Additional Information

Description

Lidocaine Hydrochloride injection 2% w/v comes with a clear and colorless solution for injection (100mg/5ml). Each 1ml of the solution contains 20mg of Lidocaine Hydrochloride USP and each 5ml contains 100mg of Lidocaine Hydrochloride USP. The solution includes the following excipients, i.e., Water for injection USP, quantity sufficient 1N HCL, and quantity sufficient 1N NaCl. Lidocaine hydrochloride injection 2% should be stored at temperatures below 25°C and away from light. The injection formulation has a shelf life of 36 months.

Lidocaine hydrochloride injection USP should be avoided in admixtures containing lidocaine and glyceryl trinitrate. Lidocaine also interacts with few drugs due to precipitation, i.e, Methohexitone Sodium, amphotericin and Sulfadiazine in glucose injection.

Other Pharmacokinetic properties

Lidocaine absorbs directly from the injection site, with the rate of absorption determined by the two factors i.e., administration site and tissue Vascularity.

After being absorbed, it binds to alpha-1-acid glycoprotein. Drug use during pregnancy is not advised because it can cross the placental and blood-brain barriers after binding to the glycoprotein.

The drug is metabolized in the liver to monoethylglycinexylidide through N-dealkylation. The liver is responsible for more than 90% of the drug''s metabolism, with the remaining 10% being eliminated unchanged in the urine. Following an IV bolus dose of lidocaine, the elimination half-life is between 1-2 hours.

Therapeutic Indications

Lidocaine Hydrochloride injection USP is indicated for use to suppress ventricular extrasystoles and ventricular tachycardia after acute myocardial infarction. As an antiarrhythmic drug, it keeps the membrane stable. Lidocaine is used in infiltration anesthesia, with a dose depending on the patient''s weight and the nature of the procedure.

Lidocaine is commonly used in dental procedures; it is usually used in conjunction with adrenaline (epinephrine). Also used for surface anesthesia, regional anesthesia, and nerve blocks. For dental cartridges, various lidocaine injections with adrenaline are available. It may be administered by subcutaneous, intramuscular, and intravenous routes.

The lidocaine injection is available in dosage strengths of 5mg (0.5%), 10mg (1%), and 20mg (2%); however, this dose may not be true in certain cases, so expert advice should be sought. To avoid overdosing in obese patients, the dose should not be calculated using ideal body weight.

Cautions

The plastic cuffs of endotracheal tubes can become damaged by topical Lidocaine preparations, according to the British National Formulary (BNF). When giving medication to children and the elderly, special safety measures must be taken.

Patients with impaired cardiac conduction, impaired cardiovascular disease, hypovolemia, shock, epilepsy, impaired respiratory function, or myasthenia gravis should use lidocaine hydrochloride injection with caution.

Contraindications

Lidocaine shouldn''t be injected into tissues that are infected or inflamed. It is not advised to use it on damaged skin. In these situations, it might have a greater effect on blood absorption, leading to systemic side effects with a lesser impact on local anesthetic effects. Additionally, nursing mothers, pregnant women, or people with hepatic or renal impairment shouldn''t be administered lidocaine.

Lidocaine injection is especially dangerous if the patient has a known allergy or hypersensitivity to lidocaine or other amide-type anesthetics. It is contraindicated in sino-atrial disorders, myocardial depression, and all grades of the atrioventricular block.

The intraocular use of Lidocaine Hydrochloride injection 2% is prohibited and it is also contraindicated as a local anesthetic in cases of complete heart block and hypovolaemia.