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Lidocaine is extensively metabolized in the liver, so drugs that decrease hepatic blood flow (e.g., propranolol) or inhibit CYP1A2/CYP3A4 (e.g., fluvoxamine, ketoconazole, clarithromycin) may elevate systemic concentrations and increase the risk of central nervous system or cardiovascular toxicity

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For example, RIN can regulate immune response and neurotrophic factor signaling pathways, such as brain-derived neurotrophin associated with neuronal survival and inflammatory factor IL-1β (Shao et al., 2016)