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Can you take Atovaquone with Benzethonium chloride / lidocaine topical?

1 drug interaction and 12 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

lidocaine topical atovaquone

Applies to: benzethonium chloride / lidocaine topical and atovaquone

Some of the medication in lidocaine topical may be absorbed into the bloodstream following local application. When present in sufficient concentrations in the blood, local anesthetics such as lidocaine topical may cause methemoglobinemia, a rare condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. The risk is increased when combined with other medications that can also induce methemoglobinemia such as atovaquone. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have anemia, diseases of the heart or lungs, blood circulation disorders, liver cirrhosis, shock, sepsis, and certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M. In addition, use of topical anesthetics on inflamed or abraded areas or broken skin, as well as excessive use such as application of large doses or on larger than recommended areas, can increase absorption and result in high blood levels of the medication. Topical anesthetics that are applied to mucous membranes such as inside the mouth, nose, or throat (e.G., for sore throat; for numbing prior to dental procedures or scoping of the lungs or gastrointestinal tract) may also be absorbed to a significant extent. Close medical supervision is necessary when medications that can cause methemoglobinemia are used together. Do not exceed the recommended dose or frequency and duration of use when treated with products that contain local anesthetics, including some over-the-counter preparations. Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment with topical anesthetics. Patients (or their caregivers) should seek immediate medical attention if they develop a gray discoloration of the skin, mouth, or nail bed; nausea; headache; dizziness; lightheadedness; fatigue; shortness of breath; rapid or shallow breathing; a rapid heartbeat; palpitation; anxiety; or confusion. 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:

atovaquone Food/Lifestyle

Applies to: atovaquone

Food significantly enhances the absorption of atovaquone. You should take each dose of atovaquone at the same time each day with a meal or a milky drink. If you receive enteral nutrition (tube feeding), take atovaquone with your feeding. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Talk to your doctor if you have questions or have difficulty taking atovaquone with food.

Minor food/lifestyle interactions

Minor:

lidocaine topical Food/Lifestyle

Applies to: benzethonium chloride / lidocaine topical

Information for this minor interaction is available on the professional version.

Disease interactions

10 potential interactions Applies to: 9 conditions, including Seizures, Diarrhea, Liver Disease, Heart Block, and Shock.

Anorexia/Feeding Problems

Moderate:

atovaquone

Atovaquone has a moderate potential interaction with Anorexia/Feeding Problems.

Oral bioavailability of atovaquone is limited under fasting conditions, but is increased approximately two-fold when administered with food. Patients with gastrointestinal disorders or eating difficulties may be more likely to have impaired absorption and, consequently, subtherapeutic levels of the drug. Alternative parenteral treatment should be considered for patients unable to achieve adequate plasma concentrations of atovaquone with oral administration.

Diarrhea

Moderate:

atovaquone

Atovaquone has a moderate potential interaction with Diarrhea.

Oral bioavailability of atovaquone is limited under fasting conditions, but is increased approximately two-fold when administered with food. Patients with gastrointestinal disorders or eating difficulties may be more likely to have impaired absorption and, consequently, subtherapeutic levels of the drug. Alternative parenteral treatment should be considered for patients unable to achieve adequate plasma concentrations of atovaquone with oral administration.

Heart Block

Major:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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.

Liver Disease

Major:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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:

atovaquone

Atovaquone has a moderate potential interaction with Liver Disease.

Atovaquone may cause elevated liver function tests. In clinical trials, elevated serum alkaline phosphatase concentrations (> 2.5 times the upper limit of normal, or ULN) were reported in approximately 8% of patients, and elevations in serum ALT and AST (> 5 times ULN) were reported in 6% and 4% of patients, respectively. Increases in serum bilirubin has occurred rarely. Atovaquone also may undergo limited metabolism by the liver. Therapy with atovaquone should be administered cautiously in patients with severe hepatic impairment. Liver function tests should be performed periodically, and therapy withdrawn if significant elevations develop.

Malabsorption Syndrome

Moderate:

atovaquone

Atovaquone has a moderate potential interaction with Malabsorption Syndrome.

Oral bioavailability of atovaquone is limited under fasting conditions, but is increased approximately two-fold when administered with food. Patients with gastrointestinal disorders or eating difficulties may be more likely to have impaired absorption and, consequently, subtherapeutic levels of the drug. Alternative parenteral treatment should be considered for patients unable to achieve adequate plasma concentrations of atovaquone with oral administration.

Renal Dysfunction

Major:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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.

Seizures

Major:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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:

benzethonium chloride / lidocaine topical

The lidocaine topical in benzethonium chloride / lidocaine topical 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

atovaquone

A total of 93 drugs are known to interact with atovaquone.

benzethonium chloride / lidocaine topical

A total of 122 drugs are known to interact with benzethonium chloride / lidocaine 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.