lALLERGY AND CROSS-SENSITIVITY
▶Hypersensitivity and cross-sensitivityHypersensitivity
reactions occur mainly with the ester-type local
anaesthetics, such as tetracaine; reactions are less
frequent with the amide types, such as articaine,
bupivacaine, levobupivacaine, lidocaine, mepivacaine,
prilocaine, and ropivacaine. Cross-sensitivity reactions
may be avoided by using the alternative chemical type.
lPREGNANCYCrosses the placenta but not known to be
harmful inanimalstudies—use if benefit outweighs risk.
When used as a local anaesthetic, large doses can cause
fetal bradycardia; if given during delivery can also cause
neonatal respiratory depression, hypotonia, or bradycardia
after paracervical or epidural block.
lBREAST FEEDINGPresent in milk but amount too small to
be harmful.
lHEPATIC IMPAIRMENTCaution—increased risk of side-
effects.
lRENAL IMPAIRMENTPossible accumulation of lidocaine
and active metabolite; caution in severe impairment.
lMONITORING REQUIREMENTS
▶With systemic useMonitor ECG and have resuscitation
facilities available.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: solution for injection, ointment
Solution for injection
▶Lidocaine hydrochloride (Non-proprietary)
Lidocaine hydrochloride 5 mg per 1 mlLidocaine 50 mg/ 10 ml
( 0. 5 %) solution for injection ampoules| 10 ampouleP£ 7. 00
Lidocaine hydrochloride 10 mg per 1 mlLidocaine 100 mg/ 10 ml
( 1 %) solution for injection Mini-Plasco ampoules| 20 ampouleP
£ 11. 21
Lidocaine 100 mg/ 10 ml ( 1 %) solution for injection ampoules|
10 ampouleP£ 4. 40 DT = £ 4. 40
Lidocaine 100 mg/ 10 ml ( 1 %) solution for injection Sure-Amp ampoules
| 20 ampouleP£ 8. 80
Lidocaine 200 mg/ 20 ml ( 1 %) solution for injection vials| 10 vialP
£ 19. 00
Lidocaine 200 mg/ 20 ml ( 1 %) solution for injection ampoules|
10 ampouleP£ 7. 00 – £ 9. 63 DT = £ 9. 63
Lidocaine 50 mg/ 5 ml ( 1 %) solution for injection ampoules|
10 ampouleP£ 2. 59 – £ 3. 10 DT = £ 2. 59
Lidocaine 20 mg/ 2 ml ( 1 %) solution for injection ampoules|
10 ampouleP£ 3. 50 DT = £ 2. 20
Lidocaine 50 mg/ 5 ml ( 1 %) solution for injection Sure-Amp ampoules|
20 ampouleP£ 6. 00
Lidocaine hydrochloride 20 mg per 1 mlLidocaine 100 mg/ 5 ml
( 2 %) solution for injection ampoules| 10 ampouleP£ 2. 70 – £ 3. 80
DT = £ 2. 70
Lidocaine 400 mg/ 20 ml ( 2 %) solution for injection vials| 10 vialP
£ 19. 50
Lidocaine 200 mg/ 10 ml ( 2 %) solution for injection Mini-Plasco
ampoules| 20 ampouleP£ 14. 95
Lidocaine 40 mg/ 2 ml ( 2 %) solution for injection ampoules|
10 ampouleP£ 4. 00 DT = £ 2. 37
Lidocaine 100 mg/ 5 ml ( 2 %) solution for injection Sure-Amp ampoules
| 20 ampouleP£ 6. 00
Lidocaine 400 mg/ 20 ml ( 2 %) solution for injection ampoules|
10 ampouleP£ 8. 00 – £ 9. 90 DT = £ 9. 90
Cream
EXCIPIENTS:May contain Benzyl alcohol, propylene glycol
▶LMX 4 (Ferndale Pharmaceuticals Ltd)
Lidocaine 40 mg per 1 gramLMX 4 cream| 5 gramp£ 2. 98 DT =
£ 2. 98 | 30 gramp£ 14. 90 DT = £ 14. 90
Ointment
▶Lidocaine hydrochloride (Non-proprietary)
Lidocaine hydrochloride 50 mg per 1 gramLidocaine 5 % ointment
| 15 gramp£ 6. 50 DT = £ 6. 18
Lidocaine with adrenaline
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, lidocaine hydrochloride p. 826 ,
adrenaline/epinephrine p. 136.lINDICATIONS AND DOSE
Local anaesthesia
▶BY LOCAL INFILTRATION
▶Child 12–17 years:Dosed according to the type of nerve
block required (consult product literature)IMPORTANT SAFETY INFORMATION
Adrenaline/epinephrine must be used in a low
concentration when administered with a local
anaesthetic. The total dose of adrenaline should not
exceed 5 micrograms/kg ( 1 mL/kg of a 1 in200 000
solution) and it is essential not to exceed a
concentration of 1 in200 000( 5 micrograms/mL) if more
than 50 mL of the mixture is to be injected.lINTERACTIONS→Appendix 1 : antiarrhythmics.
sympathomimetics, vasoconstrictor
lPROFESSION SPECIFIC INFORMATION
Dental information
A variety of lidocaine injections with adrenaline is
available in dental cartridges.
Consult expert dental sources for specific advice in
relation to dose of lidocaine for dental anaesthesia.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: solution for injection
Solution for injection
EXCIPIENTS:May contain Sulfites
▶Lignospan Special(Septodont Ltd)
Adrenaline (as Adrenaline acid tartrate) 12.5 microgram per 1 ml,
Lidocaine hydrochloride 20 mg per 1 mlLignospan Special 2 %
injection 2. 2 ml cartridges| 50 cartridgeP£ 21. 95
Lignospan Special 2 % injection 1. 8 ml cartridges| 50 cartridgeP
£ 21. 95
▶Rexocaine(Henry Schein Ltd)
Adrenaline (as Adrenaline acid tartrate) 12.5 microgram per 1 ml,
Lidocaine hydrochloride 20 mg per 1 mlRexocaine 2 % injection
2. 2 ml cartridges| 50 cartridgeP£ 23. 29
▶Xylocaine with Adrenaline(Aspen Pharma Trading Ltd)
Adrenaline (as Adrenaline acid tartrate) 5 microgram per 1 ml,
Lidocaine hydrochloride 10 mg per 1 mlXylocaine 1 % with
Adrenaline 100 micrograms/ 20 ml ( 1 in 200 , 000 ) solution for injection
vials| 5 vialP£ 9. 66 DT = £ 9. 66
Adrenaline (as Adrenaline acid tartrate) 5 microgram per 1 ml,
Lidocaine hydrochloride 20 mg per 1 mlXylocaine 2 % with
Adrenaline 100 micrograms/ 20 ml ( 1 in 200 , 000 ) solution for injection
vials| 5 vialP£ 8. 85 DT = £ 8. 85Lidocaine with cetrimide 27-Apr-2018
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, lidocaine hydrochloride p. 826.lINDICATIONS AND DOSE
Anaesthesia and disinfection in dental practice
▶TO MUCOUS MEMBRANES USING OROMUCOSAL SPRAY
▶Child 4–17 years: 10 – 20 mg, no more than 30 mg should
be applied to the same quadrant of the buccal cavity—
consult product literature, dose expressed
as lidocaine continued→BNFC 2018 – 2019 Local anaesthesia 827
Anaesthesia15