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IdentificationPharmacologyInteractionsReferencesTrialsEconomicsPropertiesSpectraTaxonomyRopivacaine
Identification
- Name
- Ropivacaine
- Accession Number
- DB00296 (APRD00492)
- Type
- Small Molecule
- Groups
- Approved
- Description
Ropivacaine is a local anaesthetic drug belonging to the amino amide group. The name ropivacaine refers to both the racemate and the marketed S-enantiomer. Ropivacaine hydrochloride is commonly marketed by AstraZeneca under the trade name Naropin.
- Structure
Structure for DB00296 (Ropivacaine)
- Synonyms
- (S)-(−)-1-propyl-2',6'-pipecoloxylidide
- (S)-ropivacaine
- L-N-n-propylpipecolic acid-2,6-xylidide
- Ropivacaina
- Ropivacaine
- Ropivacainum
- Product Ingredients
Ingredient UNII CAS InChI Key Ropivacaine hydrochloride V910P86109 132112-35-7 VSHFRHVKMYGBJL-CKUXDGONSA-N Ropivacaine hydrochloride monohydrate Not Available Not Available Not applicable - Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Naropin Injection, solution 5 mg/mL Epidural; Infiltration; Perineural Fresenius Kabi 2009-08-04 Not applicable US 
Naropin Injection, solution 2 mg/mL Epidural; Infiltration Fresenius Kabi 2009-08-04 Not applicable US Naropin Solution 2 mg Epidural; Infiltration Aspen Pharmacare Canada Inc. 1997-04-30 Not applicable Canada 
Naropin Injection, solution 2 mg/mL Epidural; Infiltration Fresenius Kabi Norge As 2011-05-31 Not applicable US Naropin Solution 10 mg Epidural Aspen Pharmacare Canada Inc. 1997-04-30 Not applicable Canada Naropin Injection, solution 10 mg/mL Epidural Fresenius Kabi 2009-08-04 Not applicable US Naropin Injection, solution 10 mg/mL Epidural Fresenius Kabi Norge As 2011-05-31 Not applicable US Naropin Injection, solution 2 mg/mL Epidural; Infiltration Fresenius Kabi Norge As 2011-05-31 Not applicable US Naropin Injection, solution 5 mg/mL Epidural; Infiltration; Perineural General Injectables & Vaccines 2014-03-11 Not applicable US Naropin Injection, solution 7.5 mg/mL Epidural; Perineural Fresenius Kabi 2011-05-31 Not applicable US - Generic Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Ropivacaine Hydrochloride Injection, solution 7.5 mg/mL Epidural; Perineural Hospira, Inc. 2014-09-23 Not applicable US Ropivacaine Hydrochloride Injection, solution 5 mg/mL Epidural; Infiltration; Perineural Sagent Pharmaceuticals 2014-09-23 Not applicable US Ropivacaine Hydrochloride Injection, solution 7.5 mg/mL Epidural; Perineural Auro Medics Pharma Llc 2016-09-15 Not applicable US Ropivacaine Hydrochloride Injection, solution 2 mg/mL Epidural; Infiltration; Perineural Auro Medics Pharma Llc 2016-09-15 Not applicable US Ropivacaine Hydrochloride Injection, solution 2 mg/mL Epidural; Infiltration; Perineural Akorn 2018-03-16 Not applicable US Ropivacaine Hydrochloride Injection, solution 10 mg/mL Epidural Auro Medics Pharma Llc 2016-09-15 Not applicable US Ropivacaine Hydrochloride Injection, solution 5 mg/mL Parenteral Sandoz 2014-07-24 Not applicable US Ropivacaine Hydrochloride Injection, solution 7.5 mg/mL Epidural; Perineural Sagent Pharmaceuticals 2014-09-23 Not applicable US Ropivacaine Hydrochloride Injection, solution 5 mg/mL Epidural; Infiltration; Perineural Auro Medics Pharma Llc 2016-09-15 Not applicable US Ropivacaine Hydrochloride Injection, solution 2 mg/mL Epidural; Infiltration; Perineural Auro Medics Pharma Llc 2016-09-15 Not applicable US - Categories
- Amide Local Anesthetic
- Amides
- Anesthetics
- Anesthetics, Local
- Central Nervous System Agents
- Central Nervous System Depressants
- Cytochrome P-450 CYP1A2 Substrates
- Cytochrome P-450 CYP2B6 Substrates
- Cytochrome P-450 CYP2D6 Substrates
- Cytochrome P-450 CYP3A4 Substrates
- Hypotensive Agents
- Nervous System
- Peripheral Nervous System Agents
- Sensory System Agents
- UNII
- 7IO5LYA57N
- CAS number
- 84057-95-4
- Weight
- Average: 274.4011
Monoisotopic: 274.204513464 - Chemical Formula
- C17H26N2O
- InChI Key
- ZKMNUMMKYBVTFN-HNNXBMFYSA-N
- InChI
- InChI=1S/C17H26N2O/c1-4-11-19-12-6-5-10-15(19)17(20)18-16-13(2)8-7-9-14(16)3/h7-9,15H,4-6,10-12H2,1-3H3,(H,18,20)/t15-/m0/s1
- IUPAC Name
- (2S)-N-(2,6-dimethylphenyl)-1-propylpiperidine-2-carboxamide
- SMILES
- CCCN1CCCC[[email protected]]1C(=O)NC1=C(C)C=CC=C1C
Pharmacology
- Indication
Used in obstetric anesthesia and regional anesthesia for surgery.
- Structured Indications
- Pharmacodynamics
Ropivacaine, 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 action
Local anesthetics such as Ropivacaine 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. Specifically, they block the sodium-channel and decrease chances of depolarization and consequent action potentials. In general, the progression of anesthesia is related to the diameter, myelination and conduction velocity of affected nerve fibers.
Target Actions Organism ASodium channel protein type 10 subunit alpha inhibitorHuman - Absorption
Bioavailability is 87%–98% following epidural administration.
- Volume of distribution
- Not Available
- Protein binding
94%, mainly to a1-acid glycoprotein
- Metabolism
Hepatic
- Route of elimination
Ropivacaine is extensively metabolized in the liver, predominantly by aromatic hydroxylation mediated by cytochrome P4501A to 3-hydroxy ropivacaine. After a single IV dose approximately 37% of the total dose is excreted in the urine as both free and conjugated 3-hydroxy ropivacaine. In total, 86% of the ropivacaine dose is excreted in the urine after intravenous administration of which only 1% relates to unchanged drug.
- Half life
Approximately 4.2 hours.
- Clearance
- 387 +/- 107 mL/min
- unbound plasma clearance=7.2 +/- 1.6 L/min
- Toxicity
Systemic exposure to excessive quantities of ropivacaine mainly result in central nervous system (CNS) and cardiovascular effects – CNS effects usually occur at lower blood plasma concentrations and additional cardiovascular effects present at higher concentrations, though cardiovascular collapse may also occur with low concentrations. CNS effects may include CNS excitation (nervousness, tingling around the mouth, tinnitus, tremor, dizziness, blurred vision, seizures) followed by depression (drowsiness, loss of consciousness, respiratory depression and apnea). Cardiovascular effects include hypotension, bradycardia, arrhythmias, and/or cardiac arrest – some of which may be due to hypoxemia secondary to respiratory depression.
