Drug interactions
Bupivacaine liposome + Lidocaine-prilocaine
Severity: Moderate
Bupivacaine liposome and Lidocaine-prilocaine: 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
Local anesthetics can displace bupivacaine from liposomes if they come into contact, rapidly increasing free bupivacaine and the risk of toxicity. This concern applies mainly to infiltration of lidocaine at the same site, whereas topical lidocaine-prilocaine on intact skin has minimal contact.
What this interaction means in plain words
Bupivacaine liposome and Lidocaine-prilocaine 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.
Why it happens
Non-bupivacaine local anesthetics disrupt the liposomal formulation, releasing unencapsulated bupivacaine.
What to do
Do not mix or co-infiltrate other local anesthetics into the same site with liposomal bupivacaine. Wait at least 20 minutes after lidocaine administration before giving it, and monitor for local anesthetic systemic toxicity.
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 Lidocaine-prilocaine
- Lidocaine-prilocaine + Phenazopyridine Major
- Bupivacaine implant + Lidocaine-prilocaine Moderate
- Disopyramide + Lidocaine-prilocaine Moderate
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lidocaine-prilocaine Moderate
- Lidocaine-prilocaine + Mexiletine Moderate
- Lidocaine-prilocaine + Nirmatrelvir / ritonavir Moderate
Frequently asked questions
Can I take Bupivacaine liposome with Lidocaine-prilocaine?
MediHelp rates the interaction as moderate. Bupivacaine liposome and Lidocaine-prilocaine 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. Local anesthetics can displace bupivacaine from liposomes if they come into contact, rapidly increasing free bupivacaine and the risk of toxicity. This concern applies mainly to infiltration of lidocaine at the same site, whereas topical lidocaine-prilocaine on intact skin has minimal contact.
How serious is the interaction between Bupivacaine liposome and Lidocaine-prilocaine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not mix or co-infiltrate other local anesthetics into the same site with liposomal bupivacaine. Wait at least 20 minutes after lidocaine administration before giving it, and monitor for local anesthetic systemic toxicity.
What other medicines interact with Lidocaine-prilocaine?
MediHelp also lists interactions of Lidocaine-prilocaine with, for example, Phenazopyridine, Bupivacaine implant, Disopyramide. The full list is on the Lidocaine-prilocaine page.
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