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Author: Admin | 2025-04-28
(off-label use): Various regimens of alkalinized lidocaine (with or without heparin) have been instilled into the bladderThe On-Q® infusion pump is used to slowly administer local anesthetics (eg, bupivacaine, lidocaine, ropivacaine) to or around surgical wound sites and/or in close proximity to nerves for pre- or postoperative regional anesthesia. When infused directly into the shoulder, destruction of articular cartilage (chondrolysis) has occurred. On-Q® pumps should never be placed directly into any joint. Dietary ConsiderationsPremixed injection may contain corn-derived dextrose and its use is contraindicated in patients with allergy to corn-related products. StorageInjection: Store at controlled room temperature. For products with an overwrap, do not remove overwrap until ready for use. Drug InteractionsAmiodarone: May increase the serum concentration of Lidocaine (Systemic). Monitor therapyAprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapyBeta-Blockers: May increase the serum concentration of Lidocaine (Systemic). Monitor therapyBosentan: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapyBroccoli: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapyBupivacaine (Liposomal): Lidocaine (Systemic) may enhance the adverse/toxic effect of Bupivacaine (Liposomal). Management: Liposomal bupivacaine should not be administered with topical lidocaine. Liposomal bupivacaine may be administered 20 minutes or more after the administration of lidocaine. Consider therapy modificationCannabis: May decrease the serum concentration of CYP1A2 Substrates (High risk with Inducers). Monitor therapyClofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapyConivaptan: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Avoid combinationCYP1A2 Inducers (Moderate): May decrease the serum concentration of Lidocaine (Systemic). Monitor therapyCYP1A2 Inhibitors (Strong): May increase the serum concentration of Lidocaine (Systemic). Monitor therapyCYP3A4 Inducers (Moderate): May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapyCYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Consider therapy modificationCYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapyCYP3A4 Inhibitors (Strong): May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors). Consider therapy modificationDabrafenib: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects). Consider therapy
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