Drug Interactions between bupivacaine / lidocaine / triamcinolone and Tonocard

Additional use of local anesthetics including lidocaine should generally be avoided within 96 hours following administration of BUPivacaine. Because the toxic effects of these medications are additive, using them together requires caution and constant monitoring of vital signs and state of consciousness to prevent serious and potentially life-threatening side effects such as methemoglobinemia (a condition that can deprive tissues and organs of oxygen), central nervous system reactions (e.G., convulsions, unconsciousness, coma, respiratory arrest), and cardiovascular disorders (e.G., low blood pressure, heart block, irregular heart rhythm, cardiac arrest). Patients require immediate medical attention if they develop signs and symptoms of methemoglobinemia such as pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue. 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.

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Using lidocaine together with tocainide may have additive effects. You should start tocainide six hours before stopping lidocaine infusions, then starting the next maintenance dose of tocainide six hours after the lidocaine drip has ended. Your heart rhythm and response should be monitored during this time. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. 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.

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Using BUPivacaine together with tocainide may have additive effects and can affect the rhythm of your heart. Contact your doctor if you experience chest pain, palpitations, nausea, vomiting, lightheadedness, nervousness, dizziness, or tremors. 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.

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