Adult Dosing

lidocaine (generic)

Ointment

• Up to 5 g per application

Note:

• Per day dose should not exceed more should be 17-20 g of ointment or 850-1000 mg lidocaine base

Solution

• Spray 1-5 mL (40-200 mg of lidocaine HCl), i.e., 0.6-3 mg/kg or 0.3-1.5 mg/lb body weight; Max dose: <300 mg, i.e., <4.5 mg/kg or 2 mg/lb body weight

Jelly

• Male patients: Slowly instill 15 mL (300 mg of 2% jelly) into the urethra or until the patient has a feeling of tension; max: 600 mg/12 hrs
• Male catheterization: Smaller volumes of 5-10 mL (100-200 mg) of 2% jelly are usually adequate for lubrication prior to catheterization
• Female patients: Slowly instill 3-5 mL (60-100 mg of 2% jelly) into the urethra; Max: 600 mg/12 hrs

Patch

• Single application up to 3 patches, for up to 12 hrs/day; It should be applied to intact skin to cover the most painful area

LTA II Kit

Solution

• For patients undergoing laryngoscopy, bronchoscopy and endotracheal intubation, spray 1-5 mL (40-200 mg of lidocaine HCl), i.e., 0.6-3 mg/kg or 0.3-1.5 mg/lb body weight; Max dose: <300 mg, i.e., <4.5 mg/kg or 2 mg/lb body weight

Xylocaine

Solution

• For patients undergoing laryngoscopy, bronchoscopy and endotracheal intubation, spray 1-5 mL (40-200 mg of lidocaine HCl), i.e., 0.6-3 mg/kg or 0.3-1.5 mg/lb body weight; Max dose: <300 mg, i.e., <4.5 mg/kg or 2 mg/lb body weight

Jelly

• Male patients: Slowly instill 15 mL (300 mg of 2% jelly) into the urethra or until the patient has a feeling of tension; max: 600 mg/12 hrs
• Male catheterization: Smaller volumes of 5-10 mL (100-200 mg) of 2% jelly are usually adequate for lubrication prior to catheterization
• Female patients: Slowly instill 3-5 mL (60-100 mg of 2% jelly) into the urethra; Max: 600 mg/12 hrs

Lidoderm

• Single application up to 3 patches, for up to 12 hrs/day; It should be applied to intact skin to cover the most painful area

• If burning or irritation occurs during treatment, remove the patches and do not reapply until irritation subsides
• Patches may be cut into smaller sizes with scissors prior to removal of the release liner
• May wear clothing over the area of application

Laryng-O-Jet Kit

• For patients undergoing laryngoscopy, bronchoscopy and endotracheal intubation, spray 1-5 mL (40-200 mg of lidocaine HCl), i.e., 0.6-3 mg/kg or 0.3-1.5 mg/lb body weight; Max dose: <300 mg, i.e., <4.5 mg/kg or 2 mg/lb body weight

Lidamantle

• Apply a thin film to the affected area bid-tid

Pediatric Dosing

lidocaine (generic), LTA II Kit, Xylocaine, Laryng-O-Jet Kit

Children <10 yrs

• Determine the maximum dose by applying one of the standard pediatric drug formulae (e.g., Clark's rule); Max dose in any case: Not more than 4.5 mg/kg (2.0 mg/lb) of body weight

Lidoderm

• Safety and effectiveness in pediatric patients for use of lidocaine patches have not been established

Lidamantle

• Consider decreasing dose as per age, body weight and physical condition

[Outline]

• Adult Dosing
• Pediatric Dosing

lidocaine (generic)

Ointment

• For producing topical anesthetic effect on accessible mucous membranes of the oropharynx; useful as an anesthetic lubricant for intubation and for the temporary relief of pain associated with minor burns, including sunburn, abrasions of the skin, and insect bites

Solution

• For producing topical anesthetic effect on the mucous membranes of the respiratory tract

Jelly

• Prevention and control of pain in procedures involving the male and female urethra, for topical treatment of painful urethritis, and as an anesthetic lubricant for endotracheal intubation (oral and nasal)

PATCH

• For relieving pain associated with post-herpetic neuralgia

LTA II Kit

• For producing topical anesthetic effect on the mucous membranes of the respiratory tract

Xylocaine

Solution

• For producing topical anesthetic effect on accessible mucus membranes of the oral and nasals cavities and proximal portions of the digestive tract

Jelly

• For preventing and controlling pain in procedures involving the male and female urethra, for topical treatment of painful urethritis, and as an anesthetic lubricant for endotracheal intubation (oral and nasal)

