Lidocaine + 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.

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.

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.