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Drug Interactions between lidocaine / sodium bicarbonate and treosulfan

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

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Interactions between your drugs

Moderate

sodium bicarbonate treosulfan

Applies to: lidocaine / sodium bicarbonate and treosulfan

Consumer information for this interaction is not currently available.

MONITOR: Parenteral hydration with sodium bicarbonate during treosulfan infusion has been related to an increase of skin disorders like rash and dermatitis. The mechanism of the interaction may be acceleration of the pH-dependent formation of alkylating epoxides. Also, this combination may induce bladder injury from activation of treosulfan in alkaline urine.

MANAGEMENT: Caution is advised when parenteral sodium bicarbonate is used during treosulfan infusion. Patients should be monitored for increased skin disorders such as rash and dermatitis, and for bladder injury. Some experts discourage the alkalinization of patients during treatment with treosulfan and recommend a split-dose or continuous IV infusion regimen of high-dose treosulfan to avoid risk of methanesulfonic acid induced acidosis.

Drug and food interactions

Moderate

lidocaine food

Applies to: lidocaine / sodium bicarbonate

Grapefruit juice may increase the blood levels of lidocaine, which may increase the risk of side effects such as low blood pressure, slow heart rate, irregular heart rhythm, difficulty breathing and convulsions. Cigarette smoking may reduce the blood levels of lidocaine, which may make the medication less effective. It is best to avoid smoking during lidocaine therapy. Consuming cruciferous vegetables (e.G., broccoli, brussels sprouts) may also reduce the blood levels of lidocaine. Talk to a healthcare professional if you have any questions or concerns. 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.

Moderate

lidocaine food

Applies to: lidocaine / sodium bicarbonate

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

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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