- Affected organisms
- Humans and other mammals
- Pathways
Pathway Category Ropivacaine Action Pathway Drug action - Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
Drug Interaction Drug group 7-Nitroindazole The risk or severity of adverse effects can be increased when Ropivacaine is combined with 7-Nitroindazole. Experimental Abiraterone The serum concentration of Ropivacaine can be increased when it is combined with Abiraterone. Approved Acebutolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Acebutolol. Approved, Investigational Acepromazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Acepromazine. Approved, Vet Approved Aceprometazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Aceprometazine. Approved Adipiplon The risk or severity of adverse effects can be increased when Ropivacaine is combined with Adipiplon. Investigational Agomelatine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Agomelatine. Approved, Investigational Alaproclate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Alaproclate. Experimental Aldesleukin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Aldesleukin. Approved Alfaxalone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Alfaxalone. Vet Approved Alfentanil The risk or severity of adverse effects can be increased when Alfentanil is combined with Ropivacaine. Approved, Illicit Aliskiren The risk or severity of adverse effects can be increased when Ropivacaine is combined with Aliskiren. Approved, Investigational Allopregnanolone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Allopregnanolone. Investigational Alphacetylmethadol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Alphacetylmethadol. Experimental, Illicit Alphaprodine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Alphaprodine. Illicit Alprazolam The risk or severity of adverse effects can be increased when Alprazolam is combined with Ropivacaine. Approved, Illicit, Investigational Amifostine The risk or severity of adverse effects can be increased when Amifostine is combined with Ropivacaine. Approved, Investigational Amiloride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Amiloride. Approved Amiodarone The metabolism of Ropivacaine can be decreased when combined with Amiodarone. Approved, Investigational Amisulpride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Amisulpride. Approved, Investigational Amitriptyline The risk or severity of adverse effects can be increased when Amitriptyline is combined with Ropivacaine. Approved Amlodipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Amlodipine. Approved Amobarbital The risk or severity of adverse effects can be increased when Amobarbital is combined with Ropivacaine. Approved, Illicit Amoxapine The risk or severity of adverse effects can be increased when Amoxapine is combined with Ropivacaine. Approved Amperozide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Amperozide. Experimental Amphotericin B The risk or severity of adverse effects can be increased when Amphotericin B is combined with Ropivacaine. Approved, Investigational Amyl Nitrite The risk or severity of adverse effects can be increased when Ropivacaine is combined with Amyl Nitrite. Approved Apalutamide The serum concentration of Ropivacaine can be decreased when it is combined with Apalutamide. Approved, Investigational Apomorphine The risk or severity of adverse effects can be increased when Apomorphine is combined with Ropivacaine. Approved, Investigational Apraclonidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Apraclonidine. Approved Aprepitant The serum concentration of Ropivacaine can be increased when it is combined with Aprepitant. Approved, Investigational Aripiprazole Aripiprazole may increase the hypotensive activities of Ropivacaine. Approved, Investigational Arotinolol The risk or severity of adverse effects can be increased when Arotinolol is combined with Ropivacaine. Investigational Arsenic trioxide The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Ropivacaine. Approved, Investigational Artemether The metabolism of Ropivacaine can be decreased when combined with Artemether. Approved Articaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Articaine. Approved Asenapine The risk or severity of adverse effects can be increased when Asenapine is combined with Ropivacaine. Approved Atazanavir The metabolism of Ropivacaine can be decreased when combined with Atazanavir. Approved, Investigational Atenolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Atenolol. Approved Atomoxetine The metabolism of Ropivacaine can be decreased when combined with Atomoxetine. Approved Azaperone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Azaperone. Investigational, Vet Approved Azelastine Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Azelastine. Approved Azilsartan medoxomil The risk or severity of adverse effects can be increased when Ropivacaine is combined with Azilsartan medoxomil. Approved, Investigational Azithromycin The metabolism of Ropivacaine can be decreased when combined with Azithromycin. Approved Baclofen The risk or severity of adverse effects can be increased when Baclofen is combined with Ropivacaine. Approved Barbexaclone Barbexaclone may increase the hypotensive activities of Ropivacaine. Experimental Barbital The risk or severity of adverse effects can be increased when Ropivacaine is combined with Barbital. Illicit Barnidipine The risk or severity of adverse effects can be increased when Barnidipine is combined with Ropivacaine. Approved Benazepril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Benazepril. Approved, Investigational Bendroflumethiazide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bendroflumethiazide. Approved Benperidol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Benperidol. Approved, Investigational Benzocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Benzocaine. Approved, Investigational Benzyl alcohol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Benzyl alcohol. Approved Bepridil The risk or severity of adverse effects can be increased when Bepridil is combined with Ropivacaine. Approved, Withdrawn Betaxolol The metabolism of Ropivacaine can be decreased when combined with Betaxolol. Approved, Investigational Bisoprolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bisoprolol. Approved Boceprevir The metabolism of Ropivacaine can be decreased when combined with Boceprevir. Approved, Withdrawn Bortezomib The metabolism of Ropivacaine can be decreased when combined with Bortezomib. Approved, Investigational Bosentan The serum concentration of Ropivacaine can be decreased when it is combined with Bosentan. Approved, Investigational Bretylium The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bretylium. Approved Brexpiprazole The risk or severity of adverse effects can be increased when Brexpiprazole is combined with Ropivacaine. Approved, Investigational Brimonidine Brimonidine may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved Bromazepam The risk or severity of adverse effects can be increased when Bromazepam is combined with Ropivacaine. Approved, Illicit, Investigational Bromisoval The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bromisoval. Experimental Bromocriptine The risk or severity of adverse effects can be increased when Bromocriptine is combined with Ropivacaine. Approved, Investigational Bromperidol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bromperidol. Approved, Investigational Brompheniramine The risk or severity of adverse effects can be increased when Brompheniramine is combined with Ropivacaine. Approved Brotizolam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Brotizolam. Approved, Investigational, Withdrawn Bumetanide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bumetanide. Approved Bupivacaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Bupivacaine. Approved, Investigational Buprenorphine Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine. Approved, Illicit, Investigational, Vet Approved Bupropion The metabolism of Ropivacaine can be decreased when combined with Bupropion. Approved Buspirone The risk or severity of adverse effects can be increased when Buspirone is combined with Ropivacaine. Approved, Investigational Butabarbital The risk or severity of adverse effects can be increased when Butabarbital is combined with Ropivacaine. Approved, Illicit Butacaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Butacaine. Vet Approved Butalbital The risk or severity of adverse effects can be increased when Butalbital is combined with Ropivacaine. Approved, Illicit Butamben The risk or severity of adverse effects can be increased when Ropivacaine is combined with Butamben. Approved, Withdrawn Butethal The risk or severity of adverse effects can be increased when Ropivacaine is combined with Butethal. Approved, Illicit Butorphanol The risk or severity of adverse effects can be increased when Butorphanol is combined with Ropivacaine. Approved, Illicit, Vet Approved Caffeine The metabolism of Ropivacaine can be decreased when combined with Caffeine. Approved Canagliflozin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Canagliflozin. Approved Candesartan cilexetil The risk or severity of adverse effects can be increased when Ropivacaine is combined with Candesartan cilexetil. Approved Canertinib The risk or severity of adverse effects can be increased when Ropivacaine is combined with Canertinib. Investigational Captopril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Captopril. Approved Carbamazepine The metabolism of Ropivacaine can be increased when combined with Carbamazepine. Approved, Investigational Carbetocin The risk or severity of adverse effects can be increased when Carbetocin is combined with Ropivacaine. Approved, Investigational Carbinoxamine The risk or severity of adverse effects can be increased when Carbinoxamine is combined with Ropivacaine. Approved Carfentanil The risk or severity of adverse effects can be increased when Ropivacaine is combined with Carfentanil. Illicit, Investigational, Vet Approved Carisoprodol The risk or severity of adverse effects can be increased when Carisoprodol is combined with Ropivacaine. Approved Carteolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Carteolol. Approved Carvedilol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Carvedilol. Approved, Investigational Celecoxib The metabolism of Ropivacaine can be decreased when combined with Celecoxib. Approved, Investigational Ceritinib The serum concentration of Ropivacaine can be increased when it is combined with Ceritinib. Approved Cetirizine The risk or severity of adverse effects can be increased when Cetirizine is combined with Ropivacaine. Approved Chloral hydrate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chloral hydrate. Approved, Illicit, Investigational, Vet Approved Chlordiazepoxide The risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Ropivacaine. Approved, Illicit, Investigational Chlormezanone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chlormezanone. Approved, Investigational, Withdrawn Chloroprocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chloroprocaine. Approved Chloroquine The metabolism of Ropivacaine can be decreased when combined with Chloroquine. Approved, Investigational, Vet Approved Chlorothiazide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chlorothiazide. Approved, Vet