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Amiodarone Intravenous, Oral and Lidocaine and Epinephrine

Determining the interaction of Amiodarone Intravenous, Oral and Lidocaine and Epinephrine and the possibility of their joint administration.

Check result:

Amiodarone Intravenous, Oral <> Lidocaine and Epinephrine

Relevance: 22.10.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using amiodarone together with lidocaine can alter the effects of both medications. Contact your doctor if you experience irregular heartbeat, chest tightness, wheezing, nausea, vomiting, and blurred vision. You may need a dose adjustment or special test to safely use both medications. 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.

Professional:

MONITOR: Limited data suggest additive depressive effects of amiodarone and lidocaine on the sinoatrial node. A 64-year-old man with sick sinus syndrome developed severe, symptomatic sinus bradycardia and sinoatrial arrest following local anesthesia with lidocaine while he was on amiodarone therapy. No other cause was identified. A case of lidocaine toxicity has also been reported during coadministration with amiodarone. The patient was receiving lidocaine infusion for the treatment of monomorphic ventricular tachycardia and developed a seizure 2 days after oral amiodarone was added. Toxic lidocaine levels and reduced lidocaine clearance were documented. The proposed mechanism is amiodarone inhibition of lidocaine metabolism via CYP450 3A4, although pharmacokinetic studies have found modest (approximately 20% decrease in clearance) to no effect of amiodarone on lidocaine metabolism.

MANAGEMENT: Patients should be under close surveillance during coadministration of amiodarone and lidocaine. Central nervous system and cardiovascular status should be monitored.

References

Nattel S, Talajic M, Beaudoin D, Matthews C, Roy D "Absence of pharmacokinetic interaction between amiodarone and lidocaine." Am J Cardiol 73 (1994): 92-4
Siegmund JB, Wilson JH, Imhoff TE "Amiodarone interaction with lidocaine." J Cardiovasc Pharmacol 21 (1993): 513-5
Keidar S, Grenadier E, Palant A "Sinoatrial arrest due to lidocaine injection in sick sinus syndrome during amiodarone administration." Am Heart J 104 (1982): 1384-5
Ha HR, Candinas R, Stieger B, Meyer UA, Follath F "Interaction between amiodarone and lidocaine." J Cardiovasc Pharmacol 28 (1996): 533-9

Amiodarone Intravenous, Oral

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: Amiodarone

What is Amiodarone Intravenous, Oral?

Lidocaine and Epinephrine

Generic Name: epinephrine / lidocaine

Brand name: D-Care 100X, Lignospan Forte, Lignospan Standard, Xylocaine MPF With Epinephrine, Xylocaine With Epinephrine

Synonyms: n.a.

What is Lidocaine and Epinephrine?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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