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Drug Interactions between bupivacaine / dexamethasone / epinephrine and tretinoin

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

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Interactions between your drugs

Moderate

dexAMETHasone tretinoin

Applies to: bupivacaine / dexamethasone / epinephrine and tretinoin

MONITOR: Concomitant use of moderate CYP450 3A4 inducers with tretinoin (systemic) may decrease the plasma concentration of tretinoin, which is a CYP450 3A4 substrate. Reduced efficacy of tretinoin may occur. Studies document the interaction between endogenous retinoids and CYP450 3A4 inducers (e.g., carbamazepine, phenytoin, phenobarbital) showing decreased concentration of the retinoids and reduced efficacy. While clinical data specific to tretinoin are not available, similar effects may occur.

MANAGEMENT: The manufacturer recommends monitoring patients for reduced efficacy of tretinoin.

References (8)
  1. (2023) "Product Information. Jamp Tretinoin (tretinoin)." Jamp Pharma Corporation
  2. (2023) "Product Information. Vesanoid (tretinoin)." Neon Healthcare Ltd
  3. fex g, larsson k, andersson a, Berggren-Soderlund M (1995) "Low serum concentration of all-trans and 13-cis retinoic acids in patients treated with phenytoin, carbamazepine and valproate. Possible relation to teratogenicity" Arch Toxicol, 69, p. 572-74
  4. nau h, tzimas g, mondry m, plum c, spohr hl (1995) "Antiepileptic drugs alter endogenous retinoid concentrations: a possible mechanism of teratogenesis of anticonvulsant therapy" Life Sci, 57, p. 53-60
  5. (2024) "Product Information. Vesanoid (tretinoin)." H2-Pharma LLC
  6. (2024) "Product Information. Vesanoid (tretinoin)." Pharmaco Australia Ltd
  7. (2022) "Product Information. Vesanoid (tretinoin)." Xediton Pharmaceuticals Inc
  8. (2023) "Product Information. VESANOID (tretinoína)." CHEPLAPHARM ARZNEIMITTEL GMBH

Drug and food interactions

Moderate

EPINEPHrine food

Applies to: bupivacaine / dexamethasone / 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.

See also

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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