Lidocaine/Selected Protease Inhibitors; Cobicistat Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Atazanavir, darunavir, fosamprenavir, indinavir, lopinavir-ritonavir, nelfinavir, nirmatrelvir-ritonavir, ombitasvir-paritaprevir-ritonavir, and tipranavir may slow down how quickly your liver processes lidocaine.

What might happen:

The amount of lidocaine in your blood may increase. This may increase your risk of toxic adverse effects.

What you should do about this interaction:

Make sure that your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to check the amount of lidocaine in your blood and/or change your dose of lidocaine. Let your doctor know right away if you notice an irregular heartbeat or have any dizziness or fainting episodes, ringing in the ears or tremors.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
  • 1.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company November, 2023.
  • 2.Evotaz (atazanavir and cobicistat) US prescribing information. Bristol-Myers-Squibb Company May, 2023.
  • 3.Evotaz (atazanavir and cobicistat) UK summary of product characteristics. Bristol-Myers-Squibb Company March, 2016.
  • 4.Prezista (darunavir) US prescribing information. Janssen Therapeutics March, 2023.
  • 5.Prezcobix (darunavir and cobicistat) US prescribing information. Janssen Pharmaceuticals, Inc. March, 2023.
  • 6.Prezista (darunavir) Canadian prescribing information. Jannsen-Ortho June, 2008.
  • 7.Prezcobix (darunavir-cobicistat) Canadian prescribing information. Janssen Inc. June 18, 2014.
  • 8.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline March, 2019.
  • 9.Telzir (fosamprenavir calcium) Canadian product monograph. ViiV Healthcare ULC February 11, 2014.
  • 10.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. September, 2016.
  • 11.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories December, 2019.
  • 12.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. September, 2016.
  • 13.Paxlovid (nirmatrelvir tablets and ritonavir tablets) US prescribing information. Pfizer Inc. May, 2023.
  • 14.Viekira Pak (ombitasvir, paritaprevir, and ritonavir; dasabuvir) US prescribing information. AbbVie Inc. December, 2019.
  • 15.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. June, 2020.
  • 16.Orlando R, Piccoli P, De Martin S, Padrini R, Floreani M, Palatini P. Cytochrome P450 1A2 is a major determinant of lidocaine metabolism in vivo: effects of liver function. Clin Pharmacol Ther 2004 Jan;75(1):80-8.
  • 17.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.