Lidocaine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Arrhythmias

Initial dose: 1 to 1.5 mg/kg/dose intravenously (IV) given over 2 to 3 minutes.
May repeat with 0.5 to 0.75 mg/kg/dose IV given over 2 to 3 minutes in 5 to 10 minutes until a total of 3 mg/kg.
Continuous IV infusion: 1 to 4 mg/min.

Prehospital post-myocardial infarction (MI) antiarrhythmic prophylaxis: 300 mg intramusculary once.

May be administered endotracheally (loading dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose. Dilute in 10 mL NS or distilled water.

Usual Adult Dose for Ventricular Fibrillation

Ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (after defibrillation and epinephrine or vasopressin):
Initial dose: 1 to 1.5 mg/kg/dose intravenously (IV).
May repeat 0.5 to 0.75 mg/kg/dose at 5 to 10 minute intervals; maximum total dose: 3 mg/kg.
Follow with continuous IV infusion after return of perfusion; continuous IV infusion: 1 to 4 mg/minute.
Note: Use only bolus doses for cardiac arrest caused by VF or pulseless VT.

May be administered endotracheally (loading dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose. Dilute in 10 mL NS or distilled water.

Prevention of ventricular fibrillation: IV bolus: 0.5 mg/kg/dose; repeat every 5 to 10 minutes to a total dose of 2 mg/kg.

Usual Adult Dose for Ventricular Tachycardia

Ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (after defibrillation and epinephrine or vasopressin):
Initial dose: 1 to 1.5 mg/kg/dose intravenously (IV).
May repeat 0.5 to 0.75 mg/kg/dose at 5 to 10 minute intervals; maximum total dose: 3 mg/kg.
Follow with continuous IV infusion after return of perfusion; continuous IV infusion: 1 to 4 mg/minute.
Note: Use only bolus doses for cardiac arrest caused by VF or pulseless VT.

May be administered endotracheally (loading dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose. Dilute in 10 mL NS or distilled water.

Prevention of ventricular fibrillation: IV bolus: 0.5 mg/kg/dose; repeat every 5 to 10 minutes to a total dose of 2 mg/kg.

Usual Adult Dose for Anesthesia

Anesthesia, local injectable: Dose varies with procedure, degree of anesthesia needed, vascularity of tissue, duration of anesthesia required, and physical condition of patient; maximum dose: 4.5 mg/kg/dose; do not repeat within 2 hours.

Usual Pediatric Dose for Ventricular Fibrillation

For use in pulseless VT or VF; give after defibrillation and epinephrine:

Loading dose: 1 mg/kg (maximum: 100 mg/dose) intravenously; may administer second bolus of 0.5 to 1 mg/kg if delay between bolus and start of infusion is more than 15 minutes.
Follow with continuous intravenous infusion: 20 to 50 mcg/kg/minute.

Continuous infusion: 20 to 50 mcg/kg/minute: Use 20 mcg/kg/minute in patients with shock, hepatic disease, cardiac arrest, or mild CHF. Moderate-to-severe CHF may require one-half the loading dose and lower infusion rates to avoid toxicity.

Endotracheal tube (if IV access unavailable - loading dose only): 2 to 3 mg/kg; flush with 5 mL of NS and follow with 5 assisted manual ventilations.

Usual Pediatric Dose for Ventricular Tachycardia

For use in pulseless VT or VF; give after defibrillation and epinephrine:

Loading dose: 1 mg/kg (maximum: 100 mg/dose) intravenously; may administer second bolus of 0.5 to 1 mg/kg if delay between bolus and start of infusion is more than 15 minutes.
Follow with continuous intravenous infusion: 20 to 50 mcg/kg/minute.

Continuous infusion: 20 to 50 mcg/kg/minute: Use 20 mcg/kg/minute in patients with shock, hepatic disease, cardiac arrest, or mild CHF. Moderate-to-severe CHF may require one-half the loading dose and lower infusion rates to avoid toxicity.

Endotracheal tube (if IV access unavailable - loading dose only): 2 to 3 mg/kg; flush with 5 mL of NS and follow with 5 assisted manual ventilations.

Usual Pediatric Dose for Anesthesia

Anesthesia, local injectable: Dose varies with procedure, degree of anesthesia needed, vascularity of tissue, duration of anesthesia required, and physical condition of patient; maximum dose: 4.5 mg/kg/dose; do not repeat within 2 hours.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Adults: Reduce dose in acute hepatitis and decompensated cirrhosis by 50%.

Pediatrics: Use continuous infusion dose of 20 mcg/kg/minute in hepatic disease.

Dose Adjustments

Adults: Decrease dose in patients with shock or hepatic disease.
Patients with impaired cardiac function: Initial bolus: 0.5 to 0.75 mg/kg/dose IVP; may repeat every 5 to 10 minutes; follow with continuous infusion: Initial: 1 to 4 mg/minute; maximum total dose: 3 mg/kg (administered over 1 hour).

Pediatrics: use continuous infusion of 20 mcg/kg/minute in patients with shock, hepatic disease, cardiac arrest, mild CHF; moderate-to-severe CHF may require 1/2 loading dose and lower infusion rates to avoid toxicity.

Dialysis

Not dialyzable (0% to 5%) by hemo- or peritoneal dialysis. A supplemental dose is not necessary.

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