Drug interactions
Nitric oxide + Prilocaine
Severity: Major
Nitric oxide and Prilocaine: 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
Prilocaine is a recognized cause of methemoglobinemia, and inhaled nitric oxide adds to this effect. The combination can reduce oxygen-carrying capacity, especially in neonates.
What this interaction means in plain words
Nitric oxide and Prilocaine 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.
Nitric oxide belongs to Genitourinary; Prilocaine belongs to Central Nervous System.
Why it happens
Additive methemoglobin formation from nitric oxide and the prilocaine metabolite o-toluidine.
What to do
Avoid prilocaine where feasible during inhaled nitric oxide therapy. If used, monitor methemoglobin and oxygen saturation.
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 Nitric oxide
Other interactions of Prilocaine
- Bupivacaine implant + Prilocaine Major
- Phenazopyridine + Prilocaine Major
- Prilocaine + Propranolol Moderate
- Prilocaine + Timolol Moderate
- Hyaluronidase + Prilocaine Minor
- Nadolol + Prilocaine Minor
Frequently asked questions
Can I take Nitric oxide with Prilocaine?
MediHelp rates the interaction as major. Nitric oxide and Prilocaine 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. Prilocaine is a recognized cause of methemoglobinemia, and inhaled nitric oxide adds to this effect. The combination can reduce oxygen-carrying capacity, especially in neonates.
How serious is the interaction between Nitric oxide and Prilocaine?
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 prilocaine where feasible during inhaled nitric oxide therapy. If used, monitor methemoglobin and oxygen saturation.
What other medicines interact with Nitric oxide?
MediHelp also lists interactions of Nitric oxide with, for example, Sodium nitroprusside. The full list is on the Nitric oxide page.
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