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Identification
NameLevobupivacaine
Accession NumberDB01002  (APRD00110)
TypeSmall Molecule
GroupsApproved
DescriptionLevobupivacaine is an amino-amide local anaesthetic drug belonging to the family of n-alkylsubstituted pipecoloxylidide. It is the S-enantiomer of bupivacaine. Levobupivacaine hydrochloride is commonly marketed by AstraZeneca under the trade name Chirocaine. Compared to bupivacaine, levobupivacaine is associated with less vasodilation and has a longer duration of action. It is approximately 13 per cent less potent (by molarity) than racemic bupivacaine.Levobupivacaine is indicated for local anaesthesia including infiltration, nerve block, ophthalmic, epidural and intrathecal anaesthesia in adults; and infiltration analgesia in children. Adverse drug reactions (ADRs) are rare when it is administered correctly. Most ADRs relate to administration technique (resulting in systemic exposure) or pharmacological effects of anesthesia, however allergic reactions can rarely occur. [Wikipedia]
Structure
Thumb
Synonyms
(-)-Bupivacaine
(S)-1-Butyl-2',6'-pipecoloxylidide
(S)-Bupivacaine
L-(-)-1-Butyl-2',6'-pipecoloxylidide
L-(-)-Bupivacaine
Levobupivacaine
External Identifiers Not Available
Approved Prescription ProductsNot Available
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
ChirocaineAbbott Laboratories
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Levobupivacaine hydrochloride
Thumb
  • InChI Key: SIEYLFHKZGLBNX-NTISSMGPSA-N
  • Monoisotopic Mass: 324.196841267
  • Average Mass: 324.889
DBSALT000834
Categories
UNIIA5H73K9U3W
CAS number27262-47-1
WeightAverage: 288.4277
Monoisotopic: 288.220163528
Chemical FormulaC18H28N2O
InChI KeyInChIKey=LEBVLXFERQHONN-INIZCTEOSA-N
InChI
InChI=1S/C18H28N2O/c1-4-5-12-20-13-7-6-11-16(20)18(21)19-17-14(2)9-8-10-15(17)3/h8-10,16H,4-7,11-13H2,1-3H3,(H,19,21)/t16-/m0/s1
IUPAC Name
(2S)-1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide
SMILES
CCCCN1CCCC[[email protected]]1C(=O)NC1=C(C)C=CC=C1C
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as alpha amino acid amides. These are amide derivatives of alpha amino acids.
KingdomOrganic compounds
Super ClassOrganic acids and derivatives
ClassCarboxylic acids and derivatives
Sub ClassAmino acids, peptides, and analogues
Direct ParentAlpha amino acid amides
Alternative Parents
Substituents
  • Alpha-amino acid amide
  • N-arylamide
  • Piperidinecarboxylic acid
  • Piperidinecarboxamide
  • 2-piperidinecarboxamide
  • Benzenoid
  • Piperidine
  • Monocyclic benzene moiety
  • Tertiary aliphatic amine
  • Tertiary amine
  • Secondary carboxylic acid amide
  • Carboxamide group
  • Azacycle
  • Organoheterocyclic compound
  • Carboxylic acid amide
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Carbonyl group
  • Amine
  • Aromatic heteromonocyclic compound
Molecular FrameworkAromatic heteromonocyclic compounds
External Descriptors
  • 1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide (CHEBI:6149 )
Pharmacology
IndicationFor the production of local or regional anesthesia for surgery and obstetrics, and for post-operative pain management
PharmacodynamicsLevobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures.
Mechanism of actionLocal anesthetics such as Levobupivacaine block the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination and conduction velocity of affected nerve fibers. Specifically, the drug binds to the intracellular portion of sodium channels and blocks sodium influx into nerve cells, which prevents depolarization.
Related Articles
AbsorptionThe plasma concentration of levobupivacaine following therapeutic administration depends on dose and also on route of administration, because absorption from the site of administration is affected by the vascularity of the tissue. Peak levels in blood were reached approximately 30 minutes after epidural administration, and doses up to 150 mg resulted in mean Cmax levels of up to 1.2 µg/mL.
