Can you take Benzethonium chloride / lidocaine topical with Nitric oxide?
1 drug interaction and 8 additional warnings found for the following 2 drugs:
- benzethonium chloride/lidocaine topical
- nitric oxide
Drug interactions
Moderate drug interactions
Moderate:
lidocaine topical nitric oxide
Applies to: benzethonium chloride / lidocaine topical and nitric oxide
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 nitric oxide. 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
7 potential interactions Applies to: 7 conditions, including Heart Failure, Seizures, Liver Disease, Heart Block, and Shock.
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 Failure
Moderate:
nitric oxide
Nitric oxide has a moderate potential interaction with Heart Failure.
Patients with left ventricular dysfunction treated with nitric oxide may experience pulmonary edema, increased pulmonary capillary wedge pressure, worsening of left ventricular dysfunction, systemic hypotension, bradycardia and cardiac arrest. Patients should be monitored and therapy should be discontinued if symptoms arise and symptomatic care should be provided.
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.
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.
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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.
nitric oxide
A total of 34 drugs are known to interact with nitric oxide.
- Nitric oxide is in the drug class miscellaneous respiratory agents.
- Nitric oxide is used to treat Respiratory Failure.
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.