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lidocaine injection

Pronunciation

Generic Name: lidocaine injection (LYE doe kane)
Brand Name: Anestacaine, Dilocaine, L-Caine, Lidoject 1, Nervocaine, Truxacaine, UAD Caine, Xylocaine HCl, Xylocaine-MPF, Xylocaine Dental Cartridges, Lidoject 2, Xylocaine Duo-Trach Kit, Xylocaine HCl For Spinal

What is lidocaine injection?

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

Lidocaine injection is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgery, needle punctures, or insertion of a catheter or breathing tube.

Lidocaine injection is sometimes used to treat irregular heart rhythms that may signal a possible heart attack.

Lidocaine injection is also given in an epidural (spinal block) to reduce the discomfort of contractions during labor.

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

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

You should not receive this medicine if you have severe heart block, or a heart rhythm disorder called Stokes-Adams syndrome or Wolff-Parkinson-White Syndrome.

What should I discuss with my healthcare provider before receiving lidocaine injection?

You should not receive this medicine if you are allergic to lidocaine injection or any other type of numbing medicine, or if you have:

  • severe heart block;

  • a heart rhythm disorder called Stokes-Adams syndrome (sudden slow heart beats that can cause you to faint); or

  • a heart rhythm disorder called Wolff-Parkinson-White Syndrome (sudden fast heartbeats that can cause you to faint or become easily tired).

To make sure lidocaine injection is safe for you, tell your doctor if you have:

  • an allergy to corn products;

  • liver disease;

  • kidney disease;

  • heart disease (unless you are being treated with lidocaine injection for a heart condition);

  • coronary artery disease, circulation problems; or

  • a history of malignant hyperthermia.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.

Lidocaine can pass into breast milk, but effects on the nursing baby are not known. Tell your doctor if you are breast-feeding.

How is lidocaine injection given?

A healthcare provider will give you this injection.

Lidocaine injection is injected into a vein through an IV to treat heart rhythm problems.

When used as a numbing medicine, lidocaine injection is injected through the skin directly into the body area to be numbed.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving lidocaine injection in a hospital setting.

If you are being treated for irregular heart rhythm, your heart rate will be constantly monitored using an electrocardiograph or ECG (sometimes called an EKG). This will help your doctor determine how long to treat you with lidocaine injection.

What happens if I miss a dose?

Since lidocaine injection is used only when needed in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid after receiving lidocaine injection?

Lidocaine injection can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after receiving this medicine.

Avoid eating or chewing within 1 hour after lidocaine injection is used to numb your mouth or throat. You may have trouble swallowing which could lead to choking. You may also accidentally bite the inside of your mouth if you are still numb an hour after treatment with lidocaine injection.

Lidocaine injection side effects

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

Tell your caregiver right away if you have:

  • twitching, tremors, seizure (convulsions);

  • a light-headed feeling, like you might pass out;

  • slow heart rate, weak pulse, weak or shallow breathing;

  • sudden feeling of warmth with muscle stiffness and pain;

  • dark urine;

  • blue appearance of the skin; or

  • severe anxiety, unusual fear or uneasy feeling.

Common side effects may include:

  • drowsiness, dizziness;

  • vomiting;

  • feeling hot or cold;

  • confusion, ringing in your ears, blurred vision, double vision; 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.

Lidocaine injection dosing information

Usual Adult Dose for Ventricular Fibrillation:

Initial dose: 50 to 100 mg IV bolus once over 2 to 3 minutes; may repeat after 5 minutes if necessary not to exceed up to 300 mg in a 1-hour period
Following bolus administration: 1 to 4 mg/min continuous IV infusion

Comments:
-Patients should be under constant ECG monitoring during administration of this drug.
-Sufficient time should be allowed to enable a slow circulation to carry this drug to the site of action.
-The rate of the IV infusion should be reassessed as soon as the patient's basic cardiac rhythm appears stable or at the earliest signs of toxicity.

Uses: For the acute management of ventricular arrhythmias occurring during cardiac manipulations, such as cardiac surgery; and for life-threatening arrhythmias which are ventricular in origin, such as those that occur during acute myocardial infarction

The American Heart Association (AHA) recommends:
IV:
-Initial dose: 1 to 1.5 mg/kg IV bolus once; may repeat if necessary at a dose of 0.5 to 0.75 mg/kg IV every 5 to 10 minutes up to a maximum cumulative dose of 3 mg/kg
-Following bolus administration: 1 to 4 mg/min continuous IV infusion (30 to 50 mcg/kg/min)

Endotracheal: May be administered endotracheally (bolus dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose diluted in 5 to 10 mL NS or distilled water

Uses: For the treatment of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) unresponsive to CPR, defibrillation, and vasopressor therapy as an alternative to amiodarone

Usual Adult Dose for Ventricular Tachycardia:

Initial dose: 50 to 100 mg IV bolus once over 2 to 3 minutes; may repeat after 5 minutes if necessary not to exceed up to 300 mg in a 1-hour period
Following bolus administration: 1 to 4 mg/min continuous IV infusion

Comments:
-Patients should be under constant ECG monitoring during administration of this drug.
-Sufficient time should be allowed to enable a slow circulation to carry this drug to the site of action.
-The rate of the IV infusion should be reassessed as soon as the patient's basic cardiac rhythm appears stable or at the earliest signs of toxicity.