Lidoderm

• For relieving pain associated with post-herpetic neuralgia

Laryng-O-Jet Kit

• For producing topical anesthetic effect on the mucous membranes of the respiratory tract

Lidamantle

• For treatment of pruritus, pruritic eczemas, abrasions, minor burns, insect bites, pain, soreness and discomfort because of pruritus ani, pruritus vulvae, hemorrhoids, anal fissures, and associated conditions of the mucous membranes and skin

• Hypersensitivity to any of the ingredients of the product
• History of hypersensitivity to local anesthetics of the amide type
• Broken or inflamed skin
• Traumatized mucosa
• Local infection at treatment site

• N/A

Renal dose adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; use with caution

See Supplemental Patient Information

• Lidocaine should be administered by clinicians who are well trained in diagnosis and management of dose-related toxicity and other acute emergencies that might arise during use
• Excessive or repeated doses and short intervals between doses may cause increased absorption leading to high blood concentrations, which may cause serious adverse events; resuscitative equipment, oxygen and other resuscitative drugs may be required to manage such events
• Repeated applications of lidocaine patches, longer duration of application, smaller patients or impaired elimination may all contribute to increased blood concentration of the drug
• Administer lower doses in children, debilitated, elderly and acutely ill patients
• Exercise caution in patients with a history of drug sensitivities, particularly if the etiologic agent is uncertain
• Do not apply on broken or inflamed skin, as this may result in higher blood concentrations; do not use in large quantities, especially over raw surfaces or blistered areas
• Do not use external heat sources such as heating pads or electric blankets over lidocaine patches
• When used for endotracheal tube lubrication, exercise caution not to allow lidocaine products into the inner lumen, as it may dry on the inner surface leaving a residue that may cause the lumen to occlude
• Use lidocaine topical solution with caution in patients with impaired cardiovascular function since they may be less able to compensate for functional changes associated with the prolongation of A-V conduction resulting from this drug
• Advice patients to avoid contact with eyes; if eye contact occurs, instruct patients to immediately wash their eyes with water or saline and protect the eye until sensation returns. If necessary, advise them to consult an ophthalmologist
• Discontinue use and institute appropriate medical therapy if irritation or sensitivity occurs or if infection appears with the use of lidocaine cream
• Familial malignant hyperthermia has been reported with many drugs used during the conduct of anesthesia. Early unexplained signs of tachycardia, tachypnea, labile blood pressure, and metabolic acidosis may precede temperature elevation
• Keep out of reach of children and pets because of the potential for serious adverse reactions

Cautions: Use cautiously in

• Hepatic impairment
• Sepsis
• Severely traumatized mucosa
• Severe shock
• Patients with heart block
• Class I antiarrhythmic drugs

Supplemental Patient Information

• Advise patients to avoid ingestion of food for 60 minutes following use of local anesthetic preparations in the mouth or throat area
• Advise patients to avoid eating food and chewing gum while the mouth or throat area is anesthetized
• Instruct patients to strictly adhere to the recommended dosage and administration guidelines
• Inform patients to discontinue use and contact their physicians if the condition worsens or does not improve within 7 days

Pregnancy Category:B

Breastfeeding: Concentrations of topical lidocaine are very low in breast milk and is poorly absorbed by the infant. No special precautions are required as it is not expected to cause any adverse effects in breastfed infants. This information is based on LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 April 2011). It is unknown whether lidocaine is excreted in human milk. As per manufacturer's data, caution should be exercised if administered during breastfeeding.

• CNS: Lightheadedness, confusion, dizziness, drowsiness, unconsciousness, convulsions, twitching, tremors, sensations of heat, cold or numbness
• PSYCHIATRY: Euphoria, nervousness, apprehension
• CV: Bradycardia, hypotension, cardiovascular collapse, cardiac arrest, arrhythmias
• RESP: Respiratory depression and arrest
• GI: Vomiting, nausea
• EENT: Blurred or double vision, tinnitus
• HYPERSENSITIVITY: Cutaneous lesions, urticaria, edema, anaphylactoid reactions, anaphylaxis
• LOCAL: Blisters, bruising, burning sensation, depigmentation, dermatitis, discoloration, edema, erythema, exfoliation, irritation, papules, petechia, pruritus, vesicles, abnormal sensation (lidocaine patch)
• MISC: Malignant hyperthermia, coma

• Local anesthetic; stabilizes the neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses
• Metabolism: Unknown
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Laryng-O-Jet Kit
• LTA II Kit
• Lidoderm
• Xylocaine
• Lidamantle

US Availability

lidocaine (generic)

