Can you take Amprenavir with Flavalta?
1 drug interaction and 30 additional warnings found for the following 2 drugs:
- amprenavir
- Flavalta (epinephrine/lidocaine)
Drug interactions
Major drug interactions
Major:
lidocaine amprenavir
Applies to: Flavalta (epinephrine / lidocaine) and amprenavir
Talk to your doctor before using lidocaine together with amprenavir. Combining these medications may significantly increase the blood levels of lidocaine.
This can increase the risk of serious side effects such as irregular heart rhythm and other cardiovascular problems.
You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
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.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
lidocaine Food/Lifestyle
Applies to: Flavalta (epinephrine / lidocaine)
Grapefruit juice may increase the blood levels of lidocaine, which may increase the risk of side effects such as:
- low blood pressure
- slow heart rate
- irregular heart rhythm
- difficulty breathing
- convulsions
Cigarette smoking may reduce the blood levels of lidocaine, which may make the medication less effective. It is best to avoid smoking during lidocaine therapy.
Consuming cruciferous vegetables (e.G., broccoli, brussels sprouts) may also reduce the blood levels of lidocaine.
Talk to a healthcare professional if you have any questions or concerns. 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.
Moderate:
amprenavir Food/Lifestyle
Applies to: amprenavir
Amprenavir can be taken with or without food. Avoid taking with a high-fat meal, which can make it harder for your body to absorb amprenavir.
Take amprenavir with a full glass (8 ounces) of water.
Do not switch from amprenavir capsules to oral liquid without your doctor's advice. Make sure you receive the right form of this medication each time you get your prescription filled.
Moderate:
EPINEPHrine Caffeine
Applies to: Flavalta (epinephrine / lidocaine)
Both EPINEPHrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
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.
Moderate:
lidocaine Nicotine
Applies to: Flavalta (epinephrine / lidocaine)
As you stop smoking during treatment with nicotine, your dosage requirement of lidocaine may need to be changed. Talk to your doctor if you have any questions or concerns.
Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
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.
Disease interactions
26 potential interactions Applies to: 21 conditions, including Heart Failure, Seizures, Hypokalemia, Hypotension, and Hyperthyroidism.
Abnormal Glucose Tolerance
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with Abnormal Glucose Tolerance.
New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.
Acidosis
Moderate:
Flavalta
The EPINEPHrine in Flavalta has a moderate potential interaction with Acidosis.
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.
Cardiovascular Conditions and Disorders
Major:
Flavalta
The EPINEPHrine in Flavalta has a major potential interaction with Cardiovascular Conditions and Disorders.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Dehydration
Major:
Flavalta
The EPINEPHrine in Flavalta has a major potential interaction with Dehydration.
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.
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with Dehydration.
Cases of nephrolithiasis have been reported during postmarketing surveillance in HIV-infected patients receiving amprenavir or fosamprenavir therapy. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made. Therapy with amprenavir or fosamprenavir should be administered cautiously in patients with a current or past history of nephrolithiasis. Adequate hydration is recommended. Those who are dehydrated may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluids if necessary. Patients should be instructed to seek medical attention if they experience potential signs and symptoms of urolithiasis such as flank pain, hematuria, dysuria, and urinary urgency. Temporary interruption or discontinuation of therapy may be required.
Diabetes Mellitus
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with Diabetes Mellitus.
New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.
Moderate:
Flavalta
The EPINEPHrine in Flavalta has a moderate potential interaction with Diabetes Mellitus.
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Heart Block
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with 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.
Heart Failure
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with Heart Failure.
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.
History, Nephrolithiasis
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with History, Nephrolithiasis.
Cases of nephrolithiasis have been reported during postmarketing surveillance in HIV-infected patients receiving amprenavir or fosamprenavir therapy. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made. Therapy with amprenavir or fosamprenavir should be administered cautiously in patients with a current or past history of nephrolithiasis. Adequate hydration is recommended. Those who are dehydrated may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluids if necessary. Patients should be instructed to seek medical attention if they experience potential signs and symptoms of urolithiasis such as flank pain, hematuria, dysuria, and urinary urgency. Temporary interruption or discontinuation of therapy may be required.
Hyperkalemia
Moderate:
Flavalta
The lidocaine in Flavalta has a moderate potential interaction with Hyperkalemia.
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 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.
Hyperthyroidism
Major:
Flavalta
The EPINEPHrine in Flavalta has a major potential interaction with Hyperthyroidism.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Hypokalemia
Moderate:
Flavalta
The lidocaine in Flavalta has a moderate potential interaction with Hypokalemia.
