Lidocaine

Lidocaine
Clinical data
PronunciationLidocaine: /ˈlaɪdəkeɪn/ LY-də-kayn[1][2]
Lignocaine: /ˈlɪɡnəkeɪn/ LIG-nə-kayn
Trade namesXylocaine, Ztlido, others
Other nameslignocaine
AHFS/Drugs.comLocal Monograph

Systemic Monograph

Ophthalmic Professional Drug Facts
MedlinePlusa682701
License data
Pregnancy
category
  • AU: A
Routes of
administration		Intravenous, subcutaneous, topical, by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability35% (by mouth)
3% (topical)
MetabolismLiver,[7] 90% CYP3A4-mediated
Onset of actionWithin 1.5 min (IV)[7]
Elimination half-life1.5 h to 2 h
Duration of action10 min to 20 min (IV),[7] 0.5 h to 3 h (local)[8][9]
ExcretionKidney[7]
Identifiers
  • 2-(diethylamino)-
    N-(2,6-dimethylphenyl)acetamide
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.004.821 Edit this at Wikidata
Chemical and physical data
FormulaC14H22N2O
Molar mass234.343 g·mol−1
3D model (JSmol)
Melting point68 °C (154 °F)
  • Cc1cccc(C)c1NC(=O)CN(CC)CC
  • InChI=1S/C14H22N2O/c1-5-16(6-2)10-13(17)15-14-11(3)8-7-9-12(14)4/h7-9H,5-6,10H2,1-4H3,(H,15,17) checkY
  • Key:NNJVILVZKWQKPM-UHFFFAOYSA-N checkY
  (verify)

Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type.[10] It is also used to treat ventricular tachycardia and ventricular fibrillation.[7][8] When used for local anaesthesia or in nerve blocks, lidocaine typically begins working within several minutes and lasts for half an hour to three hours.[8][9] Lidocaine mixtures may also be applied directly to the skin or mucous membranes to numb the area.[10][8] It is often used mixed with a small amount of adrenaline (epinephrine) to prolong its local effects and to decrease bleeding.[8]

If injected intravenously, it may cause cerebral effects such as confusion, changes in vision, numbness, tingling, and vomiting.[10][7] It can cause low blood pressure and an irregular heart rate.[7] There are concerns that injecting it into a joint can cause problems with the cartilage.[8] It appears to be generally safe for use in pregnancy.[7] A lower dose may be required in those with liver problems.[7] It is generally safe to use in those allergic to tetracaine or benzocaine.[8] Lidocaine is an antiarrhythmic medication of the class Ib type.[7] This means it works by blocking sodium channels and thus decreasing the rate of contractions of the heart.[10][7] When injected near nerves, the nerves cannot conduct signals to or from the brain.[8]

Lidocaine was discovered in 1946 and went on sale in 1948.[11] It is on the World Health Organization's List of Essential Medicines.[12] It is available as a generic medication.[8][13] In 2021, it was the 267th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[14][15]

  1. ^ "Lidocaine". Merriam-Webster.com Dictionary. Merriam-Webster.
  2. ^ "Lidocaine". Dictionary.com Unabridged (Online). n.d.
  3. ^ "Poisons Standard February 2021". Federal Register of Legislation. 1 January 2021. Retrieved 11 April 2021.
  4. ^ "Lidocaine Hydrochloride Injection BP 1% w/v - Summary of Product Characteristics (SmPC)". (emc). 29 June 2020. Retrieved 11 April 2021.
  5. ^ "Xylocaine MPF- lidocaine hydrochloride injection, solution Xylocaine- lidocaine hydrochloride injection, solution Xylocaine- lidocaine hydrochloride,epinephrine bitartrate injection, solution". DailyMed. Retrieved 11 April 2021.
  6. ^ "Ztlido- lidocaine patch". DailyMed. Retrieved 11 April 2021.
  7. ^ a b c d e f g h i j k "Lidocaine Hydrochloride (Antiarrhythmic)". Drugs.com, The American Society of Health-System Pharmacists. 10 June 2024. Retrieved 23 July 2024.
  8. ^ a b c d e f g h i "Lidocaine Hydrochloride (Local)". Drugs.com, The American Society of Health-System Pharmacists. 22 January 2024. Retrieved 23 July 2024.
  9. ^ a b Nolan JP, Baskett PJ (1997). "Analgesia and anaesthesia". In David Skinner, Andrew Swain, Rodney Peyton, Colin Robertson (eds.). Cambridge Textbook of Accident and Emergency Medicine. Project co-ordinator, Fiona Whinster. Cambridge, UK: Cambridge University Press. p. 194. ISBN 9780521433792. Archived from the original on 8 September 2017.
  10. ^ a b c d Beecham GB, Nessel TA, Goyal A (11 December 2022). "Lidocaine". StatPearls, US National Library of Medicine. Retrieved 23 July 2024.
  11. ^ Scriabine A (1999). "Discovery and development of major drugs currently in use". In Ralph Landau, Basil Achilladelis, Alexander Scriabine (eds.). Pharmaceutical Innovation: Revolutionizing Human Health. Philadelphia: Chemical Heritage Press. p. 211. ISBN 9780941901215. Archived from the original on 8 September 2017.
  12. ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  13. ^ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 22. ISBN 9781284057560.
  14. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  15. ^ "Lidocaine - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.