Drug Interactions with Lidocaine

 

The following is a (partial) list of drug that are known to interact with lidocaine and to increase the risk of an adverse reaction. Most of these drugs interfere with lidocaine metabolism by inhibiting the liver enzyme Cytochrome-P450 3A4 (CYP3A4) and thereby slowing the rate at which lidocaine is eliminated from the body. Other drugs, such as phenytoin (Dilantin) may interact without interfering with lidocaine metabolism. Other drugs will be added to this list as they are identified. (This list was most recently up-dated September 2002).

It is recommended that either 1) these drugs be discontinued one to two weeks prior to tumescent liposuction, or 2) the total dosage of lidocaine be limited to approximately 35 mg/kg.
 

Anesthetics
propofol (Diprovan)

Anti-Arrhythmia Drug
amiodarmone (Cordarone)

Antibiotics
ciprofloxacin (Cipro)
clarithromycin (Biaxin)
erythromycin

Anti-Depressants
amitriptyline (Elavil)
clomipramine (Anafranil)
flouxetine (Prozac)
fluvoxamine (Luvox)
nefazodone (Serzone)
paroxetine (Paxil)
sertraline (Zoloft)

Anti-HisaminesH2 Blockers
cimetidine (Tagamet)

Anti-Fungal Medications
fluconazole (Diflucan)
itraconazole (Sporanox)
ketoconazole (Nizoral)
miconazole (Monistat)
Anti-Neoplastics
tamoxifen (Nolvadex)

Anti-seizure medications
carbamazepine
divalproex (Depakote)
phenytoin (Dilantin)*
valproic acid (Depakene

Benzodiazepines
alprazolam – (Xanax)
diazepam- (Valium)
flurazepam (Dalmane)
midazolam (Versed)
triazolam (Halcion)

Beta Blockers
propranolol (Inderol)

Calcium Channel Blockers
amiodarone (Cordarone)
diltiazam (Cardiazam)
felodipine (Plendil)
nicardipine (Cardene)
nifedipine (Procardia)
verapamil (Calan)

Cholesterol-Lowering Drugs
cervivastatin (Baycol)
atorvastatin (Lipitor)
lovastatin (Mevacor)
simvastatin (Zocar)

Immunosuppresants
cyclosporine
Protease inhibitors/Antivirals
diethyldithiocarbamate
indinavir
nevirapine (Viramune)
nelfinavir (Viracept)
ritonavir (Norvir)
saquinavir (Invirase)

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