Approved Chlorphenamine The risk or severity of adverse effects can be increased when Chlorphenamine is combined with Ropivacaine. Approved Chlorpromazine The metabolism of Ropivacaine can be decreased when combined with Chlorpromazine. Approved, Investigational, Vet Approved Chlorprothixene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chlorprothixene. Approved, Investigational, Withdrawn Chlorthalidone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Chlorthalidone. Approved Chlorzoxazone The risk or severity of adverse effects can be increased when Chlorzoxazone is combined with Ropivacaine. Approved Cholecalciferol The metabolism of Ropivacaine can be decreased when combined with Cholecalciferol. Approved, Nutraceutical Cilazapril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Cilazapril. Approved Cilnidipine The risk or severity of adverse effects can be increased when Cilnidipine is combined with Ropivacaine. Approved, Investigational Cimetidine The metabolism of Ropivacaine can be decreased when combined with Cimetidine. Approved, Investigational Cinacalcet The metabolism of Ropivacaine can be decreased when combined with Cinacalcet. Approved Cinchocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Cinchocaine. Approved, Vet Approved Ciprofloxacin The serum concentration of Ropivacaine can be increased when it is combined with Ciprofloxacin. Approved, Investigational Citalopram The metabolism of Ropivacaine can be decreased when combined with Citalopram. Approved Clarithromycin The metabolism of Ropivacaine can be decreased when combined with Clarithromycin. Approved Clemastine The metabolism of Ropivacaine can be decreased when combined with Clemastine. Approved, Investigational Clevidipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Clevidipine. Approved, Investigational Clidinium The risk or severity of adverse effects can be increased when Clidinium is combined with Ropivacaine. Approved Clobazam The metabolism of Ropivacaine can be decreased when combined with Clobazam. Approved, Illicit Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Ropivacaine. Approved, Investigational clomethiazole The risk or severity of adverse effects can be increased when Ropivacaine is combined with clomethiazole. Investigational Clomipramine The metabolism of Ropivacaine can be decreased when combined with Clomipramine. Approved, Investigational, Vet Approved Clonazepam The risk or severity of adverse effects can be increased when Clonazepam is combined with Ropivacaine. Approved, Illicit Clonidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Clonidine. Approved Clopenthixol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Clopenthixol. Experimental Clopidogrel The metabolism of Ropivacaine can be decreased when combined with Clopidogrel. Approved Clorazepate The risk or severity of adverse effects can be increased when Clorazepate is combined with Ropivacaine. Approved, Illicit Clothiapine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Clothiapine. Experimental Clotrimazole The metabolism of Ropivacaine can be decreased when combined with Clotrimazole. Approved, Vet Approved Clozapine The metabolism of Ropivacaine can be decreased when combined with Clozapine. Approved Cobicistat The serum concentration of Ropivacaine can be increased when it is combined with Cobicistat. Approved Cocaine The metabolism of Ropivacaine can be decreased when combined with Cocaine. Approved, Illicit Codeine The risk or severity of adverse effects can be increased when Codeine is combined with Ropivacaine. Approved, Illicit Conivaptan The serum concentration of Conivaptan can be increased when it is combined with Ropivacaine. Approved, Investigational Crizotinib The metabolism of Ropivacaine can be decreased when combined with Crizotinib. Approved Cyclizine The risk or severity of adverse effects can be increased when Cyclizine is combined with Ropivacaine. Approved Cyclobenzaprine The risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Ropivacaine. Approved Cyclopropane The risk or severity of adverse effects can be increased when Ropivacaine is combined with Cyclopropane. Experimental Cyclosporine The metabolism of Ropivacaine can be decreased when combined with Cyclosporine. Approved, Investigational, Vet Approved Cyproheptadine The risk or severity of adverse effects can be increased when Cyproheptadine is combined with Ropivacaine. Approved Cyproterone acetate The serum concentration of Ropivacaine can be decreased when it is combined with Cyproterone acetate. Approved, Investigational Dabrafenib The serum concentration of Ropivacaine can be decreased when it is combined with Dabrafenib. Approved, Investigational Dantrolene The risk or severity of adverse effects can be increased when Dantrolene is combined with Ropivacaine. Approved, Investigational Dapagliflozin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dapagliflozin. Approved Dapiprazole The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dapiprazole. Approved Dapoxetine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dapoxetine. Investigational Darifenacin The metabolism of Ropivacaine can be decreased when combined with Darifenacin. Approved, Investigational Darunavir The serum concentration of Ropivacaine can be increased when it is combined with Darunavir. Approved Dasatinib The serum concentration of Ropivacaine can be increased when it is combined with Dasatinib. Approved, Investigational Deferasirox The serum concentration of Ropivacaine can be decreased when it is combined with Deferasirox. Approved, Investigational Delavirdine The metabolism of Ropivacaine can be decreased when combined with Delavirdine. Approved Deramciclane The risk or severity of adverse effects can be increased when Ropivacaine is combined with Deramciclane. Investigational Desflurane The risk or severity of adverse effects can be increased when Desflurane is combined with Ropivacaine. Approved Desipramine The metabolism of Ropivacaine can be decreased when combined with Desipramine. Approved, Investigational Desloratadine The risk or severity of adverse effects can be increased when Desloratadine is combined with Ropivacaine. Approved, Investigational Desvenlafaxine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Desvenlafaxine. Approved, Investigational Detomidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Detomidine. Vet Approved Dexbrompheniramine The risk or severity of adverse effects can be increased when Dexbrompheniramine is combined with Ropivacaine. Approved Dexmedetomidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dexmedetomidine. Approved, Vet Approved Dextromoramide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dextromoramide. Experimental, Illicit Dextropropoxyphene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dextropropoxyphene. Approved, Illicit, Investigational, Withdrawn Dezocine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dezocine. Approved, Investigational Diazepam The risk or severity of adverse effects can be increased when Diazepam is combined with Ropivacaine. Approved, Illicit, Investigational, Vet Approved Diclofenamide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Diclofenamide. Approved, Investigational Diethyl ether The risk or severity of adverse effects can be increased when Ropivacaine is combined with Diethyl ether. Experimental Difenoxin The risk or severity of adverse effects can be increased when Difenoxin is combined with Ropivacaine. Approved, Illicit Dihydrocodeine The risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Ropivacaine. Approved, Illicit Dihydroergotamine The metabolism of Ropivacaine can be decreased when combined with Dihydroergotamine. Approved, Investigational Dihydroetorphine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dihydroetorphine. Experimental, Illicit Dihydromorphine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dihydromorphine. Experimental, Illicit Diltiazem The metabolism of Ropivacaine can be decreased when combined with Diltiazem. Approved, Investigational Dimenhydrinate The risk or severity of adverse effects can be increased when Dimenhydrinate is combined with Ropivacaine. Approved Dinutuximab The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dinutuximab. Approved, Investigational Diphenhydramine The metabolism of Ropivacaine can be decreased when combined with Diphenhydramine. Approved, Investigational Diphenoxylate The risk or severity of adverse effects can be increased when Diphenoxylate is combined with Ropivacaine. Approved, Illicit Dipyridamole The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dipyridamole. Approved Dixyrazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dixyrazine. Experimental Doramectin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Doramectin. Vet Approved Dosulepin The metabolism of Ropivacaine can be decreased when combined with Dosulepin. Approved Doxazosin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Doxazosin. Approved Doxepin The risk or severity of adverse effects can be increased when Doxepin is combined with Ropivacaine. Approved, Investigational Doxorubicin The metabolism of Ropivacaine can be decreased when combined with Doxorubicin. Approved, Investigational Doxycycline The metabolism of Ropivacaine can be decreased when combined with Doxycycline. Approved, Investigational, Vet Approved Doxylamine Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved, Vet Approved DPDPE The risk or severity of adverse effects can be increased when Ropivacaine is combined with DPDPE. Experimental Dronabinol Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved, Illicit Dronedarone The metabolism of Ropivacaine can be decreased when combined with Dronedarone. Approved Droperidol Droperidol may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved, Vet Approved Drotebanol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Drotebanol. Experimental, Illicit Duloxetine Ropivacaine may increase the orthostatic hypotensive activities of Duloxetine. Approved Dyclonine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Dyclonine. Approved Ecgonine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ecgonine. Experimental, Illicit Ecopipam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ecopipam. Investigational Efavirenz The risk or severity of adverse effects can be increased when Efavirenz is combined with Ropivacaine. Approved, Investigational Efonidipine The risk or severity of adverse effects can be increased when Efonidipine is combined with Ropivacaine. Approved, Investigational Eliglustat The metabolism of Ropivacaine can be decreased when combined with Eliglustat. Approved Eltanolone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Eltanolone. Investigational Empagliflozin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Empagliflozin. Approved Enalapril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Enalapril. Approved, Vet Approved Enalaprilat The risk or severity of adverse effects can be increased when Enalaprilat is combined with Ropivacaine. Approved Enflurane The risk or severity of adverse effects can be increased when Enflurane is combined with Ropivacaine. Approved, Investigational, Vet Approved Entacapone The risk or severity of adverse effects can be increased when Entacapone is combined with Ropivacaine. Approved, Investigational Enzalutamide