Interação entre Lidocaína + epinefrina e Propofol
Lidocaína + epinefrina e Propofol: ambas as bulas profissionais sinalizam esta combinação com a linguagem mais forte, como uma contraindicação, uma advertência em caixa preta ou uma instrução para evitá-la.
Não combine sem a orientação de um prescritor. A linguagem da bula abaixo é a mais forte que a FDA usa.
O que dizem as bulas da FDA
Da bula de Lidocaína + epinefrina (Flavalta) · em vigor desde 2026-03-31
FLAVALTA is contraindicated in patients with a known history of hypersensitivity to local anesthetics of the amide type or to any components of the injectable formulations.
Known history of hypersensitivity to lidocaine or to any local anesthetics of the amide-type or to other components of FLAVALTA ( 4 )
If coadministration of other local anesthetics with FLAVALTA 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 (5.1) ].
Careful and constant monitoring of cardiovascular and respiratory (adequacy of ventilation) vital signs and the patient’s state of consciousness should be performed after each local anesthetic injection.
Possible early warning signs of central nervous system (CNS) toxicity are restlessness, anxiety, incoherent speech, lightheadedness, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, CNS depression, or drowsiness.
Da bula de Propofol (Diprivan) · em vigor desde 2025-09-10
Pain during intravenous injection may also be reduced by prior injection of intravenous lidocaine (1 mL of a 1% solution).
There have been reports in the literature indicating that the addition of lidocaine to DIPRIVAN in quantities greater than 20 mg lidocaine/200 mg DIPRIVAN results in instability of the emulsion which is associated with increases in globule sizes over time and (in rat studies) a reduction in anesthetic potency.
Pain on injection occurred frequently in pediatric patients (45%) when a small vein of the hand was utilized without lidocaine pretreatment.
With lidocaine pretreatment or when antecubital veins were utilized, pain was minimal (incidence less than 10%) and well-tolerated.
Therefore, it is recommended that lidocaine be administered prior to DIPRIVAN administration or that it be added to DIPRIVAN immediately before administration and in quantities not exceeding 20 mg lidocaine/200 mg DIPRIVAN.
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