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藥物交互作用

Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir

嚴重程度: 嚴重

Lidocaine and Ombitasvir / paritaprevir / ritonavir and dasabuvir: major interaction.

最後更新

僅供醫療專業人員參考。本頁為簡要摘要,並非醫療建議,亦不能取代官方仿單或臨床判斷。開立處方或調劑前請務必核實。

本頁的臨床內容僅提供英文版。

摘要

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.

用白話說明這項交互作用的意義

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.

證據等級: Moderate

為什麼會發生

Ritonavir and paritaprevir inhibit CYP3A4 metabolism of lidocaine.

處置方式

Avoid systemic lidocaine if possible, or reduce the dose and monitor ECG and lidocaine concentrations. Single local anaesthetic doses may be acceptable with observation.

可向藥師詢問的問題

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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  • Full clinical management advice
  • Additional notes
  • Evidence detail
  • Interaction checker for a whole prescription

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常見問題

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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