Drug General Information (ID: DDI9LGC1MB)
Drug Name			Esmolol		Drug Info		Lidocaine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Anesthetics
Structure

Mechanism of Esmolol-Lidocaine Interaction (Severity Level: Moderate)
Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Esmolol				Lidocaine
Mechanism 1		Decrease in hepatic metabolism of lidocaine due to reduced hepatic blood flow				Lidocaine
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased metabolism of Lidocaine caused by Esmolol
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Esmolol				Lidocaine
Mechanism 2		Bradycardia				Bradycardia
Key Mechanism Factor 2
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Esmolol and Lidocaine

Recommended Action
Management		Patients receiving concurrent therapy should be monitored for drowsiness, mental status changes, bradycardia, and hypotension. Lidocaine levels should be obtained when clinically necessary. If toxicity is suspected, the lidocaine infusion should be decreased, as possible.

References
1	Svendsen TL, Tango M, Waldorff S, et al "Effects of propranolol and pindolol on plasma lignocaine clearance in man." Br J Clin Pharmacol 13 (1982): s223-6
2	Ochs HR, Carstens G, Greenblatt DJ "Reduction in lidocaine clearance during continuous infusion and by coadministration of propranolol." N Engl J Med 303 (1980): 373-7
3	Conrad KA, Byers JM, Finley PR, Burnham L "Lidocaine elimination: effects of metoprolol and of propranolol." Clin Pharmacol Ther 33 (1983): 133-8