Volume of distribution

66.91 ±18.23 L [after intravenous administration of 40 mg in healthy volunteers]

Protein binding>97%
Metabolism

Levobupivacaine is extensively metabolized with no unchanged levobupivacaine detected in urine or feces. In vitro studies using [14 C] levobupivacaine showed that CYP3A4 isoform and CYP1A2 isoform mediate the metabolism of levobupivacaine to desbutyl levobupivacaine and 3-hydroxy levobupivacaine, respectively. In vivo, the 3-hydroxy levobupivacaine appears to undergo further transformation to glucuronide and sulfate conjugates. Metabolic inversion of levobupivacaine to R(+)-bupivacaine was not evident both in vitro and in vivo.

Route of eliminationFollowing intravenous administration, recovery of the radiolabelled dose of levobupivacaine was essentially quantitative with a mean total of about 95% being recovered in urine and feces in 48 hours. Of this 95%, about 71% was in urine while 24% was in feces.
Half life3.3 hours
Clearance

39.06 ±13.29 L/h [after intravenous administration of 40 mg in healthy volunteers]

ToxicityLD50: 5.1mg/kg in rabbit, intravenous; 18mg/kg in rabbit, oral; 207mg/kg in rabbit, parenteral; 63mg/kg in rat, subcutaneous (Archives Internationales de Pharmacodynamie et de Therapie. Vol. 200, Pg. 359, 1972.) Levobupivacaine appears to cause less myocardial depression than both bupivacaine and ropivacaine, despite being in higher concentrations.
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Levobupivacaine Action PathwayDrug actionSMP00397
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9814
Blood Brain Barrier+0.936
Caco-2 permeable+0.6669
P-glycoprotein substrateSubstrate0.8435
P-glycoprotein inhibitor IInhibitor0.8582
P-glycoprotein inhibitor IINon-inhibitor0.7836
Renal organic cation transporterNon-inhibitor0.6471
CYP450 2C9 substrateNon-substrate0.7957
CYP450 2D6 substrateSubstrate0.8346
CYP450 3A4 substrateSubstrate0.7045
CYP450 1A2 substrateInhibitor0.6863
CYP450 2C9 inhibitorNon-inhibitor0.9099
CYP450 2D6 inhibitorInhibitor0.8932
CYP450 2C19 inhibitorNon-inhibitor0.9026
CYP450 3A4 inhibitorInhibitor0.6205
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.6066
Ames testNon AMES toxic0.8462
CarcinogenicityNon-carcinogens0.8859
BiodegradationNot ready biodegradable0.9729
Rat acute toxicity2.2574 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.8283
hERG inhibition (predictor II)Inhibitor0.7851
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
Manufacturers
  • Purdue pharma lp
Packagers
Dosage formsNot Available
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5708011 No1994-10-132014-10-13Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
logP3.6Not Available
pKa8.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0977 mg/mLALOGPS
logP3.31ALOGPS
logP4.52ChemAxon
logS-3.5ALOGPS
pKa (Strongest Acidic)13.62ChemAxon
pKa (Strongest Basic)8ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area32.34 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity90.19 m3·mol-1ChemAxon
Polarizability34.45 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
References
Synthesis Reference

Hooshang Shahriari Zavareh, Graham Anthony Charles Frampton, “Process for preparing levobupivacaine and analogues thereof.” U.S. Patent US5777124, issued February, 1985.

US5777124
General References
  1. Burlacu CL, Buggy DJ: Update on local anesthetics: focus on levobupivacaine. Ther Clin Risk Manag. 2008 Apr;4(2):381-92. [PubMed:18728849 ]
  2. Leone S, Di Cianni S, Casati A, Fanelli G: Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed. 2008 Aug;79(2):92-105. [PubMed:18788503 ]
External Links
ATC CodesN01BB10
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (2.72 MB)
MSDSNot Available
Interactions
Drug Interactions
Drug
7-NitroindazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with 7-Nitroindazole.
AbirateroneThe serum concentration of Levobupivacaine can be increased when it is combined with Abiraterone.
AcepromazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Acepromazine.
AceprometazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Aceprometazine.
adipiplonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with adipiplon.
AgomelatineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Agomelatine.
AlfaxaloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alfaxalone.
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levobupivacaine.
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alphacetylmethadol.
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Levobupivacaine.
AmiodaroneThe serum concentration of Levobupivacaine can be increased when it is combined with Amiodarone.
AmisulprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amisulpride.
AmitriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amitriptyline.
AmobarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amobarbital.
AmoxapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amoxapine.
AmperozideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amperozide.
AprepitantThe serum concentration of Levobupivacaine can be increased when it is combined with Aprepitant.
AripiprazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Aripiprazole.
ArticaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Articaine.
AsenapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Asenapine.
AtazanavirThe serum concentration of Levobupivacaine can be increased when it is combined with Atazanavir.
AtomoxetineThe metabolism of Levobupivacaine can be decreased when combined with Atomoxetine.
AzaperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Azaperone.
AzelastineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Azelastine.
AzelastineThe risk or severity of adverse effects can be increased when Azelastine is combined with Levobupivacaine.
AzithromycinThe metabolism of Levobupivacaine can be decreased when combined with Azithromycin.
BaclofenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Baclofen.
BarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Barbital.
BenzocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benzocaine.
Benzyl alcoholThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benzyl alcohol.
BexaroteneThe serum concentration of Levobupivacaine can be decreased when it is combined with Bexarotene.
BoceprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Boceprevir.
BortezomibThe metabolism of Levobupivacaine can be decreased when combined with Bortezomib.
BosentanThe serum concentration of Levobupivacaine can be decreased when it is combined with Bosentan.
BrexpiprazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brexpiprazole.
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
BrimonidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brimonidine.
BromazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bromazepam.
BrompheniramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brompheniramine.
BrotizolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brotizolam.
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Levobupivacaine.
BuprenorphineThe risk or severity of adverse effects can be increased when Buprenorphine is combined with Levobupivacaine.
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Levobupivacaine.
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Levobupivacaine.
ButacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butacaine.
ButalbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butalbital.
ButambenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butamben.
ButethalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butethal.
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Levobupivacaine.
CaffeineThe metabolism of Levobupivacaine can be decreased when combined with Caffeine.
CarbamazepineThe risk or severity of adverse effects can be increased when Carbamazepine is combined with Levobupivacaine.
CarbinoxamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carbinoxamine.
CarfentanilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carfentanil.
CarisoprodolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carisoprodol.
CeritinibThe serum concentration of Levobupivacaine can be increased when it is combined with Ceritinib.
CetirizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cetirizine.
Chloral hydrateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chloral hydrate.
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Levobupivacaine.
ChlormezanoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlormezanone.
ChloroprocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chloroprocaine.
ChlorphenamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorphenamine.
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Levobupivacaine.
ChlorprothixeneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorprothixene.
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorzoxazone.
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Levobupivacaine.
CitalopramThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Citalopram.
CitalopramThe metabolism of Levobupivacaine can be decreased when combined with Citalopram.
ClarithromycinThe serum concentration of Levobupivacaine can be increased when it is combined with Clarithromycin.
ClemastineThe metabolism of Levobupivacaine can be decreased when combined with Clemastine.
ClemastineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clemastine.
ClidiniumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clidinium.
ClobazamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clobazam.
clomethiazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with clomethiazole.
ClomipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clomipramine.
ClonazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clonazepam.
ClonidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clonidine.
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Levobupivacaine.
ClotrimazoleThe metabolism of Levobupivacaine can be decreased when combined with Clotrimazole.
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Levobupivacaine.
CobicistatThe serum concentration of Levobupivacaine can be increased when it is combined with Cobicistat.
CocaineThe risk or severity of adverse effects can be increased when Cocaine is combined with Levobupivacaine.
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Levobupivacaine.
ConivaptanThe serum concentration of Levobupivacaine can be increased when it is combined with Conivaptan.
CrizotinibThe metabolism of Levobupivacaine can be decreased when combined with Crizotinib.
CyclizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cyclizine.
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Levobupivacaine.
CyclosporineThe metabolism of Levobupivacaine can be decreased when combined with Cyclosporine.
CyproheptadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cyproheptadine.
Cyproterone acetateThe serum concentration of Levobupivacaine can be decreased when it is combined with Cyproterone acetate.
DabrafenibThe serum concentration of Levobupivacaine can be decreased when it is combined with Dabrafenib.
DantroleneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dantrolene.
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Levobupivacaine.
DapoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dapoxetine.
DarunavirThe serum concentration of Levobupivacaine can be increased when it is combined with Darunavir.
DasatinibThe serum concentration of Levobupivacaine can be increased when it is combined with Dasatinib.
DeferasiroxThe serum concentration of Levobupivacaine can be decreased when it is combined with Deferasirox.
DelavirdineThe metabolism of Levobupivacaine can be decreased when combined with Delavirdine.
deramciclaneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with deramciclane.
DesfluraneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desflurane.
DesipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desipramine.
DesloratadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desloratadine.
DetomidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Detomidine.
DexamethasoneThe serum concentration of Levobupivacaine can be decreased when it is combined with Dexamethasone.
DexbrompheniramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dexbrompheniramine.
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Levobupivacaine.
DextromoramideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dextromoramide.
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Levobupivacaine.
DezocineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dezocine.
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Levobupivacaine.
DifenoxinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Difenoxin.
DihydrocodeineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dihydrocodeine.
DihydroergotamineThe metabolism of Levobupivacaine can be decreased when combined with Dihydroergotamine.
DihydroetorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dihydroetorphine.
DihydromorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dihydromorphine.
DiltiazemThe metabolism of Levobupivacaine can be decreased when combined with Diltiazem.
DimenhydrinateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dimenhydrinate.
DiphenhydramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Diphenhydramine.
DiphenoxylateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Diphenoxylate.
DoramectinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doramectin.
DoxepinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doxepin.
DoxycyclineThe metabolism of Levobupivacaine can be decreased when combined with Doxycycline.
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
DoxylamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doxylamine.
DPDPEThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with DPDPE.
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
DronedaroneThe metabolism of Levobupivacaine can be decreased when combined with Dronedarone.
DroperidolThe risk or severity of adverse effects can be increased when Droperidol is combined with Levobupivacaine.
DrotebanolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Drotebanol.
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Levobupivacaine.
EcgonineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ecgonine.
ECGONINE METHYL ESTERThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with ECGONINE METHYL ESTER.
EfavirenzThe serum concentration of Levobupivacaine can be decreased when it is combined with Efavirenz.
EfavirenzThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Efavirenz.
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Levobupivacaine.
EntacaponeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Entacapone.
EnzalutamideThe serum concentration of Levobupivacaine can be decreased when it is combined with Enzalutamide.
ErythromycinThe metabolism of Levobupivacaine can be decreased when combined with Erythromycin.
EscitalopramThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Escitalopram.
Eslicarbazepine acetateThe serum concentration of Levobupivacaine can be decreased when it is combined with Eslicarbazepine acetate.
EstazolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Estazolam.
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Levobupivacaine.
EthanolLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Ethanol.
EthanolThe risk or severity of adverse effects can be increased when Ethanol is combined with Levobupivacaine.
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Levobupivacaine.
EthosuximideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethosuximide.
EthotoinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethotoin.
Ethyl carbamateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethyl carbamate.
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethyl loflazepate.
EthylmorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethylmorphine.
EtidocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etidocaine.
EtifoxineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etifoxine.
EtizolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etizolam.
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Levobupivacaine.
EtoperidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etoperidone.
EtorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etorphine.
EtravirineThe serum concentration of Levobupivacaine can be decreased when it is combined with Etravirine.
EzogabineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ezogabine.
FelbamateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Felbamate.
FencamfamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fencamfamine.
FenfluramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fenfluramine.
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Levobupivacaine.
FexofenadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fexofenadine.
FlibanserinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flibanserin.
FluconazoleThe metabolism of Levobupivacaine can be decreased when combined with Fluconazole.
FludiazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fludiazepam.
FlunarizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flunarizine.
FlunitrazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flunitrazepam.
FluoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluoxetine.
FlupentixolThe risk or severity of adverse effects can be increased when Flupentixol is combined with Levobupivacaine.
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Levobupivacaine.
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Levobupivacaine.
FluspirileneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluspirilene.
Fluticasone PropionateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluticasone Propionate.
FluvoxamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluvoxamine.
FluvoxamineThe metabolism of Levobupivacaine can be decreased when combined with Fluvoxamine.
FosamprenavirThe metabolism of Levobupivacaine can be decreased when combined with Fosamprenavir.
FosaprepitantThe serum concentration of Levobupivacaine can be increased when it is combined with Fosaprepitant.
FosphenytoinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fosphenytoin.
FospropofolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fospropofol.
Fusidic AcidThe serum concentration of Levobupivacaine can be increased when it is combined with Fusidic Acid.
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Levobupivacaine.
gabapentin enacarbilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with gabapentin enacarbil.
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Gamma Hydroxybutyric Acid.
GlutethimideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Glutethimide.
GuanfacineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Guanfacine.
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Levobupivacaine.
HaloperidolThe risk or severity of adverse effects can be increased when Haloperidol is combined with Levobupivacaine.
HalothaneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Halothane.
HeroinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Heroin.
HexobarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Hexobarbital.
HyaluronidaseThe risk or severity of adverse effects can be increased when Hyaluronidase is combined with Levobupivacaine.
HydrocodoneThe risk or severity of adverse effects can be increased when Hydrocodone is combined with Levobupivacaine.
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Levobupivacaine.
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
HydroxyzineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Hydroxyzine.
IdelalisibThe serum concentration of Levobupivacaine can be increased when it is combined with Idelalisib.
IloperidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Iloperidone.
ImatinibThe metabolism of Levobupivacaine can be decreased when combined with Imatinib.
ImipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Imipramine.
IndalpineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Indalpine.
IndinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Indinavir.
IsavuconazoniumThe metabolism of Levobupivacaine can be decreased when combined with Isavuconazonium.
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Levobupivacaine.
IsradipineThe metabolism of Levobupivacaine can be decreased when combined with Isradipine.
ItraconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Itraconazole.
IvacaftorThe serum concentration of Levobupivacaine can be increased when it is combined with Ivacaftor.
KetamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ketamine.
KetazolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ketazolam.
KetobemidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ketobemidone.
KetoconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Ketoconazole.
LamotrigineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lamotrigine.
LevetiracetamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levetiracetam.
LevocabastineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levocabastine.
LevocetirizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levocetirizine.
LevodopaThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levodopa.
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levomethadyl Acetate.
LevomilnacipranThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levomilnacipran.
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Levobupivacaine.
LidocaineThe metabolism of Levobupivacaine can be decreased when combined with Lidocaine.
LidocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lidocaine.
LithiumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lithium.
LofentanilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lofentanil.
LopinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Lopinavir.
LoratadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Loratadine.
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Levobupivacaine.
LovastatinThe metabolism of Levobupivacaine can be decreased when combined with Lovastatin.
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Levobupivacaine.
Lu AA21004The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lu AA21004.
LuliconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Luliconazole.
LurasidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lurasidone.
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Magnesium SulfateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Magnesium Sulfate.
MaprotilineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Maprotiline.
MeclizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Meclizine.
MedetomidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Medetomidine.
MelatoninThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Melatonin.
MelperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Melperone.
MepivacaineThe risk or severity of adverse effects can be increased when Mepivacaine is combined with Levobupivacaine.
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Levobupivacaine.
MesoridazineThe risk or severity of adverse effects can be increased when Mesoridazine is combined with Levobupivacaine.
MetaxaloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Metaxalone.
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Levobupivacaine.
Methadyl AcetateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methadyl Acetate.
MethapyrileneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methapyrilene.
MethaqualoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methaqualone.
MethocarbamolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methocarbamol.
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Levobupivacaine.
MethotrimeprazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methotrimeprazine.
MethoxyfluraneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methoxyflurane.
MethsuximideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methsuximide.
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Methylphenobarbital is combined with Levobupivacaine.
MetyrosineLevobupivacaine may increase the sedative activities of Metyrosine.
MexiletineThe metabolism of Levobupivacaine can be decreased when combined with Mexiletine.
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Levobupivacaine.
MifepristoneThe metabolism of Levobupivacaine can be decreased when combined with Mifepristone.
MilnacipranThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Milnacipran.
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
MirtazapineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.
MirtazapineThe risk or severity of adverse effects can be increased when Mirtazapine is combined with Levobupivacaine.
MitotaneThe serum concentration of Levobupivacaine can be decreased when it is combined with Mitotane.
ModafinilThe serum concentration of Levobupivacaine can be decreased when it is combined with Modafinil.
MolindoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Molindone.
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Levobupivacaine.
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
NabiloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nabilone.
NafcillinThe serum concentration of Levobupivacaine can be decreased when it is combined with Nafcillin.
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levobupivacaine.
NefazodoneThe serum concentration of Levobupivacaine can be increased when it is combined with Nefazodone.
NelfinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Nelfinavir.
NetupitantThe serum concentration of Levobupivacaine can be increased when it is combined with Netupitant.
NevirapineThe metabolism of Levobupivacaine can be decreased when combined with Nevirapine.
NilotinibThe metabolism of Levobupivacaine can be decreased when combined with Nilotinib.
NitrazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitrazepam.
Nitrous oxideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitrous oxide.
NormethadoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Normethadone.
NortriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nortriptyline.
OlanzapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Olanzapine.