• OINT: 5%
• SOLN: 4%
• JELLY: 2%
• PATCH: 5%

Laryng-O-Jet Kit

• SOLN: 4%

LTA II Kit

• SOLN: 4%

Lidoderm

• PATCH: 5%

Xylocaine

• JELLY: 2%
• SOLN: 4%

Lidamantle

• CRE: 3%
• LOTN: 3%

Canadian Trade Name(s)

• After sun soothing spray
• Afterburn
• Band-Aid brand antiseptic wash
• Betacaine
• Bikini Zone
• Burn cream
• Caribbean Breeze Burn Relief
• Xylocaine
• Lidodan endotracheal non-aerosol spray
• Lidodan
• Lidomax 5
• Maxilene 4
• Maxilene 5
• Preattached LTA kit
• Safetec burn gel
• Safetec burn spray
• Safetec sting relief
• Smartshield after sun
• Solarcaine medicated first aid lotion
• Stallion
• Stud 100
• Water-Jel Burn Jel
• Xylocaine
• Topicaine 5

Canadian Availability

lidocaine (generic)

• OTC SOLN: 1%
• OTC SOLN: 2%
• OTC GEL: 0.72%
• OTC GEL: 0.5%
• OTC SPRAY: 0.5%

After sun soothing spray

• OTC LIQ SPRAY: 0.5%

Afterburn

• OTC GEL: 0.5%

Band-Aid brand antiseptic wash

• OTC LIQ: 2%

Betacaine

• OTC GEL: 5%

Bikini Zone

• OTC CRE: 2%

Burn cream

• OTC CRE: 2.25%

Caribbean Breeze Burn Relief

• OTC GEL: 1%

Lidodan endotracheal non-aerosol spray

• OTC LIQ: 10 mg/ACT

Lidodan

• JELLY: 2%
• OTC LIQ: 2%
• OINT: 5%

Lidomax 5

• OTC CRE: 5%

Maxilene 4

• OTC CRE: 4%

Maxilene 5

• OTC CRE: 5%

Preattached LTA kit

• SOLN: 40 mg/mL

Safetec burn gel

• OTC GEL: 2%

Safetec burn spray

• OTC SPRAY: 2%

Safetec sting relief

• OTC SOLN: 2%

Smartshield after sun

• OTC GEL: 1%

Solarcaine medicated first aid lotion

• OTC LOTN: 0.5%

Stallion

• OTC metered topical SPRAY: 9.6%

Stud 100

• OTC Aerosol: 9.6%

Water-Jel Burn Jel

• OTC GEL: 2%

Xylocaine

• OINT: 5%
• SPRAY: 4%
• LIQ: 2%
• JELLY: 2%

Topicaine 5

• OTC GEL: 5%

UK Trade Name(s)

• Boots Premjact Desensitizing Spray for Men 9.6% w/w cutaneous spray
• Boots Pharmacy Anaesthetic Throat Spray
• LMX-4
• Versatis
• Xylocaine
• Dequaspray

UK Availability

lidocaine (generic)

• SOLN: 4%

Boots Premjact Desensitizing Spray for Men 9.6% w/w cutaneous spray

• SPRAY: 9.6%

Boots Pharmacy Anaesthetic Throat Spray

• SPRAY: 2%

LMX-4

• CRE: 4%

Versatis

• Medicated Plasters: 5%

Xylocaine

• SPRAY: 10 mg/dose

Dequaspray

• SPRAY: 2%

Australian Trade Name(s)

• Seda lotion
• Stud 100 Desensitizing Spray for Men
• Xylocaine
• Ziagel

Australian Availability

lignocaine (generic)

• GEL: 2%

Seda lotion

• LOTN: 2.5%

Stud 100 Desensitizing Spray for Men

• Aerosol: 9.6%

Xylocaine

• SOLN: 4%
• SPRAY: 10%
• OINT: 5%
• OINT: 10%
• ORAL LIQ (viscous): 2%
• JELLY: 2%

Ziagel

• GEL: 5%

[Outline]

Anesthesia

Local Anesthetics; Topical

Amide-type Local Anesthetics

Analgesics

Local Anesthetics; Topical

Amide-type Local Anesthetics

Pricing data from www.DrugStore.com in U.S.A.

• LidaMantle 3 % LOTN [Bottle] (PHARMADERM)
  177 % = $241.99
  531 % = $655.98
• Lidoderm 5 % PTCH [Box] (ENDO PHARMACEUTICALS)
  30 % = $230
  90 % = $648.98
• Lidocaine HCl 2 % GEL [Tube] (AKORN)
  30 % = $19.99
  90 % = $49.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.