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Can you take Benzethonium chloride / lidocaine topical with Cyclophosphamide?

1 drug interaction and 19 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

cycloPHOSphamide lidocaine topical

Applies to: cyclophosphamide and benzethonium chloride / lidocaine topical

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 cycloPHOSphamide. 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

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

18 potential interactions Applies to: 16 conditions, including Urinary Tract Infection, Seizures, Bladder Infection, Fever, and Heart Disease.

Bladder Infection

Major:

cyclophosphamide

cycloPHOSphamide has a major potential interaction with Bladder Infection.

The use of cyclophosphamide is contraindicated in patients with urinary outflow obstruction. Urinary tract obstruction should be excluded or corrected before treatment because cyclophosphamide can cause urotoxicity, which may be fatal.

Bleeding Disorder

Major:

cyclophosphamide

cycloPHOSphamide has a major potential interaction with Bleeding Disorder.

Cyclophosphamide should not be administered to patients with neutrophil counts of 1,500/mm3 or less and platelet counts below 50,000/mm3. Cyclophosphamide can cause myelosuppression, bone marrow failure, and severe immunosuppression; complete blood counts should be monitored during treatment.

Bone Marrow Depression/Low Blood Counts

Major:

cyclophosphamide

cycloPHOSphamide has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Cyclophosphamide should not be administered to patients with neutrophil counts of 1,500/mm3 or less and platelet counts below 50,000/mm3. Cyclophosphamide can cause myelosuppression, bone marrow failure, and severe immunosuppression; complete blood counts should be monitored during treatment.

Fever

Moderate:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Fever.

Cyclophosphamide treatment may not be indicated, or may require interruption or dose reduction, in patients with a serious infection. Cyclophosphamide can cause severe immunosuppression and reactivate latent infections; it should be used with caution, if at all, in patients with active urinary tract infections.

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.

Heart Disease

Moderate:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Heart Disease.

Cyclophosphamide can cause myocarditis, myopericarditis, pericardial effusion, arrhythmias, and congestive heart failure, which may be fatal. Particular caution is necessary in patients with pre-existing cardiac disease; monitor these patients for cardiotoxicity.

History, Radiation Therapy

Moderate:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with History, Radiation Therapy.

Previous radiation treatment to the cardiac region may increase the risk of cyclophosphamide cardiotoxicity, and previous abdominal radiation is a risk factor for cyclophosphamide-associated veno-occlusive liver disease. Patients with risk factors for cardiotoxicity should be monitored during treatment.

Infection

Moderate:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Infection.

Cyclophosphamide treatment may not be indicated, or may require interruption or dose reduction, in patients with a serious infection. Cyclophosphamide can cause severe immunosuppression and reactivate latent infections; it should be used with caution, if at all, in patients with active urinary tract infections.

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:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Liver Disease.

Pre-existing disturbances of hepatic function are a risk factor for cyclophosphamide-associated veno-occlusive liver disease, which can be fatal. Severe hepatic impairment may reduce conversion of cyclophosphamide to its active metabolite, potentially reducing efficacy.

Pulmonary Impairment

Moderate:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Pulmonary Impairment.

Pneumonitis, pulmonary fibrosis, pulmonary veno-occlusive disease and other forms of pulmonary toxicity leading to respiratory failure have been reported during and following treatment with cyclophosphamide. Pneumonitis may develop years after treatment with cyclophosphamide. Patients should be monitored for signs and symptoms of pulmonary toxicity. Caution is advised in patients with preexisting pulmonary impairment.

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:

cyclophosphamide

cycloPHOSphamide has a moderate potential interaction with Renal Dysfunction.

In patients with severe renal impairment, decreased renal excretion may result in increased plasma levels of cyclophosphamide and its metabolites, which may result in increased toxicity. Monitor patients with severe renal impairment (CrCl =10 mL/min to 24 mL/min) for signs and symptoms of toxicity. Therapy with cyclophosphamide should be administered cautiously in patients with a history of or predisposition to renal dysfunction. Clinical monitoring of renal function is recommended.

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.

Urinary Tract Infection

Major:

cyclophosphamide

cycloPHOSphamide has a major potential interaction with Urinary Tract Infection.

The use of cyclophosphamide is contraindicated in patients with urinary outflow obstruction. Urinary tract obstruction should be excluded or corrected before treatment because cyclophosphamide can cause urotoxicity, which may be fatal.

Urinary Tract Obstruction

Major:

cyclophosphamide

cycloPHOSphamide has a major potential interaction with Urinary Tract Obstruction.

The use of cyclophosphamide is contraindicated in patients with urinary outflow obstruction. Urinary tract obstruction should be excluded or corrected before treatment because cyclophosphamide can cause urotoxicity, which may be fatal.

More resources

benzethonium chloride / lidocaine topical

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

cyclophosphamide

A total of 422 drugs are known to interact with cyclophosphamide.

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.