Uses: For the acute management of ventricular arrhythmias occurring during cardiac manipulations, such as cardiac surgery; and for life-threatening arrhythmias which are ventricular in origin, such as those that occur during acute myocardial infarction

The American Heart Association (AHA) recommends:
IV:
-Initial dose: 1 to 1.5 mg/kg IV bolus once; may repeat if necessary at a dose of 0.5 to 0.75 mg/kg IV every 5 to 10 minutes up to a maximum cumulative dose of 3 mg/kg
-Following bolus administration: 1 to 4 mg/min continuous IV infusion (30 to 50 mcg/kg/min)

Endotracheal: May be administered endotracheally (bolus dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose diluted in 5 to 10 mL NS or distilled water

Uses: For the treatment of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) unresponsive to CPR, defibrillation, and vasopressor therapy as an alternative to amiodarone

Usual Adult Dose for Cardiac Arrhythmia:

Initial dose: 50 to 100 mg IV bolus once over 2 to 3 minutes; may repeat after 5 minutes if necessary not to exceed up to 300 mg in a 1-hour period
Following bolus administration: 1 to 4 mg/min continuous IV infusion

Comments:
-Patients should be under constant ECG monitoring during administration of this drug.
-Sufficient time should be allowed to enable a slow circulation to carry this drug to the site of action.
-The rate of the IV infusion should be reassessed as soon as the patient's basic cardiac rhythm appears stable or at the earliest signs of toxicity.

Uses: For the acute management of ventricular arrhythmias occurring during cardiac manipulations, such as cardiac surgery; and for life-threatening arrhythmias which are ventricular in origin, such as those that occur during acute myocardial infarction

The American Heart Association (AHA) recommends:
IV:
-Initial dose: 1 to 1.5 mg/kg IV bolus once; may repeat if necessary at a dose of 0.5 to 0.75 mg/kg IV every 5 to 10 minutes up to a maximum cumulative dose of 3 mg/kg
-Following bolus administration: 1 to 4 mg/min continuous IV infusion (30 to 50 mcg/kg/min)

Endotracheal: May be administered endotracheally (bolus dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose diluted in 5 to 10 mL NS or distilled water

Uses: For the treatment of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) unresponsive to CPR, defibrillation, and vasopressor therapy as an alternative to amiodarone

Usual Adult Dose for Anesthesia:

Local Injectable Anesthesia:
-Maximum individual dose: 4 mg/kg (IV regional anesthesia); 4.5 mg/kg (infiltration)
-Maximum total dose: 300 mg

Comments:
-The manufacturer product information should be consulted.
-Dose varies with procedure, depth of anesthesia and degree of muscle relaxation needed, duration of anesthesia required, and physical condition of patient.
-For continuous epidural or caudal anesthesia, the maximum recommended dose should not be administered at intervals of less than 90 minutes.
-The maximum recommended dose per 90-minute period for paracervical block is 200 mg total.
-In all cases the lowest effective dose that will produce the desired result should be used.

Use: For the production of local or regional anesthesia by infiltration techniques such as percutaneous injection and IV regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed

Usual Pediatric Dose for Ventricular Fibrillation:

The manufacturer gives no specific dosing instructions.

The AHA recommends:
IV:
-Initial dose: 1 mg/kg IV or intraosseous once
-Maintenance infusion: 20 to 50 mcg/kg/min IV

Endotracheal: May be administered endotracheally (bolus dose only) if IV or intraosseous access unavailable at a dose of 2 to 3 times the dose (2 to 3 mg/kg) followed by a flush with at least 5 mL of NS and 5 consecutive positive-pressure ventilations

Use: For use in shock-refractory VF or pVT after resuscitation from cardiac arrest in infants and children

Usual Pediatric Dose for Ventricular Tachycardia:

The manufacturer gives no specific dosing instructions.

The AHA recommends:
IV:
-Initial dose: 1 mg/kg IV or intraosseous once
-Maintenance infusion: 20 to 50 mcg/kg/min IV

Endotracheal: May be administered endotracheally (bolus dose only) if IV or intraosseous access unavailable at a dose of 2 to 3 times the dose (2 to 3 mg/kg) followed by a flush with at least 5 mL of NS and 5 consecutive positive-pressure ventilations

Use: For use in shock-refractory VF or pVT after resuscitation from cardiac arrest in infants and children

Usual Pediatric Dose for Anesthesia:

3 years or older with normal lean body mass and normal body development: Maximum dose based on patient's age and weight

Comments:
-The manufacturer product information should be consulted.
-Dose varies with procedure, depth of anesthesia and degree of muscle relaxation needed, duration of anesthesia required, and physical condition of patient.
-In all cases the lowest effective dose that will produce the desired result should be used.

Use: For the production of local or regional anesthesia by infiltration techniques such as percutaneous injection and IV regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed

What other drugs will affect lidocaine injection?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cimetidine, fluvoxamine, nefazodone, St John's wort;

  • antibiotic or antifungal medicine;

  • antiviral medicine to treat hepatitis or HIV/AIDS;

  • heart or blood pressure medicine--amiodarone, digoxin, nicardipine, procainamide, propranolol;

  • seizure medicine--carbamazepine, phenytoin; or

  • tuberculosis medicine--isoniazid, rifampin.

This list is not complete. Other drugs may interact with lidocaine injection, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

See also: Side effects (in more detail)

Where can I get more information?

  • Your doctor or pharmacist can provide more information about lidocaine injection.
  • 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: 3.02.

Date modified: September 05, 2017
Last reviewed: February 09, 2017

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