The serum concentration of Ropivacaine can be decreased when it is combined with Enzalutamide. Approved Eplerenone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Eplerenone. Approved Epoprostenol The risk or severity of adverse effects can be increased when Epoprostenol is combined with Ropivacaine. Approved Eprosartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Eprosartan. Approved Erythromycin The metabolism of Ropivacaine can be decreased when combined with Erythromycin. Approved, Investigational, Vet Approved Escitalopram The risk or severity of adverse effects can be increased when Ropivacaine is combined with Escitalopram. Approved, Investigational Esmolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Esmolol. Approved Estazolam The risk or severity of adverse effects can be increased when Estazolam is combined with Ropivacaine. Approved, Illicit Eszopiclone The risk or severity of adverse effects can be increased when Eszopiclone is combined with Ropivacaine. Approved, Investigational Etacrynic acid The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etacrynic acid. Approved, Investigational Ethanol Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Ethanol. Approved Ethchlorvynol The risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Ropivacaine. Approved, Illicit, Withdrawn Ethosuximide The risk or severity of adverse effects can be increased when Ethosuximide is combined with Ropivacaine. Approved Ethotoin The risk or severity of adverse effects can be increased when Ethotoin is combined with Ropivacaine. Approved Ethyl carbamate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ethyl carbamate. Withdrawn Ethyl chloride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ethyl chloride. Approved, Experimental, Investigational Ethyl loflazepate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ethyl loflazepate. Approved, Illicit Ethylmorphine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ethylmorphine. Approved, Illicit Etidocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etidocaine. Approved Etifoxine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etifoxine. Investigational, Withdrawn Etizolam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etizolam. Approved Etomidate The risk or severity of adverse effects can be increased when Etomidate is combined with Ropivacaine. Approved Etoperidone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etoperidone. Withdrawn Etorphine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Etorphine. Illicit, Vet Approved Ezogabine The risk or severity of adverse effects can be increased when Ezogabine is combined with Ropivacaine. Approved, Investigational Felbamate The risk or severity of adverse effects can be increased when Felbamate is combined with Ropivacaine. Approved Felodipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Felodipine. Approved, Investigational Fencamfamine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fencamfamine. Approved, Illicit, Withdrawn Fenoldopam The risk or severity of adverse effects can be increased when Fenoldopam is combined with Ropivacaine. Approved Fentanyl The risk or severity of adverse effects can be increased when Fentanyl is combined with Ropivacaine. Approved, Illicit, Investigational, Vet Approved Fexofenadine The risk or severity of adverse effects can be increased when Fexofenadine is combined with Ropivacaine. Approved, Investigational Fimasartan The risk or severity of adverse effects can be increased when Fimasartan is combined with Ropivacaine. Approved, Investigational Flibanserin The risk or severity of adverse effects can be increased when Flibanserin is combined with Ropivacaine. Approved, Investigational Fluanisone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fluanisone. Experimental Fluconazole The metabolism of Ropivacaine can be decreased when combined with Fluconazole. Approved, Investigational Fludiazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fludiazepam. Approved, Illicit Flunarizine The risk or severity of adverse effects can be increased when Flunarizine is combined with Ropivacaine. Approved Flunitrazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Flunitrazepam. Approved, Illicit Fluoxetine The metabolism of Ropivacaine can be decreased when combined with Fluoxetine. Approved, Vet Approved Flupentixol The risk or severity of adverse effects can be increased when Flupentixol is combined with Ropivacaine. Approved, Investigational, Withdrawn Fluphenazine The risk or severity of adverse effects can be increased when Fluphenazine is combined with Ropivacaine. Approved Flurazepam The risk or severity of adverse effects can be increased when Flurazepam is combined with Ropivacaine. Approved, Illicit, Investigational Fluspirilene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fluspirilene. Approved, Investigational Fluticasone propionate The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Ropivacaine. Approved Fluvoxamine The serum concentration of Ropivacaine can be increased when it is combined with Fluvoxamine. Approved, Investigational Fosamprenavir The metabolism of Ropivacaine can be decreased when combined with Fosamprenavir. Approved Fosaprepitant The serum concentration of Ropivacaine can be increased when it is combined with Fosaprepitant. Approved Fosinopril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fosinopril. Approved Fosphenytoin The metabolism of Ropivacaine can be increased when combined with Fosphenytoin. Approved, Investigational Fospropofol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Fospropofol. Approved, Illicit, Investigational Furosemide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Furosemide. Approved, Vet Approved Fusidic Acid The serum concentration of Ropivacaine can be increased when it is combined with Fusidic Acid. Approved, Investigational Gabapentin The risk or severity of adverse effects can be increased when Gabapentin is combined with Ropivacaine. Approved, Investigational Gabapentin Enacarbil The risk or severity of adverse effects can be increased when Gabapentin Enacarbil is combined with Ropivacaine. Approved, Investigational Gamma Hydroxybutyric Acid The risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ropivacaine. Approved, Illicit, Investigational Gepirone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Gepirone. Investigational Glutethimide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Glutethimide. Approved, Illicit Guanfacine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Guanfacine. Approved, Investigational Halazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Halazepam. Approved, Illicit, Withdrawn Haloperidol The metabolism of Ropivacaine can be decreased when combined with Haloperidol. Approved Halothane The risk or severity of adverse effects can be increased when Ropivacaine is combined with Halothane. Approved, Vet Approved Heroin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Heroin. Approved, Illicit, Investigational Hexobarbital The risk or severity of adverse effects can be increased when Ropivacaine is combined with Hexobarbital. Approved Hyaluronidase The risk or severity of adverse effects can be increased when Hyaluronidase is combined with Ropivacaine. Approved, Investigational Hydralazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Hydralazine. Approved Hydrochlorothiazide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Hydrochlorothiazide. Approved, Vet Approved Hydrocodone Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone. Approved, Illicit Hydroflumethiazide The risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Ropivacaine. Approved, Investigational Hydromorphone The risk or severity of adverse effects can be increased when Hydromorphone is combined with Ropivacaine. Approved, Illicit Hydroxyzine Hydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved Idelalisib The metabolism of Ropivacaine can be decreased when combined with Idelalisib. Approved Iloperidone The risk or severity of adverse effects can be increased when Iloperidone is combined with Ropivacaine. Approved Iloprost The risk or severity of adverse effects can be increased when Iloprost is combined with Ropivacaine. Approved, Investigational Imatinib The metabolism of Ropivacaine can be decreased when combined with Imatinib. Approved Imidapril The risk or severity of adverse effects can be increased when Imidapril is combined with Ropivacaine. Investigational Imipramine The metabolism of Ropivacaine can be decreased when combined with Imipramine. Approved Indalpine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Indalpine. Investigational, Withdrawn Indapamide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Indapamide. Approved Indinavir The metabolism of Ropivacaine can be decreased when combined with Indinavir. Approved Indiplon The risk or severity of adverse effects can be increased when Ropivacaine is combined with Indiplon. Investigational Indoramin The risk or severity of adverse effects can be increased when Indoramin is combined with Ropivacaine. Withdrawn Irbesartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Irbesartan. Approved, Investigational Isavuconazole The serum concentration of Ropivacaine can be increased when it is combined with Isavuconazole. Approved, Investigational Isavuconazonium The metabolism of Ropivacaine can be decreased when combined with Isavuconazonium. Approved, Investigational Isocarboxazid The risk or severity of adverse effects can be increased when Isocarboxazid is combined with Ropivacaine. Approved Isoflurane The risk or severity of adverse effects can be increased when Isoflurane is combined with Ropivacaine. Approved, Vet Approved Isoniazid The metabolism of Ropivacaine can be decreased when combined with Isoniazid. Approved, Investigational Isosorbide Dinitrate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Isosorbide Dinitrate. Approved, Investigational Isosorbide Mononitrate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Isosorbide Mononitrate. Approved Isoxsuprine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Isoxsuprine. Approved, Withdrawn Isradipine The metabolism of Ropivacaine can be decreased when combined with Isradipine. Approved, Investigational Itraconazole The metabolism of Ropivacaine can be decreased when combined with Itraconazole. Approved, Investigational Ivacaftor The serum concentration of Ropivacaine can be increased when it is combined with Ivacaftor. Approved Ketamine The risk or severity of adverse effects can be increased when Ketamine is combined with Ropivacaine. Approved, Vet Approved Ketazolam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ketazolam. Approved Ketobemidone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ketobemidone. Approved, Investigational Ketoconazole The metabolism of Ropivacaine can be decreased when combined with Ketoconazole. Approved, Investigational Labetalol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Labetalol. Approved Lacidipine Ropivacaine may increase the hypotensive activities of Lacidipine. Approved, Investigational Lamotrigine The risk or severity of adverse effects can be increased when Lamotrigine is combined with Ropivacaine. Approved, Investigational Lercanidipine The risk or severity of adverse effects can be increased when Lercanidipine is combined with Ropivacaine. Approved, Investigational