Can you take Benzocaine / menthol topical with Hydroxyurea?
1 drug interaction and 9 additional warnings found for the following 2 drugs:
- benzocaine/menthol topical
- hydroxyurea
Drug interactions
Moderate drug interactions
Moderate:
benzocaine topical hydroxyurea
Applies to: benzocaine / menthol topical and hydroxyurea
Some of the medication in benzocaine topical may be absorbed into the bloodstream following local application. When present in sufficient concentrations in the blood, local anesthetics such as benzocaine 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 hydroxyurea.
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
- 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.
What to do: 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
- 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
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
9 potential interactions Applies to: 9 conditions, including Seizures, Fever, Psychosis, Liver Disease, and Bleeding Disorder.
Bleeding Disorder
Major:
hydroxyurea
Hydroxyurea has a major potential interaction with Bleeding Disorder.
The use of hydroxyurea is contraindicated in patients with marked myelosuppression. Hydroxyurea induces myelosuppression, primarily leukopenia. Thrombocytopenia and anemia occur less frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Hydroxyurea should not be administered if the white blood cell count falls below 2500/mm3 and/or the platelet count falls below 100,000/mm3, or in the presence of severe anemia.
Bone Marrow Depression/Low Blood Counts
Major:
hydroxyurea
Hydroxyurea has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
The use of hydroxyurea is contraindicated in patients with marked myelosuppression. Hydroxyurea induces myelosuppression, primarily leukopenia. Thrombocytopenia and anemia occur less frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Hydroxyurea should not be administered if the white blood cell count falls below 2500/mm3 and/or the platelet count falls below 100,000/mm3, or in the presence of severe anemia.
Fever
Major:
hydroxyurea
Hydroxyurea has a major potential interaction with Fever.
The use of hydroxyurea is contraindicated in patients with marked myelosuppression. Hydroxyurea induces myelosuppression, primarily leukopenia. Thrombocytopenia and anemia occur less frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Hydroxyurea should not be administered if the white blood cell count falls below 2500/mm3 and/or the platelet count falls below 100,000/mm3, or in the presence of severe anemia.
G-6-PD Deficiency
Moderate:
benzocaine / menthol topical
The benzocaine topical in benzocaine / menthol topical has a moderate potential interaction with G-6-PD Deficiency.
Rarely, benzocaine has induced methemoglobinemia resulting in respiratory distress and cyanosis. Therapy with benzocaine should be administered cautiously to patients with or predisposed to methemoglobinemia. If life-threatening or severe methemoglobinemia develops, methylene blue infused at a dosage of 1 to 2 mg/kg body weight will rapidly reverse or improve the condition except in G-6-PD-deficient patients.
Liver Disease
Moderate:
hydroxyurea
Hydroxyurea has a moderate potential interaction with Liver Disease.
There are no data supporting specific guidance for hydroxyurea dosage adjustment in patients with hepatic impairment. Caution and close monitoring is advised in these patients.
Methemoglobinemia
Moderate:
benzocaine / menthol topical
The benzocaine topical in benzocaine / menthol topical has a moderate potential interaction with Methemoglobinemia.
Rarely, benzocaine has induced methemoglobinemia resulting in respiratory distress and cyanosis. Therapy with benzocaine should be administered cautiously to patients with or predisposed to methemoglobinemia. If life-threatening or severe methemoglobinemia develops, methylene blue infused at a dosage of 1 to 2 mg/kg body weight will rapidly reverse or improve the condition except in G-6-PD-deficient patients.
Psychosis
Minor:
hydroxyurea
Hydroxyurea has a minor potential interaction with Psychosis.
Neurological symptoms such as disorientation or hallucinations have been reported very rarely during hydroxyurea therapy. Therapy with hydroxyurea should be administered cautiously to patients with or predisposed to neurological disorders.
Renal Dysfunction
Major:
hydroxyurea
Hydroxyurea has a major potential interaction with Renal Dysfunction.
Hydroxyurea is primarily eliminated by the kidney. Approximately 80% of urea is excreted in the urine as unchanged drug or urea. Patients with marked renal impairment (CrCl < 60 mL/min or ESRD) may be at increased risk of toxicity associated with administration of hydroxyurea. Therapy with hydroxyurea should be administered cautiously to patients with compromised renal function.
Seizures
Moderate:
hydroxyurea
Hydroxyurea has a moderate potential interaction with Seizures.
Seizures have been noted very rarely during hydroxyurea therapy. Therapy with hydroxyurea should be administered cautiously in patients with seizure disorders.
Report options
More resources
benzocaine / menthol topical
A total of 411 drugs are known to interact with benzocaine / menthol topical.
- Benzocaine / menthol topical is in the drug class mouth and throat products.
- Benzocaine / menthol topical is used to treat the following conditions:
hydroxyurea
A total of 296 drugs are known to interact with hydroxyurea.
- Hydroxyurea is in the drug class antimetabolites.
-
Hydroxyurea is used to treat the following conditions:
- Cervical Cancer (off-label)
- Chronic Myelogenous Leukemia
- Glioblastoma Multiforme (off-label)
- Head and Neck Cancer
- Plaque Psoriasis (off-label)
- Polycythemia Vera (off-label)
- Psoriasis (off-label)
- Psoriatic Arthritis (off-label)
- Sickle Cell Anemia
- Solid Tumors (off-label)
- Thalassemia (off-label)
- Thrombocythemia (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.