Drug General Information (ID: DDITP3BJDH)
Drug Name			Procaine		Drug Info		Sulfamethoxazole		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anesthetics				Antiinfective Agents
Structure

Mechanism of Procaine-Sulfamethoxazole Interaction (Severity Level: Moderate)
Increased risk of methemoglobinemia Click to Show/Hide Mechanism Graph
Drug Name		Procaine				Sulfamethoxazole
Mechanism 1		Methemoglobinemia				Methemoglobinemia
Key Mechanism Factor 1
		Factor Name		Methemoglobinemia
		Factor Description		Methemoglobinemia is a condition in which higher than normal levels of methemoglobin are found in the blood. Methemoglobinemia is a potentially life-threatening condition in which the oxygen-carrying capacity of circulating hemoglobin is reduced due to the conversion of some or all of the four iron species from the reduced ferrous (Fe2+) state to the oxidized iron (Fe3+) state.
Mechanism Description		Increased risk of methemoglobinemia by the combination of Procaine and Sulfamethoxazole
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Procaine				Sulfamethoxazole
Mechanism 2		Inhibit the action of sulfonamides				Sulfonamides
Key Mechanism Factor 2
		Factor Name		Pharmacodynamics
		Factor Description		Reduced pharmacological effects leading to insufficient efficacy and/or treatment failure.
Mechanism Description		Attenuated pharmacological effects of  Procaine when combined with Sulfamethoxazole

Recommended Action
Management		The administration ester-type anesthetics to patients who are on sulfonamides should generally be avoided. Amide-type anesthetics are not expected to interact and may be considered as alternatives (e.g., bupivacaine, levobupivacaine, lidocaine, mepivacaine).

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".