Levetiracetam The risk or severity of adverse effects can be increased when Levetiracetam is combined with Ropivacaine. Approved, Investigational Levobunolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Levobunolol. Approved Levobupivacaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Levobupivacaine. Approved, Investigational Levocabastine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Levocabastine. Approved, Investigational Levocetirizine The risk or severity of adverse effects can be increased when Levocetirizine is combined with Ropivacaine. Approved Levodopa Ropivacaine may increase the orthostatic hypotensive activities of Levodopa. Approved Levomethadyl Acetate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Levomethadyl Acetate. Approved, Investigational Levomilnacipran The risk or severity of adverse effects can be increased when Ropivacaine is combined with Levomilnacipran. Approved, Investigational Levorphanol The risk or severity of adverse effects can be increased when Levorphanol is combined with Ropivacaine. Approved Levosimendan The risk or severity of adverse effects can be increased when Levosimendan is combined with Ropivacaine. Approved, Investigational Lidocaine The metabolism of Ropivacaine can be decreased when combined with Lidocaine. Approved, Vet Approved Lisinopril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Lisinopril. Approved, Investigational Lithium The risk or severity of adverse effects can be increased when Ropivacaine is combined with Lithium. Approved Lobeglitazone The metabolism of Ropivacaine can be decreased when combined with Lobeglitazone. Approved, Investigational Lofentanil The risk or severity of adverse effects can be increased when Ropivacaine is combined with Lofentanil. Illicit Lofexidine The risk or severity of adverse effects can be increased when Lofexidine is combined with Ropivacaine. Approved, Investigational Lopinavir The metabolism of Ropivacaine can be decreased when combined with Lopinavir. Approved Loprazolam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Loprazolam. Experimental Loratadine The risk or severity of adverse effects can be increased when Loratadine is combined with Ropivacaine. Approved, Investigational Lorazepam The risk or severity of adverse effects can be increased when Lorazepam is combined with Ropivacaine. Approved Lorcaserin The metabolism of Ropivacaine can be decreased when combined with Lorcaserin. Approved Lormetazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Lormetazepam. Approved Lorpiprazole The serum concentration of Ropivacaine can be increased when it is combined with Lorpiprazole. Approved Losartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Losartan. Approved Lovastatin The metabolism of Ropivacaine can be decreased when combined with Lovastatin. Approved, Investigational Loxapine The risk or severity of adverse effects can be increased when Loxapine is combined with Ropivacaine. Approved Luliconazole The serum concentration of Ropivacaine can be increased when it is combined with Luliconazole. Approved Lumacaftor The serum concentration of Ropivacaine can be decreased when it is combined with Lumacaftor. Approved Lumefantrine The metabolism of Ropivacaine can be decreased when combined with Lumefantrine. Approved Lurasidone The risk or severity of adverse effects can be increased when Lurasidone is combined with Ropivacaine. Approved, Investigational Magnesium sulfate The therapeutic efficacy of Ropivacaine can be increased when used in combination with Magnesium sulfate. Approved, Investigational, Vet Approved Manidipine The metabolism of Ropivacaine can be decreased when combined with Manidipine. Approved, Investigational Mannitol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Mannitol. Approved, Investigational Maprotiline The risk or severity of adverse effects can be increased when Maprotiline is combined with Ropivacaine. Approved, Investigational Mebicar The risk or severity of adverse effects can be increased when Ropivacaine is combined with Mebicar. Experimental Mecamylamine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Mecamylamine. Approved, Investigational Meclizine The risk or severity of adverse effects can be increased when Meclizine is combined with Ropivacaine. Approved Medazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Medazepam. Experimental Medetomidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Medetomidine. Vet Approved Melatonin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Melatonin. Approved, Nutraceutical, Vet Approved Melperone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Melperone. Approved, Investigational Mepivacaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Mepivacaine. Approved, Vet Approved Meprobamate The risk or severity of adverse effects can be increased when Meprobamate is combined with Ropivacaine. Approved, Illicit Meptazinol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Meptazinol. Experimental Mesoridazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Mesoridazine. Approved, Investigational Metaxalone The risk or severity of adverse effects can be increased when Metaxalone is combined with Ropivacaine. Approved Methadone The metabolism of Ropivacaine can be decreased when combined with Methadone. Approved Methadyl Acetate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methadyl Acetate. Approved, Illicit Methapyrilene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methapyrilene. Withdrawn Methaqualone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methaqualone. Illicit, Withdrawn Methazolamide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methazolamide. Approved Methocarbamol The risk or severity of adverse effects can be increased when Methocarbamol is combined with Ropivacaine. Approved, Vet Approved Methohexital The risk or severity of adverse effects can be increased when Methohexital is combined with Ropivacaine. Approved Methotrimeprazine Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine. Approved, Investigational Methoxyflurane The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methoxyflurane. Approved, Investigational, Vet Approved Methsuximide The risk or severity of adverse effects can be increased when Methsuximide is combined with Ropivacaine. Approved Methyclothiazide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methyclothiazide. Approved Methyldopa The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methyldopa. Approved Methylecgonine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methylecgonine. Experimental Methylphenobarbital The risk or severity of adverse effects can be increased when Ropivacaine is combined with Methylphenobarbital. Approved Metipranolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Metipranolol. Approved Metolazone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Metolazone. Approved Metoprolol The metabolism of Ropivacaine can be decreased when combined with Metoprolol. Approved, Investigational Metyrosine Ropivacaine may increase the sedative activities of Metyrosine. Approved Mexiletine The metabolism of Ropivacaine can be decreased when combined with Mexiletine. Approved, Investigational Midazolam The risk or severity of adverse effects can be increased when Midazolam is combined with Ropivacaine. Approved, Illicit Midostaurin The metabolism of Ropivacaine can be decreased when combined with Midostaurin. Approved, Investigational Mifepristone The serum concentration of Ropivacaine can be increased when it is combined with Mifepristone. Approved, Investigational Milnacipran The risk or severity of adverse effects can be increased when Ropivacaine is combined with Milnacipran. Approved, Investigational Minocycline Minocycline may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved, Investigational Minoxidil The risk or severity of adverse effects can be increased when Ropivacaine is combined with Minoxidil. Approved, Investigational Mirabegron The metabolism of Ropivacaine can be decreased when combined with Mirabegron. Approved Mirtazapine Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine. Approved Mitotane The serum concentration of Ropivacaine can be decreased when it is combined with Mitotane. Approved Moexipril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Moexipril. Approved Molindone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Molindone. Approved Morphine The risk or severity of adverse effects can be increased when Morphine is combined with Ropivacaine. Approved, Investigational Moxonidine The risk or severity of adverse effects can be increased when Moxonidine is combined with Ropivacaine. Approved, Investigational Nabilone Nabilone may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved, Investigational Nadolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nadolol. Approved Nalbuphine The risk or severity of adverse effects can be increased when Nalbuphine is combined with Ropivacaine. Approved Nebivolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nebivolol. Approved, Investigational Nefazodone The metabolism of Ropivacaine can be decreased when combined with Nefazodone. Approved, Withdrawn Nelfinavir The metabolism of Ropivacaine can be decreased when combined with Nelfinavir. Approved Nesiritide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nesiritide. Approved, Investigational Netupitant The serum concentration of Ropivacaine can be increased when it is combined with Netupitant. Approved, Investigational Nevirapine The metabolism of Ropivacaine can be increased when combined with Nevirapine. Approved Nicardipine The metabolism of Ropivacaine can be decreased when combined with Nicardipine. Approved, Investigational Nicorandil Nicorandil may increase the hypotensive activities of Ropivacaine. Approved, Investigational Nifedipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nifedipine. Approved Nilotinib The metabolism of Ropivacaine can be decreased when combined with Nilotinib. Approved, Investigational Nilvadipine The risk or severity of adverse effects can be increased when Nilvadipine is combined with Ropivacaine. Approved, Investigational Nimodipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nimodipine. Approved, Investigational Nisoldipine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nisoldipine. Approved Nitrazepam The risk or severity of adverse effects can be increased when Nitrazepam is combined with Ropivacaine. Approved Nitrendipine The risk or severity of adverse effects can be increased when Nitrendipine is combined with Ropivacaine. Approved, Investigational Nitric Oxide The risk or severity of adverse effects can be increased when Nitric Oxide is combined with Ropivacaine. Approved Nitroglycerin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nitroglycerin. Approved, Investigational Nitroprusside The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nitroprusside. Approved, Investigational Nitrous acid The risk or severity of adverse effects can be increased when Ropivacaine is combined with Nitrous acid. Approved, Investigational Nitrous oxide The risk or severity of adverse effects can be increased when Nitrous oxide is combined with Ropivacaine. Approved, Vet Approved Norflurane The risk or severity of adverse effects can be increased when Ropivacaine is combined with Norflurane. Approved, Investigational