Drug interactions
Lidocaine + Nadolol
Severity: Moderate
Lidocaine and Nadolol: 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
Nonselective beta blockers can reduce hepatic blood flow and lidocaine clearance, raising plasma lidocaine concentrations and the risk of toxicity. Bradycardia and hypotension may also be additive, and with epinephrine-containing local anesthetics unopposed alpha effects can cause hypertension with reflex bradycardia.
What this interaction means in plain words
Lidocaine and Nadolol 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.
Lidocaine belongs to Cardiovascular; Nadolol belongs to Cardiovascular.
Why it happens
Reduced hepatic blood flow decreases lidocaine clearance; additive negative chronotropic effects and unopposed alpha stimulation with epinephrine.
What to do
Do not stop chronic nadolol before anesthesia; use the lowest effective lidocaine dose, limit epinephrine, and monitor heart rate, blood pressure and signs of lidocaine 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
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide Major
Other interactions of Nadolol
- Acebutolol + Nadolol Major
- Adrenaline-articaine + Nadolol Major
- Albuterol + Nadolol Major
- Amifostine + Nadolol Major
- Amiodarone + Nadolol Major
- Arformoterol + Nadolol Major
Frequently asked questions
Can I take Lidocaine with Nadolol?
MediHelp rates the interaction as moderate. Lidocaine and Nadolol 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. Nonselective beta blockers can reduce hepatic blood flow and lidocaine clearance, raising plasma lidocaine concentrations and the risk of toxicity. Bradycardia and hypotension may also be additive, and with epinephrine-containing local anesthetics unopposed alpha effects can cause hypertension with reflex bradycardia.
How serious is the interaction between Lidocaine and Nadolol?
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 stop chronic nadolol before anesthesia; use the lowest effective lidocaine dose, limit epinephrine, and monitor heart rate, blood pressure and signs of lidocaine toxicity.
What other medicines interact with Lidocaine?
MediHelp also lists interactions of Lidocaine with, for example, Bupivacaine liposome, Disopyramide, Ex vivo expanded autologous human corneal epithelial cells containing stem cells. The full list is on the Lidocaine page.
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