Drug interactions
Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Lidocaine and Ombitasvir / paritaprevir / ritonavir and dasabuvir: major 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
Ritonavir is a strong CYP3A4 inhibitor, and paritaprevir adds to this effect, which reduces lidocaine clearance. Systemic lidocaine concentrations can rise, causing CNS toxicity and arrhythmia. The label advises caution with antiarrhythmics given with this regimen.
What this interaction means in plain words
Lidocaine and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Ritonavir and paritaprevir inhibit CYP3A4 metabolism of lidocaine.
What to do
Avoid systemic lidocaine if possible, or reduce the dose and monitor ECG and lidocaine concentrations. Single local anaesthetic doses may be acceptable with observation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Lidocaine
Frequently asked questions
Can I take Lidocaine with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Lidocaine and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ritonavir is a strong CYP3A4 inhibitor, and paritaprevir adds to this effect, which reduces lidocaine clearance. Systemic lidocaine concentrations can rise, causing CNS toxicity and arrhythmia. The label advises caution with antiarrhythmics given with this regimen.
How serious is the interaction between Lidocaine and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid systemic lidocaine if possible, or reduce the dose and monitor ECG and lidocaine concentrations. Single local anaesthetic doses may be acceptable with observation.
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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