Can you take Benzethonium chloride / lidocaine topical with Ketoconazole?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- benzethonium chloride/lidocaine topical
- ketoconazole
Drug interactions
Moderate drug interactions
Moderate:
ketoconazole lidocaine topical
Applies to: ketoconazole and benzethonium chloride / lidocaine topical
Talk to your doctor before suing ketoconazole 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
Moderate food/lifestyle interactions
Moderate:
ketoconazole Food/Lifestyle
Applies to: ketoconazole
You should avoid the use of alcohol while being treated with ketoconazole. Ketoconazole may cause liver damage and using it with alcohol or products containing alcohol may increase that risk. In addition, consumption of alcoholic beverages or products containing alcohol during treatment with ketoconazole may trigger a disulfiram-like reaction in some patients, with unpleasant symptoms such as flushing, palpitations, and nausea. Ketoconazole may be taken with or without food. You should avoid consumption of grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with ketoconazole unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of ketoconazole. This may increase the risk and/or severity of side effects and liver problems. You should seek immediate medical attention if you develop signs and symptoms of liver damage during treatment with ketoconazole, such as joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. Talk to your doctor 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.
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, Arrhythmia, Adrenal Insufficiency, Liver Disease, and Heart Block.
Achlorhydria
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Achlorhydria.
Nizoral (brand of ketoconazole) tablets require acidity for proper dissolution and absorption. Therefore, the drug may not be effective in patients with achlorhydria. Taking the medication with an acidic beverage such as orange or cranberry juice may help, but an alternative antifungal agent should be considered.
Adrenal Insufficiency
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Adrenal Insufficiency.
Ketoconazole tablets decrease adrenal corticosteroid secretion at doses of 400 mg and higher. Adrenal function should be monitored in patients with adrenal insufficiency or with borderline adrenal function and in patients with prolonged periods of stress due to major surgery, intensive care, etc.
Arrhythmia
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Arrhythmia.
Some azole antifungals have been associated with prolongation of the QT interval on the ECG. Rare cases of QT prolongation and torsade de pointes have been reported during postmarketing experience; such reports usually involved seriously ill patients with multiple confounding risk factors, such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions, such as congenital/acquired QT prolongation, cardiomyopathy (especially when heart failure is present), sinus bradycardia, and existing symptomatic arrhythmias. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.
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.
Major:
ketoconazole
Ketoconazole has a major potential interaction with Liver Disease.
Serious hepatotoxicity including cases with a fatal outcome or requiring liver transplant have been reported. Some patients had no obvious risk factors for liver disease. Liver function tests should be performed prior to initiation of therapy and regularly during treatment in patients receiving prolonged therapy with ketoconazole, particularly those with a current or past history of liver disease. Therapy should be withdrawn if persistent elevations or worsening of liver enzyme levels occur, or if the abnormalities are accompanied by symptoms of possible liver injury. Since ketoconazole is primarily metabolized by the liver, empirically reducing the dosage may also be appropriate in patients with existing liver disease. The use of oral ketoconazole tablets is contraindicated in patients with acute or chronic liver disease.
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.
- Benzethonium chloride / lidocaine topical is in the drug class miscellaneous topical agents.
ketoconazole
A total of 900 drugs are known to interact with ketoconazole.
- Ketoconazole is in the drug class azole antifungals.
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Ketoconazole is used to treat the following conditions:
- Blastomycosis
- Chromomycosis
- Chronic Mucocutaneous Candidiasis (off-label)
- Coccidioidomycosis
- Dermatophytosis (off-label)
- Esophageal Candidiasis (off-label)
- Histoplasmosis
- Onychomycosis, Fingernail (off-label)
- Onychomycosis, Toenail (off-label)
- Oral Thrush (off-label)
- Paracoccidioidomycosis
- Tinea Corporis (off-label)
- Tinea Versicolor (off-label)
- Vaginal Yeast Infection (off-label)
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.