoretically, grapefruit, grapefruit juice, grapefruit hybrids, starfruit, and Seville oranges may increase the plasma concentrations of topical lidocaine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. In a drug study when a single dose of intravenous lidocaine was coadministered with potent CYP450 3A4 inhibitors, erythromycin and itraconazole, lidocaine plasma clearance was reduced by 9 to 18% in healthy subjects. The degree of systemic absorption of topical lidocaine is dependent on the duration of application, the applied surface area, and the integrity of the application site. The risk of systemic lidocaine absorption may be greater when topical lidocaine is applied to areas of high systemic absorption (e.g., mucous membranes) with repeated doses over a long period of time. However, the clinical significance of this potential interaction is unknown.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Disease interactions

13 potential interactions Applies to: 11 conditions, including Seizures, Arrhythmia, Liver Disease, Infection, and Bleeding Disorder.

Arrhythmia

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Arrhythmia.

Atrial fibrillation and atrial flutter have been observed in patients treated with acalabrutinib. It is recommended to monitor patients with abnormal heart rhythm for atrial fibrillation and atrial flutter and manage as clinically appropriate.

Bleeding Disorder

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Bleeding Disorder.

Serious hemorrhagic events, including fatal events, have occurred in patients treated with acalabrutinib. Care should be exercised when using acalabrutinib in patients with bleeding disorders. It is recommended to monitor for signs of bleeding and to consider the benefit-risk of withholding therapy for 3-7 days pre- and post-surgery depending upon the type of surgery and the risk of bleeding.

Bone Marrow Depression/Low Blood Counts

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.

Heart Block

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with Heart Block.

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.

Immunodeficiency

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Immunodeficiency.

Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.

Infection

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Infection.

Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.

Liver Disease

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with 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.

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Liver Disease.

Acalabrutinib is metabolized in the liver. Based on the population pharmacokinetic analysis, no clinically relevant difference was observed in subjects with mild or moderate hepatic impairment. The pharmacokinetic of acalabrutinib has not been evaluated in patients with severe hepatic impairment. Close monitoring of liver function is recommended in these patients.

Renal Dysfunction

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with Renal Dysfunction.

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.

Moderate:

acalabrutinib

Acalabrutinib has a moderate potential interaction with Renal Dysfunction.

Acalabrutinib undergoes minimal renal elimination. Based on the population pharmacokinetic analysis, no clinically relevant difference was observed in patients with mild or moderate renal impairment. The pharmacokinetic of acalabrutinib has not been evaluated in patients with severe renal impairment or renal impairment requiring dialysis. Close monitoring of renal function is recommended in these patients.

Seizures

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with Seizures.

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.

Shock

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with 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.

Teething Syndrome

Major:

Lidodextrapine

The lidocaine topical in Lidodextrapine has a major potential interaction with 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.

More resources

acalabrutinib

A total of 529 drugs are known to interact with acalabrutinib.

Lidodextrapine

A total of 446 drugs are known to interact with Lidodextrapine.

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.