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Drug Interactions between bretylium and Sensorcaine-MPF with Epinephrine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

bretylium BUPivacaine

Applies to: bretylium and Sensorcaine-MPF with Epinephrine (bupivacaine / epinephrine)

MONITOR: Amide-type local anesthetics may have additive cardiac effects (e.g., bradycardia, chest pain, heart block, arrhythmias, ECG abnormalities, cardiac arrest) with class III antiarrhythmic agents. Although specific trials studying the interaction have not been performed, a case report suggests additive depressive effects of amiodarone and lidocaine on the sinoatrial node. A 64-year-old man with sick sinus syndrome developed severe, symptomatic sinus bradycardia and sinoatrial arrest following local anesthesia with lidocaine while he was on amiodarone therapy. No other cause was identified.

MANAGEMENT: Patients treated with class III antiarrhythmic agents (e.g., amiodarone, dofetilide, ibutilide, sotalol) should be under close surveillance during administration of amide-type local anesthetics. ECG monitoring should be considered.

References (2)
  1. Keidar S, Grenadier E, Palant A (1982) "Sinoatrial arrest due to lidocaine injection in sick sinus syndrome during amiodarone administration." Am Heart J, 104, p. 1384-5
  2. (2001) "Product Information. Naropin (ropivacaine)." Astra-Zeneca Pharmaceuticals

Drug and food interactions

Moderate

EPINEPHrine food

Applies to: Sensorcaine-MPF with Epinephrine (bupivacaine / epinephrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References (7)
  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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

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