LMX 4 Side Effects

Generic Name: lidocaine topical

Note: This page contains information about the side effects of lidocaine topical. Some of the dosage forms included on this document may not apply to the brand name LMX 4.

Not all side effects for LMX 4 may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to lidocaine topical: topical application aerosol liquid, topical application cream, topical application dressing, topical application foam, topical application gel/jelly, topical application lotion, topical application ointment, topical application pad, topical application patch extended release, topical application powder, topical application solution, topical application spray

In addition to its needed effects, some unwanted effects may be caused by lidocaine topical (the active ingredient contained in LMX 4). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking lidocaine topical, check with your doctor or nurse immediately:

Incidence not known
  • Blurred vision
  • chest pain or discomfort
  • cold, clammy, or pale skin
  • confusion
  • cough
  • difficult or troubled breathing
  • difficulty with swallowing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • false or unusual sense of well-being
  • fast heartbeat
  • fear
  • hives or welts
  • irregular, fast or slow, or shallow breathing
  • itching
  • lightheadedness, dizziness, or fainting
  • mood or mental changes
  • nervousness
  • no blood pressure or pulse
  • pale or blue lips, fingernails, or skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness of the skin
  • seizures
  • shakiness in the legs, arms, hands, or feet
  • shortness of breath
  • skin rash
  • sleepiness
  • slow heart rate
  • slow or irregular heartbeat
  • stopping of heart
  • swelling
  • tightness in the chest
  • trembling or shaking of the hands or feet
  • twitching
  • unconsciousness
  • unusual tiredness or weakness
  • weakness
  • wheezing

Some of the side effects that can occur with lidocaine topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known
  • Cold or numbness
  • continuing ringing or buzzing or other unexplained noise in the ears
  • double vision
  • hearing loss
  • heat sensation

For Healthcare Professionals

Applies to lidocaine topical: intradermal device, mucous membrane solution, mucous membrane spray, topical cream, topical film, topical gel, topical gel with applicator, topical kit, topical liquid, topical lotion, topical ointment, topical solution, topical spray, topical stick


Local side effects associated with lidocaine topical (the active ingredient contained in LMX 4) patch have included erythema, edema, bruising, papules, vesicles, discoloration, depigmentation, burning sensation, pruritus, dermatitis, petechiae, blisters, exfoliation, skin irritation, and locus of abnormal sensation.

Local side effects associated with other forms of lidocaine topical have included erythema, edema, and locus of abnormal sensation.[Ref]

Local side effects reported with the use of lidocaine topical patch were generally experienced during or immediately following treatment. The reactions were generally reported as transient and mild, and appeared to resolve spontaneously within a few minutes to a few hours.[Ref]

Nervous system

Nervous system side effects associated with lidocaine topical (the active ingredient contained in LMX 4) patch have included paresthesia, hyperesthesia, hypoesthesia, headache, dizziness, lightheadedness, nervousness, somnolence, disorientation, and confusion. Causality has not been established.

Nervous system side effects associated with systemic lidocaine have included lightheadedness, 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 respiratory arrest.[Ref]

Systemic lidocaine can exhibit CNS excitation and/or depression. Excitatory CNS effects may occur briefly or not at all. Drowsiness may be an early clinical symptom of high lidocaine serum levels.[Ref]


Gastrointestinal side effects associated with lidocaine topical (the active ingredient contained in LMX 4) patch have included metallic taste, taste alteration, nausea, and vomiting. Causality has not been established.[Ref]


Hypersensitivity reactions associated with systemic lidocaine have rarely included urticaria, angioedema, bronchospasm, laryngospasm, dermatitis, pruritus, dyspnea, and shock.[Ref]


Cardiovascular side effects associated with systemic lidocaine have included bradycardia, hypotension, and cardiovascular collapse leading to possible cardiac arrest.[Ref]


Ocular side effects associated with lidocaine topical (the active ingredient contained in LMX 4) patch have included visual disturbances and blurred vision. Causality has not been established.[Ref]


Respiratory side effects have included occlusion of the endotracheal tube. This effect is typically the result of the presence of dried lidocaine topical (the active ingredient contained in LMX 4) jelly residue in the inner lumen of the tube.[Ref]


Other side effects associated with lidocaine topical (the active ingredient contained in LMX 4) patch have included asthenia, tinnitus, tremor, and flushing. Causality has not been established.[Ref]


1. "Product Information. Lidoderm (lidocaine topical)." Endo Laboratories LLC, Chaddsford, PA.

2. Gammaitoni AR, Davis MW "Pharmacokinetics and tolerability of lidocaine patch 5% with extended dosing." Ann Pharmacother 36 (2002): 236-40

3. "Product Information. Zingo (lidocaine topical)." Sagent Pharmaceuticals, Inc., Schaumberg, IL.

4. Cerner Multum, Inc. "Australian Product Information." O 0

5. Gammaitoni AR, Alvarez NA, Galer BS "Pharmacokinetics and safety of continuously applied lidocaine patches 5%." Am J Health Syst Pharm 59 (2002): 2215-20

6. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

7. "Product Information. LMX 4 (lidocaine topical)." Ferndale Laboratories Inc, Ferndale, MI.

8. "Product Information. Xylocaine 2% jelly (lidocaine topical)" Astra-Zeneca Pharmaceuticals, Wilmington, DE.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.