7 DRUG INTERACTIONS
7.1 Local Anesthetics
The toxic effects of local anesthetics are additive. If coadministration of other local anesthetics with BUPIVACAINE SPINAL cannot be avoided, monitor patients for neurologic and cardiovascular effects related to local anesthetic systemic toxicity [see Dosage and Administration (2.1), Warnings and Precautions (5.3)].
7.2 Drugs Associated with Methemoglobinemia
Patients who are administered BUPIVACAINE SPINAL are at increased risk of developing methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics [see Warnings and Precautions (5.5)].
Examples of Drugs Associated with Methemoglobinemia:
nitric oxide, nitroglycerin, nitroprusside, nitrous oxide
articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine
cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase
dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides
phenobarbital, phenytoin, sodium valproate
acetaminophen, metoclopramide, quinine, sulfasalazine