Lidocaine (lignocaine) Hydrochloride 2%, 10%

Lidocaine (lignocaine) Hydrochloride 2%, 10% is used for: Hemorrhoids, Itching, Perianal pain and itching, Postherpetic Neuralgia, Surface anaesthesia, Burning and pain and skin inflammations, Anorectal disorders, Anesthetic Lubricant for Intubation

Topical as Gel/Jelly Mouth/Throat Surface anaesthesia Adult: As 2% soln (Gel): For pain: 300 mg rinsed and ejected for mouth and throat pain; or gargled and swallowed if necessary for pharyngeal pain. Not to be used more frequently than every 3 hr. Max (topical oral soln): 2.4 g/day. Anesthetic Lubricant for Intubation Indicated as an anesthetic lubricant for oral or nasal endotracheal intubation Gel (2%): Apply moderate amount to external surface of endotracheal tube shortly before use Not to exceed 600 mg/12 hr Urethral Surface Anesthesia When using Xylocaine 2% Jelly 30 mL tubes for urologic procedures, sterilize the plastic cone for 5 minutes in boiling water, cool, and attach to the tube Females Instill 2-5 mL jelly (60-100 mg) into urethra Some jelly may also be deposited on a cotton swab and introduced into urethra Allow several minutes following instillation prior to performing urological procedure Males Slowly instill 15 mL (300 mg lidocaine) into urethra or until patient experiences tension Apply a penile clamp for several minutes at the corona An additional dose of not more than 15 mL (300 mg) can be instilled for adequate anesthesia Prior to sounding or cystoscopy, a penile clamp should be applied for 5-10 minutes to obtain adequate anesthesia A total dose of 30 mL (600 mg) is usually required to fill and dilate the male urethra Prior to catheterization, smaller volumes of 5-10 mL (100-200 mg) are usually adequate for lubrication Skin Irritation Indicated for temporary relief of pain and itching caused by minor skin irritations (eg, sunburn, minor burns, minor cuts, scrapes, insect bites, minor skin irritations) Apply topically to affected area TID/QID Rectal as gel/jelly Haemorrhoids; Perianal pain and itching Adult: Apply topically or using applicator insert rectally, up to 6 times daily. Topical as Spray For dentistry and otorhinolaryngology procedures: As 10% soln (Spray): 10-50 mg sprayed to mucous membrane. Premature Ejaculation Temporarily reduces sensitivity of the penis, which helps to delay ejaculation Apply 3 or more sprays (10 mg/spray), not to exceed 10 sprays, to the head and shaft of the penis before intercourse

Topical as Gel/Jelly Anesthetic Lubricant for Intubation Indicated as an anesthetic lubricant for oral or nasal endotracheal intubation Jelly (2%): Apply moderate amount to external surface of endotracheal tube shortly before use Children aged <10 years: Not to exceed 4.5 mg/kg per 12 hr Older children/adolescents: Not to exceed 600 mg/12 hr Skin Irritation Indicated for temporary relief of pain and itching caused by minor skin irritations (eg, sunburn, minor burns, minor cuts, scrapes, insect bites, minor skin irritations) <2 years: Safety and efficacy not established >2 years: Apply topically to affected area TID/QID Rectal as gel/jelly Haemorrhoids; Perianal pain and itching Child: >12 yr Apply topically or using applicator insert rectally, up to 6 times daily.

Hypovolaemia; heart block or other conduction disturbances.

Hepatic or renal impairment; CHF and following cardiac surgery; bradycardia; respiratory depression; porphyria; elderly or debilitated patients; pregnancy. Lactation: Distributed in human breast milk; caution advised

Pregnancy There are no available data regarding use in pregnant women Reproduction studies with lidocaine have been performed in rats at doses up to 30 mg/kg SC and have revealed no evidence of harm to the fetus due to lidocaine There are, however, no adequate and well-controlled studies in pregnant women Because animal reproduction studies are not always predictive of human response, should be used during pregnancy only if clearly needed Lactation There are no available data regarding use in breastfeeding women; caution if administered Lidocaine is excreted in human milk, and the milk: plasma ratio of lidocaine is 0.4

May increase serum levels w/ cimetidine and propranolol. Increased risk of cardiac depression w/ beta-blockers and other antiarrhythmics. Additive cardiac effects w/ IV phenytoin. Hypokalaemia caused by acetazolamide, loop diuretics and thiazides may antagonise effect of lidocaine. Dose requirements may be increased w/ long-term use of phenytoin and other enzyme-inducers.

Side effects of Lidocaine (lignocaine) Hydrochloride 2%, 10% : Application site reactions Abnormal sensation, Pallor or blanching when the application time is very prolonged (>2 hr), Alterations in temperature sensations, Edema, Itching, Rash Systemic reactions Unlikely due to the small dose absorbed; may occur with repeated doses or application to large surface area CNS excitation and/or depression Light-headedness, nervousness, apprehension, euphoria, confusion Dizziness, Drowsiness, Tinnitus, Blurred or double vision, Vomiting, Sensations of heat, cold or numbness, Twitching, tremors, convulsions.Unconsciousness, respiratory depression, and arrest.Cardiovascular manifestations (eg, bradycardia, hypotension, and cardiovascular collapse leading to arrest) Potentially Fatal: Hypotension and bradycardia leading to cardiac arrest; anaphylaxis.

Lidocaine is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.