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Can you take Benzethonium chloride / lidocaine topical with Idelalisib?

1 drug interaction and 16 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

lidocaine topical idelalisib

Applies to: benzethonium chloride / lidocaine topical and idelalisib

Talk to your doctor before suing idelalisib together with lidocaine topical. Combining these medication may increase the blood levels and effects of lidocaine topical. This may increase the risk of side effects such as drowsiness, dizziness, trembling, numbness, slow heartbeat, or low blood pressure. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. There may be alternative medications that do not interact, or your doctor may recommend a dose adjustment or more frequent monitoring 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

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

15 potential interactions Applies to: 14 conditions, including Seizures, Diarrhea, Liver Disease, Infection, and Interstitial Lung Disease.

Bone Marrow Depression/Low Blood Counts

Moderate:

idelalisib

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

Cases of neutropenia have been reported with the use of idelalisib. It is recommended to monitor blood counts at least every 2 weeks for the first 6 months of therapy, and periodically thereafter. Care and close monitoring is recommended.

Dermatitis, Drug-Induced

Major:

idelalisib

Idelalisib has a major potential interaction with Dermatitis, Drug-Induced.

Fatal cases of severe cutaneous reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have occurred in patients treated with idelalisib. It is recommended that if SJS or TEN is suspected to interrupt therapy until the etiology of the reaction has been determined, and if SJS or TEN is confirmed to permanently discontinue treatment with idelalisib. Monitor patients for the development of severe cutaneous reactions and discontinue idelalisib if clinically appropriate.

Diarrhea

Major:

idelalisib

Idelalisib has a major potential interaction with Diarrhea.

Severe diarrhea or colitis have been reported in patients treated with idelalisib. It is recommended to avoid concurrent use of idelalisib and other drugs that cause diarrhea. Care should be taken when using this agent in patients with diarrhea or colitis.

Gastrointestinal Perforation

Moderate:

idelalisib

Idelalisib has a moderate potential interaction with Gastrointestinal Perforation.

Fatal and serious intestinal perforations have been reported in patients treated with idelalisib, some patients reporting moderate to severe diarrhea at the time of perforation. Advise patients to promptly report any new or worsening abdominal pain, chills, fever, nausea, or vomiting. Discontinue therapy with idelalisib permanently in patients who experience intestinal perforation.

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.

Infection

Moderate:

idelalisib

Idelalisib has a moderate potential interaction with Infection.

Fatal and/or serious infections, including pneumonia, sepsis, febrile neutropenia, Pneumocystis jirovecii pneumonia (PJP) or cytomegalovirus (CMV) have been reported in patients treated with idelalisib. It is recommended to monitor patients for signs and symptoms of infection and to interrupt therapy with idelalisib for Grade 3 or higher infection. Consider prophylaxis for PJP in patients at risk and interrupt therapy in patients with suspected PJP infection of any grade, and permanently discontinue treatment if PJP infection of any grade is confirmed or interrupt idelalisib in the setting of positive CMV PCR or antigen test until the infection has resolved. If therapy is subsequently resumed, patients should be monitored (by PCR or antigen test) for CMV reactivation at least monthly.

Interstitial Lung Disease

Moderate:

idelalisib

Idelalisib has a moderate potential interaction with Interstitial Lung Disease.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

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:

idelalisib

Idelalisib has a major potential interaction with Liver Disease.

Fatal and/or serious hepatotoxicity have been reported in patients treated with idelalisib. Monitor ALT and AST in all patients as clinically appropriate. Patients with baseline hepatic impairment should be monitored for signs of idelalisib toxicity and dose modification with idelalisib should be made accordingly. It is recommended to monitor weekly for liver toxicity if the ALT or AST rises above 3 times the upper limit of normal until resolved and withhold therapy with idelalisib if the ALT or AST is greater than 5 times the upper limit of normal, and continue to monitor AST, ALT and total bilirubin weekly until the normal levels are attained. Discontinue idelalisib for recurrent hepatotoxicity and to avoid concurrent use with other drugs that may cause liver toxicity.

Noninfectious Colitis

Major:

idelalisib

Idelalisib has a major potential interaction with Noninfectious Colitis.

Severe diarrhea or colitis have been reported in patients treated with idelalisib. It is recommended to avoid concurrent use of idelalisib and other drugs that cause diarrhea. Care should be taken when using this agent in patients with diarrhea or colitis.

Pulmonary Impairment

Moderate:

idelalisib

Idelalisib has a moderate potential interaction with Pulmonary Impairment.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

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

benzethonium chloride / lidocaine topical

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

idelalisib

A total of 944 drugs are known to interact with idelalisib.

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.