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Lignocaine

Lidocaine
Lidocaine.svg
Lidocaine-from-xtal-3D-balls.png
Clinical data
Pronunciation Lidocaine /ˈldəˌkn/
lignocaine /ˈlɪɡnəˌkn/
Trade names Xylocaine
AHFS/Drugs.com

Local Monograph

Injectable Monograph
Pregnancy
category
  • AU: A
  • US: B (No risk in non-human studies)
Routes of
administration
intravenous, subcutaneous, topical, oral
ATC code C01BB01 (WHO) C05AD01 (WHO) D04AB01 (WHO) N01BB02 (WHO) R02AD02 (WHO) S01HA07 (WHO) S02DA01 (WHO)
Legal status
Legal status
  • AU: S4 (Prescription only)
  • US: Rx above 5% concentration

OTC up to 5% for topical application depending on use (OTC for ≤4% for topical application for skin numbing use

or ≤5% for anorectal hemorroidal pain and to prevent premature ejaculation) Above 5% or other routes of administration: RX only.
Pharmacokinetic data
Bioavailability 35% (oral)
3% (topical)
Metabolism Liver, 90% CYP3A4-mediated
Onset of action within 1.5 min (IV)
Biological half-life 1.5–2 h
Duration of action 10 to 20 min(IV), 0.5 to 3 h (injection)
Excretion Kidney
Identifiers
Synonyms N-(2,6-dimethylphenyl)-N2,N2-diethylglycinamide
CAS Number 137-58-6 YesY
73-78-9 (hydrochloride)
PubChem (CID) 367
IUPHAR/BPS 2623
DrugBank DB00281 YesY
ChemSpider 3548 YesY
UNII 98PI200987 YesY
KEGG D00358 YesY
ChEBI CHEBI:6456 YesY
ChEMBL CHEMBL79 YesY
ECHA InfoCard 100.004.821
Chemical and physical data
Formula C14H22N2O
Molar mass 234.34 g/mol
3D model (Jmol) Interactive image
Melting point 68 °C (154 °F)
  

Local Monograph

OTC up to 5% for topical application depending on use (OTC for ≤4% for topical application for skin numbing use

Lidocaine, also known as xylocaine and lignocaine, is a medication used to numb tissue in a specific area and to treat ventricular tachycardia. It can also be used for nerve blocks. Lidocaine mixed with a small amount of epinephrine is available to allow larger doses for numbing, and to make it last longer. When used as an injectable, it typically begins working within four minutes and lasts for half an hour to three hours. Lidocaine may also be applied directly to the skin for numbing.

Common side effects with intravenous use include sleepiness, muscle twitching, confusion, changes in vision, numbness, tingling, and vomiting. It can cause low blood pressure and an irregular heart rate. There are concerns that injecting it into a joint can cause problems with the cartilage. It appears to be generally safe for use in pregnancy. A lower dose may be required in those with liver problems. It is generally safe to use in those allergic to tetracaine or benzocaine. Lidocaine is an antiarrhythmic medication of the class Ib type. Lidocaine works by blocking sodium channels and thus decreasing the rate of contractions of the heart. When used locally as a numbing agent, local neurons cannot signal the brain.

Lidocaine was discovered in 1946 and went on sale in 1948. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication and is not very expensive. The wholesale cost in the developing world in 2014 was US$0.45 to $1.05 wholesale per 20ml vial of medication.


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