OlaparibThe metabolism of Levobupivacaine can be decreased when combined with Olaparib.
OlopatadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Olopatadine.
OndansetronThe risk or severity of adverse effects can be increased when Ondansetron is combined with Levobupivacaine.
OpiumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Opium.
OrphenadrineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
OrphenadrineThe risk or severity of adverse effects can be increased when Orphenadrine is combined with Levobupivacaine.
OsanetantThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Osanetant.
OsimertinibThe serum concentration of Levobupivacaine can be increased when it is combined with Osimertinib.
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Levobupivacaine.
OxprenololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Oxprenolol.
OxybuprocaineThe risk or severity of adverse effects can be increased when Oxybuprocaine is combined with Levobupivacaine.
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Levobupivacaine.
OxymorphoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Oxymorphone.
PalbociclibThe serum concentration of Levobupivacaine can be increased when it is combined with Palbociclib.
PaliperidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Paliperidone.
ParaldehydeLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
ParaldehydeThe risk or severity of adverse effects can be increased when Paraldehyde is combined with Levobupivacaine.
ParoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Paroxetine.
Peginterferon alfa-2bThe serum concentration of Levobupivacaine can be increased when it is combined with Peginterferon alfa-2b.
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Levobupivacaine.
PentobarbitalThe risk or severity of adverse effects can be increased when Pentobarbital is combined with Levobupivacaine.
PerampanelThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Perampanel.
PerospironeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Perospirone.
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Levobupivacaine.
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Levobupivacaine.
PhenobarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenobarbital.
PhenoxyethanolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenoxyethanol.
PhenytoinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenytoin.
PimozideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pimozide.
PipamperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pipamperone.
PipotiazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pipotiazine.
PizotifenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pizotifen.
PomalidomideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pomalidomide.
PosaconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Posaconazole.
PramipexoleLevobupivacaine may increase the sedative activities of Pramipexole.
PramocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pramocaine.
PrazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Prazepam.
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Levobupivacaine.
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Levobupivacaine.
PrimidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Primidone.
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Levobupivacaine.
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Levobupivacaine.
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Levobupivacaine.
PromethazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Promethazine.
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Levobupivacaine.
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Levobupivacaine.
PropoxycaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Propoxycaine.
ProtriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Protriptyline.
PSD502The risk or severity of adverse effects can be increased when Levobupivacaine is combined with PSD502.
QuazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Quazepam.
QuetiapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Quetiapine.
RamelteonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ramelteon.
RanolazineThe metabolism of Levobupivacaine can be decreased when combined with Ranolazine.
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Levobupivacaine.
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Levobupivacaine.
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Levobupivacaine.
RifabutinThe metabolism of Levobupivacaine can be increased when combined with Rifabutin.
RifampicinThe metabolism of Levobupivacaine can be increased when combined with Rifampicin.
RifapentineThe metabolism of Levobupivacaine can be increased when combined with Rifapentine.
RisperidoneThe risk or severity of adverse effects can be increased when Risperidone is combined with Levobupivacaine.
RitonavirThe serum concentration of Levobupivacaine can be increased when it is combined with Ritonavir.
RomifidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Romifidine.
RopiniroleLevobupivacaine may increase the sedative activities of Ropinirole.
RopiniroleThe metabolism of Levobupivacaine can be decreased when combined with Ropinirole.
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Levobupivacaine.
RotigotineLevobupivacaine may increase the sedative activities of Rotigotine.
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Levobupivacaine.
S-EthylisothioureaThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with S-Ethylisothiourea.
SaquinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Saquinavir.
ScopolamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Scopolamine.
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Levobupivacaine.
SertindoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sertindole.
SertralineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sertraline.
SevofluraneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sevoflurane.
SildenafilThe metabolism of Levobupivacaine can be decreased when combined with Sildenafil.
SiltuximabThe serum concentration of Levobupivacaine can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Simeprevir.
Sodium oxybateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sodium oxybate.
St. John's WortThe serum concentration of Levobupivacaine can be decreased when it is combined with St. John's Wort.
StiripentolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Stiripentol.
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Levobupivacaine.
SulfisoxazoleThe metabolism of Levobupivacaine can be decreased when combined with Sulfisoxazole.
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Levobupivacaine.
SuvorexantThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Suvorexant.
TapentadolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tapentadol.
TasimelteonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tasimelteon.