Normethadone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Normethadone. Approved, Illicit Nortriptyline The risk or severity of adverse effects can be increased when Nortriptyline is combined with Ropivacaine. Approved Obinutuzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ropivacaine. Approved, Investigational Olanzapine The risk or severity of adverse effects can be increased when Olanzapine is combined with Ropivacaine. Approved, Investigational Olaparib The metabolism of Ropivacaine can be decreased when combined with Olaparib. Approved Olmesartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Olmesartan. Approved, Investigational Olopatadine The risk or severity of adverse effects can be increased when Olopatadine is combined with Ropivacaine. Approved Ondansetron The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ondansetron. Approved Opium The risk or severity of adverse effects can be increased when Ropivacaine is combined with Opium. Approved, Illicit Orphenadrine Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine. Approved Osanetant The risk or severity of adverse effects can be increased when Ropivacaine is combined with Osanetant. Investigational Osimertinib The serum concentration of Ropivacaine can be increased when it is combined with Osimertinib. Approved Oxazepam The risk or severity of adverse effects can be increased when Oxazepam is combined with Ropivacaine. Approved Oxethazaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Oxethazaine. Approved, Investigational Oxprenolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Oxprenolol. Approved Oxybuprocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Oxybuprocaine. Approved, Investigational Oxycodone The risk or severity of adverse effects can be increased when Oxycodone is combined with Ropivacaine. Approved, Illicit, Investigational Oxymorphone The risk or severity of adverse effects can be increased when Oxymorphone is combined with Ropivacaine. Approved, Investigational, Vet Approved Paclitaxel The risk or severity of adverse effects can be increased when Paclitaxel is combined with Ropivacaine. Approved, Vet Approved Palbociclib The serum concentration of Ropivacaine can be increased when it is combined with Palbociclib. Approved, Investigational Paliperidone The risk or severity of adverse effects can be increased when Paliperidone is combined with Ropivacaine. Approved Panobinostat The serum concentration of Ropivacaine can be increased when it is combined with Panobinostat. Approved, Investigational Papaverine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Papaverine. Approved, Investigational Paraldehyde Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde. Approved, Investigational Paroxetine The metabolism of Ropivacaine can be decreased when combined with Paroxetine. Approved, Investigational Peginterferon alfa-2b The serum concentration of Ropivacaine can be decreased when it is combined with Peginterferon alfa-2b. Approved Penbutolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Penbutolol. Approved, Investigational Penfluridol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Penfluridol. Experimental Pentazocine The risk or severity of adverse effects can be increased when Pentazocine is combined with Ropivacaine. Approved, Vet Approved Pentobarbital The metabolism of Ropivacaine can be increased when combined with Pentobarbital. Approved, Investigational, Vet Approved Perampanel Perampanel may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved Perazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Perazine. Approved, Investigational Perindopril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Perindopril. Approved Perospirone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Perospirone. Approved Perphenazine The risk or severity of adverse effects can be increased when Perphenazine is combined with Ropivacaine. Approved Pethidine The risk or severity of adverse effects can be increased when Pethidine is combined with Ropivacaine. Approved Phenazocine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Phenazocine. Experimental Phenelzine The risk or severity of adverse effects can be increased when Phenelzine is combined with Ropivacaine. Approved Phenibut The risk or severity of adverse effects can be increased when Ropivacaine is combined with Phenibut. Experimental Phenobarbital The metabolism of Ropivacaine can be increased when combined with Phenobarbital. Approved, Investigational Phenoperidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Phenoperidine. Experimental Phenoxybenzamine The risk or severity of adverse effects can be increased when Phenoxybenzamine is combined with Ropivacaine. Approved Phenoxyethanol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Phenoxyethanol. Approved Phentolamine The risk or severity of adverse effects can be increased when Phentolamine is combined with Ropivacaine. Approved Phenytoin The metabolism of Ropivacaine can be increased when combined with Phenytoin. Approved, Vet Approved Pimozide The risk or severity of adverse effects can be increased when Pimozide is combined with Ropivacaine. Approved Pindolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Pindolol. Approved, Investigational Pipamperone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Pipamperone. Approved, Investigational Pipotiazine The risk or severity of adverse effects can be increased when Pipotiazine is combined with Ropivacaine. Approved, Investigational Piritramide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Piritramide. Approved, Investigational Pitolisant The serum concentration of Ropivacaine can be decreased when it is combined with Pitolisant. Approved, Investigational Pizotifen The risk or severity of adverse effects can be increased when Pizotifen is combined with Ropivacaine. Approved Pomalidomide The risk or severity of adverse effects can be increased when Pomalidomide is combined with Ropivacaine. Approved Posaconazole The metabolism of Ropivacaine can be decreased when combined with Posaconazole. Approved, Investigational, Vet Approved Pramipexole Ropivacaine may increase the sedative activities of Pramipexole. Approved, Investigational Pramocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Pramocaine. Approved Prazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Prazepam. Approved, Illicit Prazosin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Prazosin. Approved Pregabalin The therapeutic efficacy of Ropivacaine can be increased when used in combination with Pregabalin. Approved, Illicit, Investigational Prilocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Prilocaine. Approved Primidone The metabolism of Ropivacaine can be increased when combined with Primidone. Approved, Vet Approved Procaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Procaine. Approved, Investigational, Vet Approved Prochlorperazine The risk or severity of adverse effects can be increased when Prochlorperazine is combined with Ropivacaine. Approved, Vet Approved Promazine The metabolism of Ropivacaine can be decreased when combined with Promazine. Approved, Vet Approved Promethazine The risk or severity of adverse effects can be increased when Promethazine is combined with Ropivacaine. Approved, Investigational Propanidid The risk or severity of adverse effects can be increased when Ropivacaine is combined with Propanidid. Experimental Proparacaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Proparacaine. Approved, Vet Approved Propofol The serum concentration of Ropivacaine can be increased when it is combined with Propofol. Approved, Investigational, Vet Approved Propoxycaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Propoxycaine. Approved Propranolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Propranolol. Approved, Investigational Protriptyline The risk or severity of adverse effects can be increased when Protriptyline is combined with Ropivacaine. Approved Proxibarbal The risk or severity of adverse effects can be increased when Ropivacaine is combined with Proxibarbal. Experimental PSD502 The risk or severity of adverse effects can be increased when Ropivacaine is combined with PSD502. Investigational Quazepam The serum concentration of Ropivacaine can be increased when it is combined with Quazepam. Approved, Illicit Quetiapine The risk or severity of adverse effects can be increased when Quetiapine is combined with Ropivacaine. Approved Quinapril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Quinapril. Approved, Investigational Quinidine The metabolism of Ropivacaine can be decreased when combined with Quinidine. Approved, Investigational Quinine The metabolism of Ropivacaine can be decreased when combined with Quinine. Approved Quinisocaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Quinisocaine. Experimental Raclopride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Raclopride. Investigational Ramelteon The risk or severity of adverse effects can be increased when Ramelteon is combined with Ropivacaine. Approved, Investigational Ramipril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ramipril. Approved Ranolazine The metabolism of Ropivacaine can be decreased when combined with Ranolazine. Approved, Investigational Rasagiline The risk or severity of adverse effects can be increased when Rasagiline is combined with Ropivacaine. Approved Remifentanil The risk or severity of adverse effects can be increased when Remifentanil is combined with Ropivacaine. Approved Remoxipride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Remoxipride. Approved, Withdrawn Reserpine The risk or severity of adverse effects can be increased when Reserpine is combined with Ropivacaine. Approved, Investigational Rifabutin The metabolism of Ropivacaine can be increased when combined with Rifabutin. Approved, Investigational Rifampicin The metabolism of Ropivacaine can be increased when combined with Rifampicin. Approved Rifapentine The metabolism of Ropivacaine can be increased when combined with Rifapentine. Approved, Investigational Riociguat The risk or severity of adverse effects can be increased when Ropivacaine is combined with Riociguat. Approved Risperidone Ropivacaine may increase the hypotensive activities of Risperidone. Approved, Investigational Ritanserin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Ritanserin. Investigational Ritonavir The metabolism of Ropivacaine can be decreased when combined with Ritonavir. Approved, Investigational Rolapitant The metabolism of Ropivacaine can be decreased when combined with Rolapitant. Approved, Investigational Romifidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Romifidine. Vet Approved Ropinirole Ropivacaine may increase the sedative activities of Ropinirole. Approved, Investigational Rotigotine Ropivacaine may increase the sedative activities of Rotigotine. Approved Rucaparib The metabolism of Ropivacaine can be decreased when combined with Rucaparib. Approved, Investigational Rufinamide The risk or severity of adverse effects can be increased when Rufinamide is combined with Ropivacaine. Approved Sacubitril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sacubitril. Approved Saquinavir The metabolism of Ropivacaine can be decreased when combined with Saquinavir. Approved, Investigational Sarilumab The therapeutic efficacy of Ropivacaine can be decreased when used in combination with