Lidocaine Topical Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Anesthesia

Lidocaine 2% jelly:
Cystoscopy: Instill 30 to 40 mL in 3 to 4 portions and allow to act for 10 to 12 minutes before procedure.
Endoscopy: Instill 10 to 20 mL and apply small amount to instrument.
Endotracheal intubation: Apply small amount (approximately 2 mL) to the external surface of the endotracheal tube before insertion. Do not introduce jelly into tube lumen.
Surface urethral anesthesia before procedures:
Male: 20 mL instilled slowly in 2 portions: Instill approximately 10 mL slowly until the patient feels tension, apply a penile clamp for several minutes, then instill remaining jelly.
Female: 5 to 10 mL instilled slowly to fill entire urethra. A small amount may be applied to the orifice.
Anterior male urethral anesthesia before catheterization: 5 to 10 mL instilled slowly.

Lidocaine 2% viscous solution:
Topical anesthesia before inserting catheters or instruments into upper respiratory or GI tracts:
Topical pharyngeal analgesia: Gargle 5 to 15 mL and spit out or swallow.

Lidocaine 4% solution:
Topical anesthesia of oropharyngeal, nasal, tracheal, and bronchial areas during endotracheal intubation and endoscopic procedures: Spray 2 to 7.5 mL to the desired area. May also be applied with cotton applicators or by instillation. Use 5 to 10 mL if inhaled via nebulizer.
Maximum Dose: 5 mL if applied to larynx, trachea, and bronchi.

Lidocaine dental patch transoral delivery system:
Topical anesthesia of oral mucous membranes before superficial dental procedures: Isolate and dry tissue in the procedure area. Remove clear liner and apply the patch using firm pressure. Leave in place until desired anesthetic effect for up to a maximum of 15 minutes.

Usual Adult Dose for Gastrointestinal Tract Examination

Lidocaine 2% jelly:
Cystoscopy: Instill 30 to 40 mL in 3 to 4 portions and allow to act for 10 to 12 minutes before procedure.
Endoscopy: Instill 10 to 20 mL and apply small amount to instrument.
Endotracheal intubation: Apply small amount (approximately 2 mL) to the external surface of the endotracheal tube before insertion. Do not introduce jelly into tube lumen.
Surface urethral anesthesia before procedures:
Male: 20 mL instilled slowly in 2 portions: Instill approximately 10 mL slowly until the patient feels tension, apply a penile clamp for several minutes, then instill remaining jelly.
Female: 5 to 10 mL instilled slowly to fill entire urethra. A small amount may be applied to the orifice.
Anterior male urethral anesthesia before catheterization: 5 to 10 mL instilled slowly.

Lidocaine 2% viscous solution:
Topical anesthesia before inserting catheters or instruments into upper respiratory or GI tracts:
Topical pharyngeal analgesia: Gargle 5 to 15 mL and spit out or swallow.

Lidocaine 4% solution:
Topical anesthesia of oropharyngeal, nasal, tracheal, and bronchial areas during endotracheal intubation and endoscopic procedures: Spray 2 to 7.5 mL to the desired area. May also be applied with cotton applicators or by instillation. Use 5 to 10 mL if inhaled via nebulizer.
Maximum Dose: 5 mL if applied to larynx, trachea, and bronchi.

Lidocaine dental patch transoral delivery system:
Topical anesthesia of oral mucous membranes before superficial dental procedures: Isolate and dry tissue in the procedure area. Remove clear liner and apply the patch using firm pressure. Leave in place until desired anesthetic effect for up to a maximum of 15 minutes.

Usual Adult Dose for Pain

Lidocaine 0.5% or 2%: Apply thin film to affected area up to 3 to 4 times daily as needed.
Lidocaine 3% gel: Apply thin film to affected area 2 to 3 times daily as needed not to exceed 12 pumps in 24 hours.

Lidocaine 2% viscous solution:
Topical anesthesia of irritated/inflamed oral mucous membranes: Swish 5 to 15 mL in the mouth until pain relief occurs and spit out.
Maximum Dose: Every 3 hours or 8 doses per 24 hours.

