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Lidocaine (Ophthalmic)

Medically reviewed by Last updated on Oct 10, 2020.


(LYE doe kane)

Index Terms

  • Lidocaine Hydrochloride
  • Lignocaine Hydrochloride

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Gel, Ophthalmic, as hydrochloride [preservative free]:

Akten: 3.5% (1 mL)

Brand Names: U.S.

  • Akten

Pharmacologic Category

  • Local Anesthetic
  • Local Anesthetic, Ophthalmic


Local anesthetics block both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction.

Onset of Action

20 seconds to 5 minutes (median: 40 seconds)

Duration of Action

5 to 30 minutes (median: 15 minutes)

Use: Labeled Indications

Anesthesia, ocular: To provide local anesthesia to ocular surface during ophthalmologic procedures


There are no contraindications listed in the manufacturer's labeling

Dosing: Adult

Anesthesia, ocular: Apply 2 drops to ocular surface in area where procedure will occur; may reapply to maintain effect.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Anesthesia, ocular: Ophthalmic gel: Children and Adolescents: Apply 2 drops to ocular surface in area where procedure to occur; may reapply to maintain effect


Store at 15°C to 25°C (59°F to 77°F). Protect from light. Discard after use.

Drug Interactions

Bupivacaine: Local Anesthetics may enhance the adverse/toxic effect of Bupivacaine. Management: Avoid using any additional local anesthetics within 96 hours after insertion of the bupivacaine implant (Xaracoll). Monitor therapy

Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Monitor therapy

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined.

Central Nervous System: Localized burning

Ophthalmic: Conjunctival hyperemia, diplopia, epithelial keratopathy, visual disturbance


Concerns related to adverse effects:

• Corneal ulceration: Prolonged use may cause permanent corneal ulceration and/or opacification with loss of vision.

Dosage form specific issues:

• Appropriate use: For ophthalmic use only; not for injection.

Pregnancy Risk Factor


Pregnancy Considerations

Adverse events were not observed in animal reproduction studies. Although systemic exposure is not expected following application of the ophthalmic gel, cumulative exposure from all routes of administration should be considered.

Patient Education

What is this drug used for?

• It is used during eye surgery.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Burning

• Headache

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Blindness

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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