Technetium Tc-99m tilmanoceptLevobupivacaine may decrease effectiveness of Technetium Tc-99m tilmanocept as a diagnostic agent.
TelaprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Telaprevir.
TelithromycinThe serum concentration of Levobupivacaine can be increased when it is combined with Telithromycin.
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Levobupivacaine.
TenofovirThe metabolism of Levobupivacaine can be decreased when combined with Tenofovir.
TeriflunomideThe serum concentration of Levobupivacaine can be decreased when it is combined with Teriflunomide.
TetrabenazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetrabenazine.
TetracaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetracaine.
TetrodotoxinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetrodotoxin.
ThalidomideLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
ThalidomideThe risk or severity of adverse effects can be increased when Thalidomide is combined with Levobupivacaine.
TheophyllineThe metabolism of Levobupivacaine can be decreased when combined with Theophylline.
ThiamylalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Thiamylal.
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Levobupivacaine.
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Levobupivacaine.
ThiothixeneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Thiothixene.
TiagabineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tiagabine.
TiclopidineThe metabolism of Levobupivacaine can be decreased when combined with Ticlopidine.
TiletamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tiletamine.
TizanidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tizanidine.
TocilizumabThe serum concentration of Levobupivacaine can be decreased when it is combined with Tocilizumab.
TolcaponeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tolcapone.
TopiramateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Topiramate.
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Levobupivacaine.
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trans-2-Phenylcyclopropylamine.
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Levobupivacaine.
TrazodoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trazodone.
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Levobupivacaine.
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Levobupivacaine.
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Levobupivacaine.
TrimipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trimipramine.
TriprolidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Triprolidine.
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Levobupivacaine.
VemurafenibThe serum concentration of Levobupivacaine can be increased when it is combined with Vemurafenib.
VenlafaxineThe metabolism of Levobupivacaine can be decreased when combined with Venlafaxine.
VerapamilThe metabolism of Levobupivacaine can be decreased when combined with Verapamil.
VigabatrinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vigabatrin.
VilazodoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vilazodone.
VoriconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Voriconazole.
VortioxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vortioxetine.
XylazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Xylazine.
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Levobupivacaine.
ZiconotideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ziconotide.
ZimelidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zimelidine.
ZiprasidoneThe metabolism of Levobupivacaine can be decreased when combined with Ziprasidone.
ZiprasidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ziprasidone.
ZolazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zolazepam.
ZolpidemThe risk or severity of adverse effects can be increased when Zolpidem is combined with Levobupivacaine.
ZonisamideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zonisamide.
ZopicloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zopiclone.
ZotepineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zotepine.
ZuclopenthixolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zuclopenthixol.
Food InteractionsNot Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Voltage-gated sodium channel activity
Specific Function:
Tetrodotoxin-resistant channel that mediates the voltage-dependent sodium ion permeability of excitable membranes. Assuming opened or closed conformations in response to the voltage difference across the membrane, the protein forms a sodium-selective channel through which sodium ions may pass in accordance with their electrochemical gradient. Plays a role in neuropathic pain mechanisms.
Gene Name:
SCN10A
Uniprot ID:
Q9Y5Y9
Molecular Weight:
220623.605 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
  3. Ueta K, Sugimoto M, Suzuki T, Uchida I, Mashimo T: In vitro antagonism of recombinant ligand-gated ion-channel receptors by stereospecific enantiomers of bupivacaine. Reg Anesth Pain Med. 2006 Jan-Feb;31(1):19-25. [PubMed:16418020 ]
  4. Vladimirov M, Nau C, Mok WM, Strichartz G: Potency of bupivacaine stereoisomers tested in vitro and in vivo: biochemical, electrophysiological, and neurobehavioral studies. Anesthesiology. 2000 Sep;93(3):744-55. [PubMed:10969308 ]
  5. Brau ME, Branitzki P, Olschewski A, Vogel W, Hempelmann G: Block of neuronal tetrodotoxin-resistant Na+ currents by stereoisomers of piperidine local anesthetics. Anesth Analg. 2000 Dec;91(6):1499-505. [PubMed:11094008 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. Most active in catalyzing 2-hydroxylation. Caffeine is metabolized primarily by cytochrome CYP1A2 in the liver through an initial N...
Gene Name:
CYP1A2
Uniprot ID:
P05177
Molecular Weight:
58293.76 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
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Drug created on June 13, 2005 07:24 / Updated on August 17, 2016 12:23