Lidocaine topical

XYLOCAINE

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Pronunciation: LYE-doe-kayn

Lidocaine topical ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Lidocaine topical ballicule

Lidocaine topical XYLOCAINE mascot mnemonic cartoon — Visual mnemonic: Lidocaine topical mascot
**“Lit up Xylo cane”**

What it isSodium channel blocker applied to skin or mucosa; localized neuropathic pain (patch) and topical or mucosal anesthesia.

Why this oneThe patch gives segmental pain relief with negligible systemic exposure, which is why it survives in patients who tolerate no systemic analgesic.

What limits itMucosal and large-area application can still reach toxic systemic levels — perioral tingling, then seizures and cardiovascular collapse — so the area covered and the number of patches are both capped.

Lidocaine topical molecular structure (skeletal formula) — Molecular structure: Lidocaine topical

FDA-approved for

local anesthesia (~1948)

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Max
Symptomatic irritated/inflamed mucous membranes of mouth and pharynx	Adults	15 mL undiluted, swished or gargled, not more often than q3h	300 mg (<=4.5 mg/kg) per dose; <=8 doses/24h
Oral/pharyngeal topical anesthesia	Children >3 yr (normal lean mass)	Weight/age-based (e.g., 3.7–5 mL in a 50-lb 5-yr-old)	Do not exceed weight-based maximum
Oral topical anesthesia	Infants and children <3 yr	<=1.2 mL to affected area via cotton-tipped applicator; wait >=3h	<=4 doses per 12h

Renal Undefined

Hepatic Undefined

Max single dose <=4.5 mg/kg (2 mg/lb), not to exceed 300 mg total; space doses >=3h.

Instructions

For the mouth: swish solution around and spit out.
For the pharynx: gargle undiluted solution; may be swallowed.
Measure pediatric doses accurately — overdoses have occurred from inappropriate dosing.
Adjust dose for patient age, weight, and physical condition.

Available strengths

patch 1.8, 5 %
jelly 2 %
ointment 5 %
granules 100 kg/100 kg
drops 40 mg/mL
emulsion 5 g/100 mL
sol 2, 4 %
cream 0.5 g/10 g
+ 34 other marketed forms not shown

Cautions

Dose-related systemic toxicity from high plasma levels or rapid absorption (CNS excitation then depression, convulsions, respiratory arrest)
Cardiovascular depression: bradycardia, hypotension, cardiovascular collapse, cardiac arrest
Allergic reactions, incl. to methylparaben/propylparaben excipients
Risk of overdose in pediatric patients

Adverse reactions

CNS: lightheadedness, dizziness, tinnitus, blurred/double vision, tremors, convulsions, respiratory depression
Cardiovascular: bradycardia, hypotension, cardiovascular collapse, cardiac arrest
Allergic: urticaria, edema, anaphylactoid reactions

Pregnancy No evidence of fetal harm in animal studies; no adequate human studies; use in pregnancy only if clearly needed.

Lactation Undefined

Cost

Lidocaine topical (XYLOCAINE)

Strength		#/mo	CostPlus
8 mg/mL	inj	per unit	not offered
15 mg/mL	inj	per unit	not offered
40 mg/mL	inj	per unit	not offered
2 %	jelly	per unit	not offered
5 %	ointment	per unit	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Lidocaine topical is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Other forms: Lidocaine injection (XYLOCAINE)

Generic entry1982

⚠ BOXED WARNINGS

Life-threatening and fatal events in infants and young children with the viscous oral solution
Seizures
Cardiopulmonary arrest

Principal riskSystemic toxicity: perioral tingling, then seizures

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger4 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilitySystemic local-anesthetic toxicity causes seizures, conduction block and ventricular dysrhythmia.

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