Lidocaine 2.5% liquid: Apply small amount to affected area 1 to 3 times daily. Do not use for more than 1 week unless directed by physician.

Lidocaine 4% cream: Apply thin film to affected area 3 to 4 times daily as needed. Do not use for more than 1 week unless directed by physician.

Lidocaine 5% patch:
Pain associated with herpetic neuralgia: Apply up to 3 patches for up to 12 hours within a 24 hour period to cover the most painful area(s). Apply only to intact skin. Remove if irritation/burning occurs and do not reapply until it subsides.

Usual Adult Dose for Pruritus

Lidocaine 0.5% or 2%: Apply thin film to affected area up to 3 to 4 times daily as needed.
Lidocaine 3% gel: Apply thin film to affected area 2 to 3 times daily as needed not to exceed 12 pumps in 24 hours.

Lidocaine 2% viscous solution:
Topical anesthesia of irritated/inflamed oral mucous membranes: Swish 5 to 15 mL in the mouth until pain relief occurs and spit out.
Maximum Dose: Every 3 hours or 8 doses per 24 hours.

Lidocaine 2.5% liquid: Apply small amount to affected area 1 to 3 times daily. Do not use for more than 1 week unless directed by physician.

Lidocaine 4% cream: Apply thin film to affected area 3 to 4 times daily as needed. Do not use for more than 1 week unless directed by physician.

Lidocaine 5% patch:
Pain associated with herpetic neuralgia: Apply up to 3 patches for up to 12 hours within a 24 hour period to cover the most painful area(s). Apply only to intact skin. Remove if irritation/burning occurs and do not reapply until it subsides.

Usual Adult Dose for Burns - External

Lidocaine 0.5% or 2%: Apply thin film to affected area up to 3 to 4 times daily as needed.
Lidocaine 3% gel: Apply thin film to affected area 2 to 3 times daily as needed not to exceed 12 pumps in 24 hours.

Lidocaine 2% viscous solution:
Topical anesthesia of irritated/inflamed oral mucous membranes: Swish 5 to 15 mL in the mouth until pain relief occurs and spit out.
Maximum Dose: Every 3 hours or 8 doses per 24 hours.

Lidocaine 2.5% liquid: Apply small amount to affected area 1 to 3 times daily. Do not use for more than 1 week unless directed by physician.

Lidocaine 4% cream: Apply thin film to affected area 3 to 4 times daily as needed. Do not use for more than 1 week unless directed by physician.

Lidocaine 5% patch:
Pain associated with herpetic neuralgia: Apply up to 3 patches for up to 12 hours within a 24 hour period to cover the most painful area(s). Apply only to intact skin. Remove if irritation/burning occurs and do not reapply until it subsides.

Usual Adult Dose for Hemorrhoids

Lidocaine 3%, 4%, 5% lotion or cream: Apply thin film to affected area 2 to 3 times daily as needed.

Lidocaine 3% gel: Apply thin film to affected area 2 to 3 times daily as needed not to exceed 12 pumps in 24 hours.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Patients with severe hepatic insufficiency may develop toxic levels due to their inability to metabolize lidocaine.

Precautions

If other lidocaine products are used, the total dose from all formulations should be considered.

Elderly, children, or debilitated patients may be more sensitive to systemic effects of lidocaine and should be given reduced doses.

Caution should be used when administering to patients with severe shock or heart block.

Lidocaine should be discontinued for at least 3 days before administering a bentiromide pancreatic function test as it will interfere with the results.

Dialysis

Data not available

Other Comments

Lidocaine 0.5% powder for injection system should only be used on intact skin. Lidocaine 0.5% powder for injection system should not be used around the eyes, on body orifices, mucous membranes, or on areas with a compromised skin barrier.

Application of one additional lidocaine 0.5% powder for injection system at a new location is acceptable after a failed attempt at venous access. Multiple administrations at the same location are not recommended.

One pump of lidocaine 3% gel pump covers an area of 2 X 2 inches. Larger areas will require additional applications or the advice of a physician.

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