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Can you take Benzethonium chloride / lidocaine topical with Cimetidine?

1 drug interaction and 14 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

cimetidine lidocaine topical

Applies to: cimetidine and benzethonium chloride / lidocaine topical

Cimetidine may increase the blood levels of lidocaine topical. This may increase the risk of side effects including dizziness, drowsiness, numbness, blurred vision, or tremor. 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.

Food/lifestyle interactions

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.

Minor:

cimetidine Alcohol (Ethanol)

Applies to: cimetidine

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

Minor:

cimetidine Caffeine

Applies to: cimetidine

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

Minor:

cimetidine Nicotine

Applies to: cimetidine

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

Disease interactions

10 potential interactions Applies to: 8 conditions, including Seizures, Hemodialysis, Liver Disease, Heart Block, and Shock.

Gastrointestinal Hemorrhage

Major:

cimetidine

Cimetidine has a major potential interaction with Gastrointestinal Hemorrhage.

Histamine H2 receptor antagonists should not be used in the presence of vomit with blood, or bloody or black stools. These might be serious conditions and the diagnosis needs to be ruled out.

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.

Hemodialysis

Moderate:

cimetidine

Cimetidine has a moderate potential interaction with Hemodialysis.

Cimetidine is partially removed by hemodialysis and should be administered after dialysis.

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.

Major:

cimetidine

Cimetidine has a major potential interaction with Liver Disease.

Cimetidine is partially metabolized by the liver, and to a greater extent when administered orally than when given intravenously. Although dosage reductions are generally not necessary, therapy with cimetidine should be administered cautiously in patients with liver disease. Hepatotoxicity has been associated with cimetidine use. In addition, liver disease appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are usually reversible within 3 to 4 days after discontinuation of therapy.

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.

Moderate:

cimetidine

Cimetidine has a moderate potential interaction with Renal Dysfunction.

Cimetidine and its metabolites are primarily eliminated by the kidney. The daily dosage should initially be reduced in patients with moderate to severe renal impairment (CrCl < 50 mL/min). If necessary, the daily dosage may be increased with caution. Renal dysfunction also appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are generally reversible within 3 to 4 days after discontinuation of therapy.

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

benzethonium chloride / lidocaine topical

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

cimetidine

A total of 494 drugs are known to interact with cimetidine.

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.