LYE-doe-kane
High Alert
Local
Local
Absorption: IV administration results in complete bioavailability; some absorption follows local use.
Distribution: Widely distributed. Concentrates in adipose tissue. Crosses the blood-brain barrier.
Half-Life: Biphasic—initial phase, 7–30 min; terminal phase, 90–120 min; ↑ in HF and hepatic impairment.
(IV = antiarrhythmic effects; local = anesthetic effects)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| IV | immediate | immediate | 10–20 min (up to several hr after continuous infusion) |
| Local | rapid | unknown | 1–3 hr |
Contraindicated in:
Use Cautiously in:
CV: arrhythmias, bradycardia, CARDIAC ARREST, heart block, hypotension
EENT:
mucosal use
↓or absent gag reflexHemat: methemoglobinemia
Local: stinging, burning, contact dermatitis, erythema
MS: chondrolysis
Neuro: confusion, drowsiness, agitation, blurred vision, dizziness, paresthesia, SEIZURES, slurred speech, tremor
Resp: bronchospasm
Drug-drug:
Ventricular Tachycardia (with a Pulse) or Pulseless Ventricular Tachycardia/Ventricular Fibrillation
Endotracheal
(Adults ): Give 2–2.5 times the IV loading dose down the endotracheal tube, followed by a 10 mL saline flush.Endotracheal
(Children ): Give 2–3 mg/kg down the endotracheal tube followed by a 5 mL saline flush.Local
Infiltration
(Adults and Children ): Infiltrate affected area as needed (increased amount and frequency of use increases likelihood of systemic absorption and adverse reactions).Mucosal
(Adults ): For anesthetizing oral surfaces: 20 mg as 2 sprays/quadrant (not to exceed 30 mg/quadrant) may be used. 15 mL of the viscous solution may be used every 3 hr for oral or pharyngeal pain. For anesthetizing the female urethra: 3–5 mL of the jelly or 20 mg as 2% solution may be used. For anesthetizing the male urethra: 5–10 mL of the jelly or 5–15 mL of 2% solution may be used before catheterization or 30 mL of jelly before cystoscopy or similar procedures. Topical solutions may be used to anesthetize mucous membranes of the larynx, trachea, or esophagus.Mucosal
(Children ≥3 yr): Do not exceed 4.5 mg/kg/dose (or 300 mg/dose) of viscous solution; swish in the mouth and spit out no more frequently than every 3 hr (maximum: 4 doses per 12-hr period).Mucosal
(Children <3 yr): ≤1.2 mL applied to area with a cotton-tipped applicator no more frequently than every 3 hr (maximum: 4 doses per 12-hr period); use only if the underlying condition requires treatment with product volume of ≤1.2 mL.Lab Test Considerations:
Toxicity and Overdose:
Lidocaine is readily absorbed through mucous membranes. Inadvertent overdose of lidocaine jelly and spray has resulted in patient harm or death from neurologic and/or cardiac toxicity. Do not exceed recommended doses.
IV Administration:
lidocaine (parenteral): Xylocaine,
lidocaine (local anesthetic): Xylocaine,
lidocaine (mucosal): Xylocaine Viscous,
lidocaine (topical): Glydo, Lidoderm, L-M-X 4, L-M-X 5, Xylocaine, ZTLido
lidocaine (parenteral): Xylocard,
lidocaine (mucosal): Jampocaine Viscous,
lidocaine (topical): Betacaine, Cathejell, Lidodan, Lyracaine, Maxilene, Stallion, Topicaine
NDC Code