Sarilumab. Approved, Investigational Scopolamine The risk or severity of adverse effects can be increased when Scopolamine is combined with Ropivacaine. Approved, Investigational Secobarbital The risk or severity of adverse effects can be increased when Secobarbital is combined with Ropivacaine. Approved, Vet Approved Selegiline The risk or severity of adverse effects can be increased when Ropivacaine is combined with Selegiline. Approved, Investigational, Vet Approved Sepranolone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sepranolone. Investigational Sertindole The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sertindole. Approved, Investigational, Withdrawn Sertraline The metabolism of Ropivacaine can be decreased when combined with Sertraline. Approved Sevoflurane The risk or severity of adverse effects can be increased when Sevoflurane is combined with Ropivacaine. Approved, Vet Approved Sildenafil The metabolism of Ropivacaine can be decreased when combined with Sildenafil. Approved, Investigational Siltuximab The serum concentration of Ropivacaine can be decreased when it is combined with Siltuximab. Approved, Investigational Simeprevir The serum concentration of Ropivacaine can be increased when it is combined with Simeprevir. Approved Sodium oxybate Sodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved Sorafenib The metabolism of Ropivacaine can be decreased when combined with Sorafenib. Approved, Investigational Sotalol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sotalol. Approved Spironolactone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Spironolactone. Approved St. John's Wort The serum concentration of Ropivacaine can be decreased when it is combined with St. John's Wort. Approved, Investigational, Nutraceutical Stiripentol The serum concentration of Ropivacaine can be increased when it is combined with Stiripentol. Approved Streptokinase The risk or severity of adverse effects can be increased when Ropivacaine is combined with Streptokinase. Approved, Investigational Sufentanil The risk or severity of adverse effects can be increased when Sufentanil is combined with Ropivacaine. Approved, Investigational Sulfisoxazole The metabolism of Ropivacaine can be decreased when combined with Sulfisoxazole. Approved, Vet Approved Sulpiride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sulpiride. Approved, Investigational Sultopride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Sultopride. Experimental Suvorexant Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant. Approved, Investigational Tamsulosin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tamsulosin. Approved, Investigational Tandospirone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tandospirone. Investigational Tapentadol Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Ropivacaine. Approved Tasimelteon The risk or severity of adverse effects can be increased when Tasimelteon is combined with Ropivacaine. Approved, Investigational Technetium Tc-99m tilmanocept Ropivacaine may decrease effectiveness of Technetium Tc-99m tilmanocept as a diagnostic agent. Approved, Investigational Telaprevir The metabolism of Ropivacaine can be decreased when combined with Telaprevir. Approved, Withdrawn Telithromycin The metabolism of Ropivacaine can be decreased when combined with Telithromycin. Approved Telmisartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Telmisartan. Approved, Investigational Temazepam The risk or severity of adverse effects can be increased when Temazepam is combined with Ropivacaine. Approved, Investigational Tenofovir disoproxil The metabolism of Ropivacaine can be decreased when combined with Tenofovir disoproxil. Approved, Investigational Terazosin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Terazosin. Approved Terbinafine The metabolism of Ropivacaine can be decreased when combined with Terbinafine. Approved, Investigational, Vet Approved Teriflunomide The serum concentration of Ropivacaine can be decreased when it is combined with Teriflunomide. Approved Tetrabenazine The risk or severity of adverse effects can be increased when Tetrabenazine is combined with Ropivacaine. Approved, Investigational Tetracaine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tetracaine. Approved, Vet Approved Tetrahydropalmatine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tetrahydropalmatine. Investigational Tetrodotoxin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tetrodotoxin. Investigational Thalidomide Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide. Approved, Investigational, Withdrawn Theophylline The metabolism of Ropivacaine can be decreased when combined with Theophylline. Approved Thiamylal The risk or severity of adverse effects can be increased when Ropivacaine is combined with Thiamylal. Approved, Vet Approved Thiopental The risk or severity of adverse effects can be increased when Ropivacaine is combined with Thiopental. Approved, Vet Approved Thioridazine The metabolism of Ropivacaine can be decreased when combined with Thioridazine. Approved, Withdrawn Thiotepa The metabolism of Ropivacaine can be decreased when combined with Thiotepa. Approved, Investigational Thiothixene The risk or severity of adverse effects can be increased when Thiothixene is combined with Ropivacaine. Approved Tiagabine The risk or severity of adverse effects can be increased when Tiagabine is combined with Ropivacaine. Approved, Investigational Tiapride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tiapride. Approved, Investigational Ticlopidine The metabolism of Ropivacaine can be decreased when combined with Ticlopidine. Approved Tiletamine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tiletamine. Vet Approved Tilidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tilidine. Experimental Timolol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Timolol. Approved Tipranavir The metabolism of Ropivacaine can be decreased when combined with Tipranavir. Approved, Investigational Tizanidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tizanidine. Approved, Investigational Tocilizumab The serum concentration of Ropivacaine can be decreased when it is combined with Tocilizumab. Approved Tolazoline The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tolazoline. Approved, Vet Approved Tolcapone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tolcapone. Approved, Withdrawn Topiramate The risk or severity of adverse effects can be increased when Topiramate is combined with Ropivacaine. Approved Torasemide The risk or severity of adverse effects can be increased when Ropivacaine is combined with Torasemide. Approved Tramadol The risk or severity of adverse effects can be increased when Tramadol is combined with Ropivacaine. Approved, Investigational Trandolapril The risk or severity of adverse effects can be increased when Ropivacaine is combined with Trandolapril. Approved Tranylcypromine The metabolism of Ropivacaine can be decreased when combined with Tranylcypromine. Approved, Investigational Trazodone The risk or severity of adverse effects can be increased when Ropivacaine is combined with Trazodone. Approved, Investigational Tretinoin The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tretinoin. Approved, Investigational, Nutraceutical Triamterene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Triamterene. Approved Triazolam The risk or severity of adverse effects can be increased when Triazolam is combined with Ropivacaine. Approved, Investigational Tricaine methanesulfonate The risk or severity of adverse effects can be increased when Ropivacaine is combined with Tricaine methanesulfonate. Vet Approved Trichloroethylene The risk or severity of adverse effects can be increased when Ropivacaine is combined with Trichloroethylene. Approved Trifluoperazine The risk or severity of adverse effects can be increased when Trifluoperazine is combined with Ropivacaine. Approved, Investigational Trifluperidol The risk or severity of adverse effects can be increased when Ropivacaine is combined with Trifluperidol. Experimental Triflupromazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Triflupromazine. Approved, Vet Approved Trimipramine The risk or severity of adverse effects can be increased when Trimipramine is combined with Ropivacaine. Approved Triprolidine The risk or severity of adverse effects can be increased when Triprolidine is combined with Ropivacaine. Approved Valproic Acid The risk or severity of adverse effects can be increased when Ropivacaine is combined with Valproic Acid. Approved, Investigational Valsartan The risk or severity of adverse effects can be increased when Ropivacaine is combined with Valsartan. Approved, Investigational Vemurafenib The serum concentration of Ropivacaine can be increased when it is combined with Vemurafenib. Approved Venlafaxine The metabolism of Ropivacaine can be decreased when combined with Venlafaxine. Approved Veralipride The risk or severity of adverse effects can be increased when Ropivacaine is combined with Veralipride. Experimental Verapamil The metabolism of Ropivacaine can be decreased when combined with Verapamil. Approved Vigabatrin The risk or severity of adverse effects can be increased when Vigabatrin is combined with Ropivacaine. Approved Vinyl ether The risk or severity of adverse effects can be increased when Ropivacaine is combined with Vinyl ether. Experimental Voriconazole The metabolism of Ropivacaine can be decreased when combined with Voriconazole. Approved, Investigational Vortioxetine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Vortioxetine. Approved, Investigational Xenon The risk or severity of adverse effects can be increased when Ropivacaine is combined with Xenon. Experimental Xylazine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Xylazine. Vet Approved Zaleplon The risk or severity of adverse effects can be increased when Zaleplon is combined with Ropivacaine. Approved, Illicit, Investigational Ziconotide The risk or severity of adverse effects can be increased when Ziconotide is combined with Ropivacaine. Approved Zimelidine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Zimelidine. Withdrawn Ziprasidone The metabolism of Ropivacaine can be decreased when combined with Ziprasidone. Approved Zolazepam The risk or severity of adverse effects can be increased when Ropivacaine is combined with Zolazepam. Vet Approved Zolpidem Ropivacaine may increase the central nervous system depressant (CNS depressant) activities of Zolpidem. Approved Zonisamide The risk or severity of adverse effects can be increased when Zonisamide is combined with Ropivacaine. Approved, Investigational Zopiclone The risk or severity of adverse effects can be increased when Zopiclone is combined with Ropivacaine. Approved Zotepine The risk or severity of adverse effects can be increased when Ropivacaine is combined with Zotepine. Approved, Investigational, Withdrawn Zucapsaicin The metabolism of Ropivacaine can be decreased when combined with Zucapsaicin. Approved, Investigational Zuclopenthixol The risk or severity of adverse effects can be increased when Zuclopenthixol is combined with Ropivacaine. Approved, Investigational - Food Interactions
- Not Available
References
- Synthesis Reference
Peter Jaksch, "Process for the preparation of ropivacaine hydrochloride monohydrate." U.S. Patent US5959112, issued February, 1970.
