Adrenaline + Lidocaine Hydrochloride

Prescribing Information (Research Brand)

Indications

This drug is indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection, 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.

Therapeutic Class

Local & Surface anesthesia

Pharmacology

Lidocaine is a local anaesthetic which decreases permeability of sodium ions, blocking induction and conduction of nerve impulses. Combination with epinephrine restricts systemic spread of lidocaine, vascular absorption and its duration of local anaesthetic effect.

Dosage & Administration

Dosage depends on several factors such as route, type and extent of surgical procedure, duration of anaesthesia and patient's condition and age.

Adult: Max dose of lidocaine given with epinephrine: 7 mg/kg and not >500 mg.
Child: 3 mth-12 yr: Max dose 3 mg/kg. Ideal body weight should be used in children with high body weight.

Interaction

Halogenated inhalation anaesthetics; alpha or beta blocking agents; methyldopa, guanethidine; drugs with vasoconstrictor and pressor effects; antihypertensives; adrenergic neuron blockers; potassium-depleting drugs; cardiac glycosides; ephedra, yohimbe. TCAs may induce hypertension and arrhythmia.

Contraindications

Tachycardia, hypertension, cerebral arteriosclerosis, ischaemic heart disease, IV admin, anaesthetise digits or appendages, myasthenia gravis.

Side Effects

More common side effects: Minor redness, burning, irritation, or numbness at the application site; lightheadedness; nausea.

Severe side effects: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; dizziness; fainting; fast, slow, or irregular heartbeat; loss of consciousness; mental or mood changes; nervousness; paleness; redness or warmth of skin; ringing in the ears or hearing changes; seizures; sensation of heat or cold; shortness of breath; swelling or blistering of skin; tremors or twitching; vision changes or double vision; vomiting.

Pregnancy & Lactation

Pregnancy Category C+B. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using epinephrine/lidocaine iontophoretic patch while you are pregnant. Epinephrine/lidocaine iontophoretic patch is found in breast milk. If you are or will be breast-feeding while you use epinephrine/lidocaine iontophoretic patch, check with your doctor. Discuss any possible risks to your baby.

Precautions

Epilepsy, impaired cardiac conduction, CHE DM, closed angle glaucoma, impaired liver function (if site of admin is likely to result in high blood levels), severe renal dysfunction. Local anaesthetic effect may be reduced if injected into an inflamed or infected area. Cerebrovascular insufficiency, hyperthyroidism. Neonates, elderly, patients in poor general condition (optimise patient's condition before major block), pregnancy.

Reconstitutions

Can be diluted if necessary in glucose 5%, sodium chloride 0.9% and lactated Ringer's solution.

Storage Conditions

Store at room temperature, between 20℃ to 25℃. Store away from heat and light. Keep the child-resistant envelope sealed at all times when not in use. Keep out of the reach of children and away from pets.