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 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.
Hypotension
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with 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.
Liver Disease
Major:
amprenavir
Amprenavir has a major potential interaction with Liver Disease.
The use of amprenavir oral solution is contraindicated in patients with renal and/or hepatic failure due to the large amount of excipient propylene glycol in the formulation. In general, use of the solution should be limited to patients in whom the capsule formulation or other protease inhibitors are not feasible options. Caution is advised in patients with renal or hepatic impairment due to increased risk of propylene glycol-associated adverse events. All patients receiving the oral solution should be monitored for signs of propylene glycol toxicity including seizures, stupor, tachycardia, hyperosmolality, lactic acidosis, renal toxicity, and hemolysis.
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with 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.
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with Liver Disease.
Amprenavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from amprenavir due to decreased drug clearance. Therapy with amprenavir should be administered cautiously in patients with moderate or severe hepatic impairment, and the dosage should be reduced as follows: 450 mg (three 150 mg capsules) or 513 mg (34 mL oral solution) orally twice a day for Child-Pugh score 5 to 8; 300 mg (two 150 mg capsules) or 342 mg (23 mL oral solution) orally twice a day for Child-Pugh score 9 to 12.
Magnesium Imbalance
Moderate:
Flavalta
The lidocaine in Flavalta has a moderate potential interaction with 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 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.
Nephrolithiasis
Moderate:
amprenavir
Amprenavir has a moderate potential interaction with Nephrolithiasis.
Cases of nephrolithiasis have been reported during postmarketing surveillance in HIV-infected patients receiving amprenavir or fosamprenavir therapy. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made. Therapy with amprenavir or fosamprenavir should be administered cautiously in patients with a current or past history of nephrolithiasis. Adequate hydration is recommended. Those who are dehydrated may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluids if necessary. Patients should be instructed to seek medical attention if they experience potential signs and symptoms of urolithiasis such as flank pain, hematuria, dysuria, and urinary urgency. Temporary interruption or discontinuation of therapy may be required.
Neurological Disorders
Moderate:
Flavalta
The EPINEPHrine in Flavalta has a moderate potential interaction with Neurological Disorders.
Epinephrine should be administered with caution to patients with Parkinson's disease as these patients may experience psychomotor agitation or notice a temporary worsening of symptoms.
Parkinsonism
Moderate:
Flavalta
The EPINEPHrine in Flavalta has a moderate potential interaction with Parkinsonism.
Epinephrine should be administered with caution to patients with Parkinson's disease as these patients may experience psychomotor agitation or notice a temporary worsening of symptoms.
Pheochromocytoma
Major:
Flavalta
The EPINEPHrine in Flavalta has a major potential interaction with Pheochromocytoma.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Renal Dysfunction
Major:
amprenavir
Amprenavir has a major potential interaction with Renal Dysfunction.
The use of amprenavir oral solution is contraindicated in patients with renal and/or hepatic failure due to the large amount of excipient propylene glycol in the formulation. In general, use of the solution should be limited to patients in whom the capsule formulation or other protease inhibitors are not feasible options. Caution is advised in patients with renal or hepatic impairment due to increased risk of propylene glycol-associated adverse events. All patients receiving the oral solution should be monitored for signs of propylene glycol toxicity including seizures, stupor, tachycardia, hyperosmolality, lactic acidosis, renal toxicity, and hemolysis.
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with 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.
Seizures
Major:
Flavalta
The lidocaine in Flavalta has a major potential interaction with 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.
Vitamin K Deficiency
Minor:
amprenavir
Amprenavir has a minor potential interaction with Vitamin K Deficiency.
Formulations of Agenerase (brand of amprenavir) provide high daily doses of vitamin E exceeding the Reference Daily Intake (adults 30 Intl units, pediatrics approximately 10 Intl units). The effects of long-term, high-dose vitamin E administration in humans are unclear. High levels of vitamin E may exacerbate the blood coagulation defect of vitamin K deficiency caused by anticoagulant therapy or malabsorption.
More resources
amprenavir
A total of 572 drugs are known to interact with amprenavir.
- Amprenavir is in the drug class protease inhibitors.
- Amprenavir is used to treat HIV-1 Infection.
Flavalta
A total of 726 drugs are known to interact with Flavalta.
- Flavalta is in the drug class local injectable anesthetics.
- Flavalta is used to treat Local Anesthesia.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.