Lidocaine Plus Injection

Lidocaine Plus is indicated for dental infiltration anesthesia and all dental nerve block techniques.

Each mL contains

• Lidocaine Hydrochloride USP (as anhydrous 20mg) &
• Epinephrine 12.5mcg (as Epinephrine Bitartrate USP)

This is a sterile, non-pyrogenic aqueous solution that contains a local anaesthetic agent- Lidocaine Hydrochloride with Epinephrine. Lidocaine is a local anaesthetic of the amide type. It stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anaesthetic action. Lidocaine has a rapid onset of action and intermediate duration of action. The speed of onset and duration fo action are increased by the addition of vasconstrictor-epinephrine and absorption into circulation from the site of injection is reduced. The duration of action is approximately one and-a half to two hours with Epinephrine.

Infiltration: The usual dose is 1 mL.
Nerve block: The usual dose is 1.5 to 2.0 mL.

The maximum recommended dose for Lidocaine Hydrochloride when given with Epinephrine is 500 mg. Children and elderly or debilitated patients require smaller doses.

It exhibits interaction with monoamine oxidase inhibitors, tricyclic antidepressants, phenothiazines, butyrophenones, vasopressor drugs (for the treatment of hypotension related to obstetric blocks) and ergot-type drugs

Known hypersensitivity to anesthetics of amide type. The use of vasoconstrictor is contraindicated for anesthesia of fingers, toes, tip of nose, ears and penis. Jasocaine-A DC should not be given intravenously.

In common with other local anesthetics, adverse reactions to Lidocaine Plus is extremely rare in dental practice and is usually the result of extensively high blood concentration due to inadvertent intravascular injection, excessive dosage, rapid absorption or occasionally to hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. In such circumstances systemic effects occur involving the central nervous system and/or the cardiovascular system. CNS reactions are excitatory and/or depressant, and may be characterized by nervousness, dizzines, blurred vision and tremors, followed by drowsiness, convulsions, unconsciousness and possibly respiratory arrest. The excitatory reactions may be very brief or may not occur at all, in which case the first manifestations of toxicity may be drowsiness merging into unconsciousness and respiratory arrest.

Cardiovascular reactions are depressant, and may be characterized by hypotension, myocardial depression, bradycardia and possibly arrest. Allergic reactions are extremely rare. They may be characterized by cutaneous lesion, urticaria, oedema or anaphylactic reactions. Detection of sensitivity by skin testing is of doubtful value.

Although there is no evidence from animal studies of harm to the fetus, as with all drugs, it should not be given during early pregnancy unless the benefits are considered to outweigh the risks. It is not known whether the drug is excreted in breast milk. Caution should be exercised when it is administered nursing women.

In common with other local anesthetics, Lidocaine Plus should be used cautiously in patients with epilepsy, impaired cardiac conduction, and impaired respiratory function and in patients with impaired hepatic function if the dose or site of administration is likely to result in high blood levels. Facilities for resuscitation should be available when local anesthetics are administered.

The effect of local anesthetics may be reduced if an injection is made into an inflamed or infected area. Solutions containing Epinephrine should be used with caution in patient with hypertension, cardiac disease, cerebrovascular insufficiency as thyrotoxicosis.

Solutions containing Epinephrine should be used where possible so as to prolong anesthesia and reduce systemic absorption. This is particularly important in highly vascular areas.

Local & Surface anesthesia

Store below 30°C in a dry place, away from light. Keep out of the reach of children.