US5959112- General References
- Weinberg G, Ripper R, Feinstein DL, Hoffman W: Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med. 2003 May-Jun;28(3):198-202. [PubMed:12772136]
- Picard J, Meek T: Lipid emulsion to treat overdose of local anaesthetic: the gift of the glob. Anaesthesia. 2006 Feb;61(2):107-9. [PubMed:16430560]
- Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB: Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology. 2006 Jul;105(1):217-8. [PubMed:16810015]
- External Links
- Human Metabolome Database
- HMDB0014441
- KEGG Compound
- C07532
- PubChem Compound
- 175805
- PubChem Substance
- 46504712
- ChemSpider
- 153165
- ChEBI
- 8890
- ChEMBL
- CHEMBL1077896
- Therapeutic Targets Database
- DAP001230
- PharmGKB
- PA451271
- RxList
- RxList Drug Page
- Drugs.com
- Drugs.com Drug Page
- Wikipedia
- Ropivacaine
- ATC Codes
- N01BB09 — Ropivacaine
- AHFS Codes
- 72:00.00 — Local Anesthetics
- FDA label
- Download (274 KB)
- MSDS
- Download (57 KB)
Clinical Trials
- Clinical Trials
Pharmacoeconomics
- Manufacturers
- App pharmaceuticals llc
- Packagers
- APP Pharmaceuticals
- Astra Pharma Inc.
- AstraZeneca Inc.
- Pharmakon
- Pharmedium
- Dosage forms
Form Route Strength Injection, solution Epidural; Infiltration 2 mg/mL Liquid Parenteral 7.5 mg Injection, solution Epidural 10 mg/mL Injection, solution Epidural; Infiltration; Perineural 2 mg/mL Injection, solution Epidural; Infiltration; Perineural 5 mg/mL Injection, solution Epidural; Perineural 7.5 mg/mL Injection, solution Parenteral 10 mg/mL Injection, solution Parenteral 5 mg/mL Solution Epidural; Infiltration 2 mg Solution Epidural 10 mg Solution Epidural 7.5 mg Solution Epidural; Infiltration 5 mg - Prices
Unit description Cost Unit Ropivacaine hcl-ns 0.5% 1.84USD ml Ropivacaine hcl 0.2% on-q pump 0.99USD ml Naropin 10 mg/ml ampule 0.97USD ml Ropivacaine hcl-ns 0.3% 0.9USD ml Ropivacaine-ns 0.1% on-q pump 0.71USD ml Naropin 7.5 mg/ml ampule 0.62USD ml Naropin 5 mg/ml vial 0.58USD ml Ropivacaine hcl-ns 0.15% 0.51USD ml Ropivacaine hcl-ns 0.125% 0.48USD ml Naropin 5 mg/ml ampule 0.46USD ml Naropin 2 mg/ml ampule 0.44USD ml Ropivacaine hcl-ns 0.1% 0.39USD ml Ropivacaine hcl-ns 0.25% 0.34USD ml Ropivacaine hcl-ns 0.2% 0.29USD ml Naropin 2 mg/ml infusion btl 0.23USD ml DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.- Patents
Patent Number Pediatric Extension Approved Expires (estimated) US5670524 No 1994-05-26 2014-05-26 US US4870086 No 1993-09-24 2010-09-24 US CA2165446 No 2005-07-05 2014-05-26 Canada CA1337549 No 1995-11-14 2012-11-14 Canada US8118802 No 2003-05-18 2023-05-18 US US7857802 No 2006-11-28 2026-11-28 US US7828787 No 2005-10-18 2025-10-18 US US8162915 No 2004-05-23 2024-05-23 US
Properties
- State
- Solid
- Experimental Properties
Property Value Source water solubility 57.6 mg/L Not Available logP 2.90 HANSCH,C ET AL. (1995) pKa 8.07 Not Available - Predicted Properties
Property Value Source Water Solubility 0.253 mg/mL ALOGPS logP 2.91 ALOGPS logP 4.07 ChemAxon logS -3 ALOGPS pKa (Strongest Acidic) 13.62 ChemAxon pKa (Strongest Basic) 7.82 ChemAxon Physiological Charge 1 ChemAxon Hydrogen Acceptor Count 2 ChemAxon Hydrogen Donor Count 1 ChemAxon Polar Surface Area 32.34 Å2 ChemAxon Rotatable Bond Count 4 ChemAxon Refractivity 85.59 m3·mol-1 ChemAxon Polarizability 32.67 Å3 ChemAxon Number of Rings 2 ChemAxon Bioavailability 1 ChemAxon Rule of Five Yes ChemAxon Ghose Filter Yes ChemAxon Veber's Rule Yes ChemAxon MDDR-like Rule No ChemAxon - Predicted ADMET features
Property Value Probability Human Intestinal Absorption + 0.9705 Blood Brain Barrier + 0.9377 Caco-2 permeable + 0.5912 P-glycoprotein substrate Substrate 0.8037 P-glycoprotein inhibitor I Inhibitor 0.8768 P-glycoprotein inhibitor II Non-inhibitor 0.6339 Renal organic cation transporter Non-inhibitor 0.6611 CYP450 2C9 substrate Non-substrate 0.819 CYP450 2D6 substrate Substrate 0.8919 CYP450 3A4 substrate Substrate 0.723 CYP450 1A2 substrate Non-inhibitor 0.5499 CYP450 2C9 inhibitor Non-inhibitor 0.9246 CYP450 2D6 inhibitor Inhibitor 0.8821 CYP450 2C19 inhibitor Non-inhibitor 0.8773 CYP450 3A4 inhibitor Non-inhibitor 0.5902 CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.6116 Ames test Non AMES toxic 0.8507 Carcinogenicity Non-carcinogens 0.8763 Biodegradation Not ready biodegradable 0.9783 Rat acute toxicity 2.2964 LD50, mol/kg Not applicable hERG inhibition (predictor I) Weak inhibitor 0.8009 hERG inhibition (predictor II) Inhibitor 0.8438
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
Taxonomy
- Description
- This compound belongs to the class of organic compounds known as alpha amino acid amides. These are amide derivatives of alpha amino acids.
- Kingdom
- Organic compounds
- Super Class
- Organic acids and derivatives
- Class
- Carboxylic acids and derivatives
- Sub Class
- Amino acids, peptides, and analogues
- Direct Parent
- Alpha amino acid amides
- Alternative Parents
- Piperidinecarboxamides / Anilides / m-Xylenes / N-arylamides / Trialkylamines / Secondary carboxylic acid amides / Azacyclic compounds / Organopnictogen compounds / Organic oxides / Hydrocarbon derivatives show 1 more
- Substituents
- Alpha-amino acid amide / 2-piperidinecarboxamide / Piperidinecarboxamide / Anilide / M-xylene / Xylene / N-arylamide / Monocyclic benzene moiety / Benzenoid / Piperidine show 16 more
- Molecular Framework
- Aromatic heteromonocyclic compounds
- External Descriptors
- piperidinecarboxamide, ropivacaine (CHEBI:8890)
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 acro...
- Gene Name
- SCN10A
- Uniprot ID
- Q9Y5Y9
- Uniprot Name
- Sodium channel protein type 10 subunit alpha
- Molecular Weight
- 220623.605 Da
References
- 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]
- 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]
- Liu BG, Zhuang XL, Li ST, Xu GH: The effects of ropivacaine on sodium currents in dorsal horn neurons of neonatal rats. Anesth Analg. 2000 May;90(5):1034-8. [PubMed:10781449]
Enzymes
- 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 un...
- Gene Name
- CYP1A2
- Uniprot ID
- P05177
- Uniprot Name
- Cytochrome P450 1A2
- Molecular Weight
- 58293.76 Da
References
- Arlander E, Ekstrom G, Alm C, Carrillo JA, Bielenstein M, Bottiger Y, Bertilsson L, Gustafsson LL: Metabolism of ropivacaine in humans is mediated by CYP1A2 and to a minor extent by CYP3A4: an interaction study with fluvoxamine and ketoconazole as in vivo inhibitors. Clin Pharmacol Ther. 1998 Nov;64(5):484-91. [PubMed:9834040]
- 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]
- Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
- Kind
- Protein
- Organism
- Human
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Steroid 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 oxidizes a variety of structurally un...
- Gene Name
- CYP2B6
- Uniprot ID
- P20813
- Uniprot Name
- Cytochrome P450 2B6
- Molecular Weight
- 56277.81 Da
References
- 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
- Steroid hydroxylase activity
- Specific Function
- Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
- Gene Name
- CYP2D6
- Uniprot ID
- P10635
- Uniprot Name
- Cytochrome P450 2D6
- Molecular Weight
- 55768.94 Da
References
- 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
- 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 react...
- Gene Name
- CYP3A4
- Uniprot ID
- P08684
- Uniprot Name
- Cytochrome P450 3A4
- Molecular Weight
- 57342.67 Da
References
- 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]
Drug created on June 13, 2005 07:24 / Updated on April 25, 2018 19:54