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lidocaine topical

Pronunciation

Generic Name: lidocaine topical (LYE doe kane TOP i kal)
Brand Name: AneCream, AneCream with Tegaderm, Bactine, LidaMantle, Lidocream, Lidoderm, LidoRx, LMX 4, LMX 4 with Tegaderm, LMX 5, Medi-Quik Spray, RectiCare, Regenecare HA Spray, Solarcaine Aloe Extra Burn Relief, Solarcaine Cool Aloe, Xylocaine Jelly, Xylocaine Topical

What is lidocaine topical?

Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine topical (for use on the skin) is used to reduce pain or discomfort caused by skin irritations such as sunburn, insect bites, poison ivy, poison oak, poison sumac, and minor cuts, scratches, hemorrhoids, and burns.

Lidocaine topical may also be used for purposes not listed in this medication guide.

What is the most important information I should know about lidocaine topical?

An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

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Always get your pet's drug and dose recommendation from the veterinarian.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Keep both used and unused lidocaine skin patches out of the reach of children or pets. The amount of lidocaine in the skin patches could be harmful to a child or pet who accidentally sucks on or swallows the patch. Seek emergency medical attention if this happens.

What should I discuss with my healthcare provider before using lidocaine topical?

An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood.

Overdose is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

You should not use lidocaine topical if you are allergic to any other type of numbing medicine.

To make sure you can safely use lidocaine topical, tell your doctor if you have any of these other conditions:

  • liver disease; or

  • broken, swollen, or damaged skin.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Lidocaine topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use lidocaine topical?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Lidocaine topical comes in many different forms for different uses. Lidocaine topical cream, lotion, spray, solution, film, and transdermal patch are generally for use on the skin only.

If your medication comes with patient instructions for safe and effective use, follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Lidocaine topical may be applied with your finger tips or a cotton swab. Follow your doctor's instructions.

Do not apply this medication to swollen skin areas or deep puncture wounds. Avoid using the medicine on skin that is raw or blistered, such as a severe burn or abrasion.

Store at room temperature away from moisture and heat.

Keep both used and unused lidocaine topical patches out of the reach of children or pets. The amount of lidocaine in the skin patches could be harmful to a child or pet who accidentally sucks on or swallows the patch. Seek emergency medical attention if this happens.

What happens if I miss a dose?

Since lidocaine is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Lidocaine topical applied to the skin is not likely to cause an overdose unless you apply more than the recommended dose. Overdose may also occur if you apply heat, bandages, or plastic wrap to treated skin areas.

Improper use of lidocaine topical may result in death.

Overdose symptoms may include drowsiness, confusion, nervousness, ringing in your ears, blurred vision, feeling hot or cold, numbness, muscle twitches, uneven heartbeats, seizure (convulsions), slowed breathing, or respiratory failure (breathing stops).

What should I avoid while using lidocaine topical?

Do not allow this medication to come into contact with your eyes. If it does, rinse with water. Avoid touching the sticky side of a lidocaine skin patch while applying it.

Avoid using other topical medications on the affected area unless your doctor has told you to.

Lidocaine topical side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using lidocaine topical and call your doctor at once if you have any of these serious side effects:

  • uneven heartbeats;

  • drowsiness, confusion;

  • tremors, seizure (convulsions); or

  • blurred vision.

Less serious side effects include:

  • mild irritation, redness, or swelling where the medication is applied; or

  • numbness in places where the medicine is accidentally applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Lidocaine topical dosing 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 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.

Usual Pediatric Dose for Burns - External:

Lidocaine 2% spray:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 2.5% liquid:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 4% cream:
Greater than or equal to 2 years: Apply topically to affected area 1 to 4 times daily.

Lidocaine 3% gel: The maximum amount administered should not exceed 4.3 mg/kg of body weight.

Usual Pediatric Dose for Pain:

Lidocaine 2% spray:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 0.5% gel:
Greater than or equal to 2 years: Apply to affected area up to 3 to 4 times daily as needed.

Lidocaine 2.5% liquid:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 4% cream:
Greater than or equal to 2 years: Apply topically to affected area 1 to 4 times daily.

Lidocaine 0.5% powder injection system:
Ages 3 to 18 years: Apply one 0.5 mg lidocaine topical to the site of intact skin planned for venipuncture or peripheral intravenous cannulation, 1 to 3 minutes prior to needle insertion. Perform procedure within 10 minutes after administration.

Transdermal patch: Postherpetic neuralgia: Apply patch to most painful areas, Up to 3 patches may be applied per application. Patch may remain in place up to 12 hours in any 24 hour period.

L-M-X (R) 4: Circumcision: Full-term neonates: Apply to foreskin and penis and occlude with plastic wrap for 20 minutes prior to procedure.

Gel, ointment: Children greater than or equal to 2 years: Apply to affected area less than or equal to 4 times per day as needed (maximum dose: 4 to 5
mg/kg, not to exceed 300 mg)

Jelly: Children: Dose varies with age and weight; maximum dose: 4.5 mg/kg

Anesthesia of urethra: Male: 5 to 30 mL (100 to 600 mg); Female: 3 to 5 mL (60 to 100 mg)

Lubrication of endotracheal tube: Apply a moderate amount to external surface only.

Oral solution (viscous):
Infants and Children less than 3 years: 1.25 mL applied to area with a cotton tipped applicator no more frequently than every 3 hours (maximum: 4 doses per 12 hour period).
Children greater than or equal to 3 years: Should not exceed 4.5 mg/kg/dose (or 300 mg/dose); swished in the mouth and spit out no more frequently than every 3 hours.

Lidocaine 3% gel: The maximum amount administered should not exceed 4.3 mg/kg of body weight.

Usual Pediatric Dose for Hemorrhoids:

Lidocaine 3% cream or lotion:
Apply topically amount commensurate with age, body weight and physical condition to affected area as directed by physician.

Lidocaine 3% gel: The maximum amount administered should not exceed 4.3 mg/kg of body weight.

Usual Pediatric Dose for Pruritus:

Lidocaine 2% spray:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 2.5% liquid:
Greater than or equal to 2 years: Apply topically to affected area 1 to 3 times daily.

Lidocaine 4% cream:
Greater than or equal to 2 years: Apply topically to affected area 1 to 4 times daily.

Lidocaine 3% cream or lotion:
Apply topically amount commensurate with age, body weight and physical condition to affected area as directed by physician.

Lidocaine 3% gel: The maximum amount administered should not exceed 4.3 mg/kg of body weight.

What other drugs will affect lidocaine topical?

Tell your doctor about all other medicines you use, especially:

  • quinidine (Quin-G);

  • disopyramide (Norpace);

  • flecainide (Tambocor);

  • mexiletine (Mexitil);

  • procainamide (Procan, Pronestyl);

  • tocainide (Tonocard); or

  • propafenone (Rythmol).

This list is not complete and other drugs may interact with lidocaine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about lidocaine topical.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.03. Revision Date: 2013-09-25, 11:05:23 AM.

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