Drug Interactions between sulfadiazine and Zynrelef

Using sulfADIAZINE together with BUPivacaine may cause methemoglobinemia, a rare condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have diseases of the heart or lungs, certain genetic predispositions, or glucose-6-phosphate dehydrogenase deficiency. Medical supervision may be necessary when medications that can cause methemoglobinemia are used together. Signs and symptoms of methemoglobinemia may occur immediately or hours after treatment. Patients or their caregivers should seek immediate medical attention if they develop gray discoloration of the skin, abnormal blood coloration, nausea, headache, dizziness, lightheadedness, fatigue, shortness of breath, rapid or shallow breathing, a rapid heartbeat, palpitation, anxiety, or confusion. 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.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with CYP450 2C9 inhibitors may increase the plasma concentration of meloxicam, which has been shown to be primarily metabolized by this isoenzyme. In a study of healthy volunteers, voriconazole, a weak CYP450 2C9 inhibitor increased the systemic exposure of meloxicam by 47% and prolonged the average meloxicam half-life by 51%.

MANAGEMENT: The potential for an interaction should be considered during concomitant use. If coadministration is required, monitor patients for NSAID-related side effects and toxicity including gastrointestinal bleeding or perforation. Dose adjustment of meloxicam may be warranted.