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Lidocaine and epinephrine (Injection)

Generic Name: epinephrine/lidocaine (LYE-doe-kane, ep-i-NEF-rin)

Pharmacologic Class: Sympathomimetic

Chemical Class: Amino Amide

Medically reviewed by Drugs.com. Last updated on Aug 14, 2020.

Uses for lidocaine and epinephrine

Lidocaine and epinephrine combination injection is used to cause numbness or loss of feeling for patients having certain medical procedures (by blocking certain nerves using the brachial plexus, intercostal, lumbar, or epidural blocking techniques).

Lidocaine and epinephrine is to be given only by or under the direct supervision of your doctor.

Before using lidocaine and epinephrine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lidocaine and epinephrine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to lidocaine and epinephrine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Because of lidocaine and epinephrine's toxicity, it should be used with extreme caution in children younger than 6 months of age. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment.

Geriatric

No information is available on the relationship of age to the effects of lidocaine and epinephrine combination injection in geriatric patients. However, because of lidocaine and epinephrine's toxicity, it should be used with caution. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment.

Breastfeeding

Epinephrine

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Lidocaine

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving lidocaine and epinephrine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using lidocaine and epinephrine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Dihydroergotamine
  • Dronedarone
  • Isocarboxazid
  • Linezolid
  • Phenelzine
  • Saquinavir
  • Tranylcypromine
  • Vernakalant

Using lidocaine and epinephrine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amifampridine
  • Amineptine
  • Amiodarone
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Amprenavir
  • Arbutamine
  • Atazanavir
  • Benperidol
  • Bromperidol
  • Bucindolol
  • Bupivacaine
  • Bupivacaine Liposome
  • Bupropion
  • Carteolol
  • Carvedilol
  • Clomipramine
  • Cobicistat
  • Dasabuvir
  • Delavirdine
  • Desipramine
  • Dibenzepin
  • Digoxin
  • Dilevalol
  • Disopyramide
  • Dixyrazine
  • Donepezil
  • Doxepin
  • Droperidol
  • Encainide
  • Entacapone
  • Ergonovine
  • Etravirine
  • Fexofenadine
  • Flecainide
  • Fluphenazine
  • Fosamprenavir
  • Fosphenytoin
  • Fospropofol
  • Furazolidone
  • Haloperidol
  • Halothane
  • Hyaluronidase
  • Imipramine
  • Iobenguane I 123
  • Iproniazid
  • Lacosamide
  • Levalbuterol
  • Levobunolol
  • Lofepramine
  • Lopinavir
  • Loxapine
  • Melitracen
  • Melperone
  • Methdilazine
  • Methotrimeprazine
  • Methylene Blue
  • Methylergonovine
  • Metipranolol
  • Metopimazine
  • Metoprolol
  • Mexiletine
  • Moricizine
  • Nadolol
  • Nialamide
  • Nortriptyline
  • Ombitasvir
  • Opicapone
  • Opipramol
  • Oxprenolol
  • Paritaprevir
  • Penbutolol
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenytoin
  • Pindolol
  • Pipamperone
  • Pipotiazine
  • Practolol
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propiomazine
  • Propofol
  • Propranolol
  • Protriptyline
  • Quinidine
  • Rasagiline
  • Selegiline
  • Sotalol
  • St John's Wort
  • Succinylcholine
  • Telaprevir
  • Terfenadine
  • Tertatolol
  • Thiethylperazine
  • Thioproperazine
  • Thioridazine
  • Tianeptine
  • Timolol
  • Tocainide
  • Trifluoperazine
  • Triflupromazine
  • Trimipramine

Using lidocaine and epinephrine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cimetidine
  • Labetalol
  • Penbutolol

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of lidocaine and epinephrine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood vessel disease or
  • Heart disease or
  • Hypertension (high blood pressure) or
  • Liver disease—Use with caution. The chance of side effects may be increased.
  • Brain or nerve disease or
  • Heart block or
  • Hypertension (high blood pressure), severe or
  • Sepsis or
  • Shock, severe or
  • Spine problems—Use with caution.
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
  • Heart problems or
  • Lung or breathing problems or
  • Methemoglobinemia (blood disorder), hereditary or idiopathic (unknown cause)—Use with caution. May increase risk of having methemoglobinemia.
  • Sulfite allergy—Lidocaine with epinephrine injection contains sodium metabisulfite, which may cause allergic reactions.

Proper use of lidocaine and epinephrine

A nurse or other trained health professional will give you lidocaine and epinephrine in a medical facility. It is given through a needle placed into one of your veins, into your upper arm, into the head and neck area, or into the space around the spinal nerves in your lower back.

Precautions while using lidocaine and epinephrine

It is very important that your doctor check your or your child's progress closely while you are receiving lidocaine and epinephrine to make sure lidocaine and epinephrine is working properly. Blood tests may be needed to check for unwanted effects.

Lidocaine and epinephrine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child have the following symptoms after receiving lidocaine and epinephrine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

If you receive lidocaine and epinephrine into your lower back (epidural), you may experience temporary loss of sensation and movement, usually in the lower half of your body. Talk with your doctor if you have concerns.

Make sure any doctor or dentist who treats you knows that you are using lidocaine and epinephrine. Lidocaine and epinephrine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Lidocaine and epinephrine side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

  • Bluish-colored lips, fingernails, or palms blurred or double vision
  • chest pain or discomfort
  • cold, clammy, pale skin
  • confusion
  • continuing ringing or buzzing or other unexplained noise in the ears
  • cough
  • dark urine
  • difficulty breathing
  • difficulty swallowing
  • dizziness or lightheadedness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • fast heartbeat
  • fever
  • headache
  • hearing loss
  • hives, itching, skin rash
  • irregular heartbeat
  • irregular, fast or slow, or shallow breathing
  • loss of consciousness
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid or slow heart rate
  • seizures
  • slow or irregular heartbeat
  • sore throat
  • sweating
  • tightness in the chest
  • tremor
  • twitching
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Cold or numb feeling
  • false or unusual sense of well-being
  • feeling of heat
  • loss of bladder and bowel control
  • loss of genital sensation and sexual function
  • nervousness
  • vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.