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Bupivacaine should be used with caution in patients receiving other local anaesthetics or agents structurally similar to local anaesthetics, i.e. class IB anti-arrhythmic drugs, as the systemic toxic effects are additive.
Specific interaction studies with bupivacaine and anti-arrhythmic drugs class III (e.g., amiodarone) have not been performed, but caution should be advised (see also Precautions).
