Drug interactions
Bupivacaine + Dofetilide
Severity: Moderate
Bupivacaine and Dofetilide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bupivacaine is cardiotoxic when systemic levels are high, causing conduction block and arrhythmias. Dofetilide prolongs repolarization and carries a risk of torsades de pointes, so the combination may add to arrhythmic risk.
What this interaction means in plain words
Bupivacaine and Dofetilide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bupivacaine belongs to Central Nervous System; Dofetilide belongs to Cardiovascular.
Why it happens
Additive cardiac electrophysiologic effects: sodium channel blockade by bupivacaine and IKr blockade by dofetilide.
What to do
Use the lowest effective bupivacaine dose with careful avoidance of intravascular injection. Monitor ECG and keep potassium and magnesium within normal range.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Bupivacaine
- Bupivacaine + Bupivacaine implant Major
- Amlodipine-benazepril + Bupivacaine Moderate
- Benazepril + Bupivacaine Moderate
- Bupivacaine + Bupivacaine liposome Moderate
- Bupivacaine + Captopril Moderate
- Bupivacaine + Iloprost Moderate
Other interactions of Dofetilide
- Amiodarone + Dofetilide Contraindicated
- Amisulpride + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
Frequently asked questions
Can I take Bupivacaine with Dofetilide?
MediHelp rates the interaction as moderate. Bupivacaine and Dofetilide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bupivacaine is cardiotoxic when systemic levels are high, causing conduction block and arrhythmias. Dofetilide prolongs repolarization and carries a risk of torsades de pointes, so the combination may add to arrhythmic risk.
How serious is the interaction between Bupivacaine and Dofetilide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective bupivacaine dose with careful avoidance of intravascular injection. Monitor ECG and keep potassium and magnesium within normal range.
What other medicines interact with Bupivacaine?
MediHelp also lists interactions of Bupivacaine with, for example, Bupivacaine implant, Amlodipine-benazepril, Benazepril. The full list is on the Bupivacaine page.
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