Aczone Topical and Prilovix Ultralite Plus

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Some of the medication in prilocaine topical is absorbed through the skin into the bloodstream and may cause interactions with other medications such as lidocaine topical. When used together, this combination may increase the risk of methemoglobinemia, a condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have anemia, diseases of the heart or lungs, blood circulation disorders, shock, sepsis, and certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M. In addition, excessive use of prilocaine topical such as application of large doses or on larger than recommended areas can increase absorption and result in high blood levels of the medication. Close medical supervision is necessary when medications that can cause methemoglobinemia are used together. Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment with prilocaine topical. Patients (or their caregivers) should seek immediate medical attention if they develop a gray discoloration of the skin, mouth, or nail bed; nausea; headache; dizziness; lightheadedness; fatigue; shortness of breath; rapid or shallow breathing; a rapid heartbeat; anxiety; and confusion. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other agents that are also associated with methemoglobinemia including other local anesthetics (e.g., benzocaine, lidocaine), antimalarials (e.g., chloroquine, primaquine, quinine, tafenoquine), nitrates and nitrites, sulfonamides, acetaminophen, aminosalicylic acid, dapsone, dimethyl sulfoxide, flutamide, metoclopramide (primarily in infants), nitrofurantoin (primarily in infants), phenazopyridine, phenobarbital, phenytoin, and rasburicase may increase the risk. Additional risk factors include very young age, anemia, cardiac/pulmonary disease, peripheral vascular disease, shock, sepsis, acidosis, and genetic predisposition (e.g., NADH cytochrome-b5 reductase deficiency; glucose-6-phosphate dehydrogenase deficiency; hemoglobin M). There have been reports of significant methemoglobinemia (20% to 30%) in infants and children following excessive applications of lidocaine-prilocaine cream. These cases involved the use of large doses, larger than recommended areas of application, or infants under the age of 3 months who did not have fully mature enzyme systems. In addition, a few cases involved the concomitant administration of methemoglobin-inducing agents, including a published case of an infant who was treated with lidocaine-prilocaine cream and sulfamethoxazole-trimethoprim. Most patients recovered spontaneously after removal of the cream. The incidence of systemic adverse reactions including methemoglobinemia following topical use is related to level of systemic absorption and can be expected to be directly proportional to the surface area and duration of exposure. In addition, systemic blood levels may be increased in smaller patients (e.g., children) and patients with impaired drug elimination.

MANAGEMENT: Concomitant use of topical lidocaine-prilocaine formulations with other methemoglobinemia-inducing agents should be avoided in infants younger than 12 months of age. Caution is advised when used in other patients. Signs and symptoms of methemoglobinemia may be delayed some hours after drug exposure. Patients or their caregivers should be advised to seek medical attention if they notice signs and symptoms of methemoglobinemia such as slate-grey cyanosis in buccal mucous membranes, lips, and nail beds; nausea; headache; dizziness; lightheadedness; lethargy; fatigue; dyspnea; tachypnea; tachycardia; anxiety; and confusion. In severe cases, patients may progress to central nervous system depression, stupor, seizures, acidosis, cardiac arrhythmias, syncope, and shock. Methemoglobinemia should be considered if central cyanosis is unresponsive to oxygen. Calculated oxygen saturation and pulse oximetry are generally not accurate in the setting of methemoglobinemia. The diagnosis can be confirmed by an elevated methemoglobin level of at least 10%. If patient does not respond to administration of oxygen, clinically significant methemoglobinemia should be treated with methylene blue 1 to 2 mg/kg by slow intravenous injection over 5 minutes.

Aczone Topical

Generic Name: dapsone topical

Brand name: Aczone

Synonyms: Aczone

What is Aczone Topical?

Prilovix Ultralite Plus

Generic Name: lidocaine / prilocaine topical

Brand name: Emla, Emla Anesthetic Disc, Livixil Pak, AgonEaze, Prizopak, LiproZonePak, Medolor Pak, Anodyne LPT

Synonyms: n.a.

What is Prilovix Ultralite Plus?