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Drug Interactions between DermacinRx Lidotral and nebivolol

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

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Interactions between your drugs

Moderate

lidocaine topical nebivolol

Applies to: DermacinRx Lidotral (lidocaine topical) and nebivolol

MONITOR: Some beta-blockers may increase lidocaine levels and risk of toxicity. This interaction may also apply to topical formulations of lidocaine. The proposed mechanism is inhibition of CYP450 metabolism and/or decreased cardiac output and hepatic blood flow resulting in decreased hepatic metabolism of lidocaine. In addition, beta-blockers and lidocaine may also have additive negative inotropic effects on the heart. Data have been conflicting and variable. The degree of systemic absorption of topical lidocaine may be dependent on the duration of application and the applied surface area.

MANAGEMENT: Patients receiving concurrent therapy should be monitored for drowsiness, mental status changes, bradycardia, and hypotension. Lidocaine levels should be obtained when clinically necessary. If toxicity is suspected, the lidocaine infusion should be decreased, as possible or the topical formulation of lidocaine should be discontinued.

References (13)
  1. Miners JO, Wing MH, Lillywhite KJ, Smith KJ (1984) "Failure of "therapeutic" doses of beta-adrenoceptor antagonists to alter the disposition of tolbutamide and lignocaine." Br J Clin Pharmacol, 18, p. 853-60
  2. Ochs HR, Carstens G, Greenblatt DJ (1980) "Reduction in lidocaine clearance during continuous infusion and by coadministration of propranolol." N Engl J Med, 303, p. 373-7
  3. Schneck DW, Luderer JR, Davis D, Vary J (1984) "Effects of nadolol and propranolol on plasma lidocaine clearance." Clin Pharmacol Ther, 36, p. 584-7
  4. Svendsen TL, Tango M, Waldorff S, et al. (1982) "Effects of propranolol and pindolol on plasma lignocaine clearance in man." Br J Clin Pharmacol, 13, s223-6
  5. Conrad KA, Byers JM, Finley PR, Burnham L (1983) "Lidocaine elimination: effects of metoprolol and of propranolol." Clin Pharmacol Ther, 33, p. 133-8
  6. Jordo L, Johnsson G, Lundborg P, Regardh CG (1984) "Pharmacokinetics of lidocaine in healthy individuals pretreated with multiple doses of metoprolol." Int J Clin Pharmacol Ther Toxicol, 22, p. 312-5
  7. Graham CF, Turner WM, Jones JK (1981) "Lidocaine-propranolol interactions ." N Engl J Med, 304, p. 1301
  8. Ochs HR, Skanderra D, Abernethy DR, Greenblatt DJ (1983) "Effect of penbutolol on lidocaine kinetics." Arzneimittelforschung, 33, p. 1680-1
  9. Bax ND, Tucker GT, Lennard MS, Woods HF (1985) "The impairment of lignocaine clearance by propranolol: major contribution from enzyme inhibition." Br J Clin Pharmacol, 19, p. 597-603
  10. Parker G, Ene MD, Daneshmend TK, Roberts CJ (1984) "Do beta blockers differ in their effects on hepatic microsomal enzymes and liver blood flow?" J Clin Pharmacol, 24, p. 493-9
  11. (2023) "Product Information. LMX 4 (lidocaine topical)." Ferndale Pharmaceuticals Ltd
  12. (2021) "Product Information. Versatis (lidocaine topical)." Seqirus Pty Ltd
  13. (2024) "Product Information. Xylocaine Topical (lidocaine topical)." Aspen Pharmacare Australia Pty Ltd

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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

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

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