Drug Interaction Report

Using BUPivacaine together with atovaquone 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.

Food significantly enhances the absorption of atovaquone. You should take each dose of atovaquone at the same time each day with a meal or a milky drink. If you receive enteral nutrition (tube feeding), take atovaquone with your feeding. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Talk to your doctor if you have questions or have difficulty taking atovaquone with food.