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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class Ib
lidocaine
C01BB01
Forms & Strengths
- injection 5 mg/mL
- injection 10 mg/mL
- injection 20 mg/mL
- topical 2% jelly
- topical 2% solution
- topical 4% solution
- transdermal patch 5%
Adult Dosing
- local anesthesia: 5-20 mL of 0.5-2% injection
- epidural anesthesia: 15-25 mL of 1-2% injection
- caudal anesthesia: 15-30 mL of 1-2% injection
- intravenous dosing: 50-100 mg over 1-2 minutes
- max dose: 4.5 mg/kg or 300 mg total
Pediatric Dosing
- local anesthesia: 0.5-1 mL of 0.5-1% injection per 10 pounds of body weight
- epidural anesthesia: 0.5-1 mL of 1% injection per 10 pounds of body weight
- caudal anesthesia: 0.5-1 mL of 1% injection per 10 pounds of body weight
- intravenous dosing: 1 mg/kg over 1 minute, max dose: 60 mg total
Indications
- local and regional anesthesia
- prolonged conduction anesthesia
- relief of pain in acute inflammatory conditions
- management of ventricular arrhythmias
- diagnosis and treatment of certain cardiac arrhythmias
Mechanism of Action
- blocks sodium channels
- decreases automaticity of cardiac tissue
- decreases depolarization rate of cardiac tissue
- suppresses conduction in nerve tissues
Contraindications
- hypersensitivity to lidocaine or amide local anesthetics
- severe heart block
- Adam-Stokes syndrome
- congenital or idiopathic methemoglobinemia
- porphyria
Adverse Reactions
- central nervous system toxicity
- peripheral nervous system toxicity
- cardiovascular toxicity
- allergic reactions
- methemoglobinemia
- hives and itching
- angioedema
Drug Interactions
- MAOIs: increased risk of cardiac arrhythmias
- beta blockers: increased risk of cardiac arrhythmias
- cimetidine: increased lidocaine levels
- phenytoin: decreased lidocaine levels
- sulfonamides: increased risk of methemoglobinemia
Curated Content: Needs Vetting Before Put to Clinical Use