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lidocaine injection (Xylocaine) Uses, Side Effects & Dosage

What is lidocaine injection?

Lidocaine is an antiarrhythmic agent (affects heart
rhythm) as well as a local anesthetic (amide type).

Why is lidocaine injection prescribed to patients?

Lidocaine is prescribed for local or regional anesthesia
(loss of sensation) during surgical procedures as well as for control of
ventricular arrhythmias associated with heart attack or cardiac surgery.

Do I need a prescription for lidocaine injection?


Is lidocaine injection available as a generic drug?


What are the side effects of lidocaine injection?

Side effects vary by dose and site of administration. The most common adverse reactions include:

Additional side effects include:

  • shivering,
  • tingling,
  • sedation,
  • blurry vision,
  • confusion,
  • nervousness, and
  • euphoria.

Rare, but serious side effects include:

What is the dosage for lidocaine injection?

The initial dose for anesthesia in adults depends on the procedure,
necessary depth of anesthesia, blood flow to the region, desired duration of
anesthesia, and condition of the patient. For anesthesia, the maximum dose is
4.5 mg/kg and should not exceed 300 mg per dose. For control of arrhythmias
(abnormal heart rhythm), an initial intravenous or intraosseous (injected into
bone) dose is 1 to 1.5 mg/kg. If providing dose by endotrachial tube the initial
dose is 2 to 3.75 mg/kg. Lidocaine is rapidly metabolized. Any conditions that
later liver functions may alter the half live of lidocaine.


In the U.S., 1 in every 4 deaths is caused by heart disease.
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Which drugs or supplements interact with lidocaine injection?

Dronedarone increases blood levels of lidocaine and its
side effects by reducing its breakdown in the liver. Lidocaine increases the
effect of bupivicaine liposomal because it increases the availability of
bupivicaine. The two drugs should not be mixed.
(Tegretol, Tegretol XR, Equetro, Carbatrol),
phenobarbital, and rifampin may reduce blood levels of lidocaine by increasing
its breakdown in the liver. Erythromycin,
(Prilosec), and
(Cirpo, Cirpo XR, Proquin XR) may increase levels of lidocaine by reducing its breakdown in the liver.

Is lidocaine injection safe to use during pregnancy or while breastfeeding?

There are no adequate studies of use in pregnant women. Available evidence does not suggest harm to the fetus. Lidocaine crosses the placenta and does enter the fetal blood stream so close monitoring of the heart is recommended.

Lidocaine is excreted in breast milk so it should be used cautiously by nursing mothers. The amount absorbed by the infant is not expected
to be significant.

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What else should I know about lidocaine injection?

What preparations of lidocaine injection are available?

Injection Solution with or without preservatives: 0.4%, 0.5%, 0.8%, 1%, 1.5%, 2%, 4%, 5% in 2, 5, 10, 20, 30, 50, 250, 500 mL.

How should I keep lidocaine injection stored?

Lidocaine should be stored at room temperature, between 15 C to 30 C (59 F to 86 F).

How does lidocaine injection work?

Lidocaine is similar to bupivacaine
and procaine. Lidocaine, like other local anesthetics causes a loss of sensation
by reducing the flow of sodium in and out nerves to decrease the initiation and
transfer of nerve signals. Compared to procaine, lidocaine has a more rapid
onset, longer duration of action, and more potent activity. Lidocaine works as
an antiarrhythmic by also decreasing conduction of electrical signals in damaged
(ischemic) heart tissue.

When was lidocaine injection approved by the FDA?

Lidocaine was approved by the FDA in November 1948.


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