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Xylocaine MPF and Zorbtive

Determining the interaction of Xylocaine MPF and Zorbtive and the possibility of their joint administration.

Check result:
Xylocaine MPF <> Zorbtive
Relevance: 27.05.2022 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:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Coadministration with inducers of CYP450 1A2 and/or 3A4 may decrease the plasma concentrations of lidocaine, which is primarily metabolized by these isoenzymes. In four healthy volunteers (2 smokers and 2 nonsmokers), administration of a single 400 mg oral dose of lidocaine following pretreatment with the CYP450 inducer phenobarbital (15 mg/day for 4 weeks, followed by 30 mg/day for 4 weeks) decreased lidocaine systemic exposure (AUC) by 37% and increased its oral clearance by 56% compared to administration of lidocaine alone. In another study, the mean bioavailability of a single 750 mg oral dose of lidocaine in six patients receiving chronic antiepileptic drug therapy (consisting of one or more of the following enzyme-inducing anticonvulsants: phenobarbital, primidone, phenytoin, carbamazepine) was approximately 2.5-fold lower than that reported for six healthy control subjects, while intrinsic clearance was nearly threefold higher. By contrast, the interaction was modest for lidocaine administered intravenously, suggesting induction of primarily hepatic first-pass rather than systemic metabolism of lidocaine. When a single 100 mg dose of lidocaine was given intravenously, mean lidocaine AUC was reduced by less than 10% and serum clearance increased by just 17% in the epileptic patients compared to controls. These changes were not statistically significant. Likewise, mean lidocaine AUC decreased by approximately 11% and plasma clearance increased by 15% when a single 50 mg intravenous dose of lidocaine was administered following pretreatment with the potent CYP450 inducer rifampin (600 mg/day for six days) in ten healthy, nonsmoking male volunteers. Another study found that cigarette smoke, an inducer of CYP450 1A2, reduced the bioavailability of lidocaine when administered orally, but had only minor effects on lidocaine administered intravenously. Lidocaine AUC following oral administration was almost 70% lower in the smoking subjects (n=4) compared to the nonsmoking subjects (n=5). Because lidocaine is not available commercially for oral administration, the interaction may be of limited clinical relevance.

References
  • Heinonen J, Takki S, Jarho L "Plasma lidocaine levels in patients treated with potential inducers of microsomal enzymes." Acta Anaesthesiol Scand 14 (1970): 89-95
  • Perucca E, Richens A "Reduction of oral bioavailability of lignocaine by induction of first pass metabolism in epileptic patients." Br J Clin Pharmacol 8 (1979): 21-31
  • Perucca E, Ruprah M, Richens A, Park BK, Betteridge DJ, Hedges AM "Effect of low-dose phenobarbitone on five indirect indices of hepatic microsomal enzyme induction and plasma lipoproteins in normal subjects." Br J Clin Pharmacol 12 (1981): 592-6
  • Reichel C, Skodra T, Nacke A, Spengler U, Sauerbruch T "The lignocaine metabolite (MEGX) liver function test and P-450 induction in humans." Br J Clin Pharmacol 46 (1998): 535-9
Xylocaine MPF

Generic Name: epinephrine / lidocaine

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

Synonyms: Lidocaine and Epinephrine

Zorbtive

Generic Name: somatropin

Brand name: Genotropin, Genotropin Miniquick, Humatrope, Norditropin FlexPro Pen, Norditropin Nordiflex Pen, Nutropin AQ NuSpin 10, Nutropin AQ Pen 10 Cartridge, Omnitrope, Saizen, Serostim, Tev-Tropin, Zomacton, Zorbtive, Nutropin, Norditropin, Nutropin AQ, Nutropin Depot, Norditropin Cartridge, Saizen Click-Easy, Omnitrope Pen 5 Cartridge, HumatroPen, Omnitrope Pen 10 Cartridge, Nutropin AQ Pen 20 Cartridge, Nutropin AQ NuSpin 5, Nutropin AQ NuSpin 20, Saizen Kit

Synonyms: n.a.

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.

Interaction with food and lifestyle
Disease interaction