Drug Interaction:
Antiarrhythmic agents include-
Group I - Moricizine, Qunidine, Procainamide, Disopyramide, Lidocaine, Phenytoin,
Tocainide, Mexiletine, Flecanide, , Propafenone
Group II- Propranolol, Esmolol, Acebutol
Group III- Bretylium, Amiodarone, Solatol
Group IV- Verapramil, Digoxin, Adenosine
Interacting drugs- summary
+ Lidocaine-
Beta blockers
increased lidocaine levels ,possibly resulting in in toxicity
Cimetidine
decreased lidocaine clearance with possible toxicity. Ranitidine and
other H2 antagonists, do not appear to interact.
Procainamide
additive cardiodepressant action occur with potential for
conduction abnormalities
Tocainide
concomittant use cause an increased incidence of adverse
reactions
Lidocaine +
Succinyl choline
prolongation of neuromuscular blockade occur.
Indication:
Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
1.Lidocaine 2.5% w/w 26-03-2010
+ Pilocaine 2.5% w/w gel
(Addl.higher stgth.)
As approved
2.Lidocaine 7.5mg + Prilocaine 2.5mg 12-03-2010
Acutation spray
For the treatment of adult male patients with premature ejaculation
3.Lidocaine Hcl Ophthalmic 30-07-2010
sterile Gel 35mg/ml
Indicated for ocular surface anesthesia during ophthalmic procedures
4.Lidocaine Lozenges 15-07-2010
100mg ( Addl.stgth.)
Same as approved
5.Lidocaine Lozenges 26-02-2009
200mg/300mg
For single agent anenthesia in upper gastro-intestinal endoscopy
6.Lidocaine Lozenges 19-08-2009
200mg/300mg
(Addl.Indtn.)
For single agent anesthesia inprocedure invloving the introduction
of instrument & tubes into respiratory tract
7.Lidocaine patch 350mg 17-06-2010
(Addl.pack size)
For the relief of pain associated with post-hepatic neuralgia. It should
be applied only to intact skin.
8.Lidocaine patch 700mg in 26-03-2009
aqueous base
(50mg/gm adhesive)
For relief of pain associated with post-herpetic neuralgia. It should be
appliedonly to intact skin.
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1.Cross linked Hyaluronic acid 24mg+ 28-05-2010
Lidocaine 3mg Pre filled syringe
For filling any medium sized depression of the skin via
mid dermis injection as as lip definition. The presence of
lidocaine is meant to reduce the patients pain during
the treatment
2.Lidocaine2% + May 1999
Prilocaine 2.5% w/w cream
As a topical anesthetic for use on normal intact skin
for local anesthesia
3. Lidocaine 2.5% w/w + 26-03-2010
Prilocaine 2.5% w/w Gel
Addl.stgth
As a topical anesthetic for use on normal intact skin
for local anesthestia
4. Lidocaine 7.5mg + 03-12-2010
Prilocaine 2.5mg per actuation spray
For the treatment of adult male patients with premature
ejaculation
Acute management of ventricular arrhythmias occuring during cardiac manupulation, viz. cardiac surgery, acute myocardial infraction
Antiarrhythmic agents include-
Group I - Moricizine, Qunidine, Procainamide, Disopyramide, Lidocaine, Phenytoin,
Tocainide, Mexiletine, Flecanide, Propafenone
Group II- Propranolol, Esmolol, Acebutol
Group III- Bretylium, Amiodarone, Solatol
Group IV- Verapramil, Digoxin, Adenosine
Adverse Reaction:
Lightheadedness, nervousness, drowsiness, dizziness, apprenhension, confusion, mood changes, doom anxiety, hallucinations, euphoria, blurred or double vision. Hypotension, bradycardia, cardiovascular collapse, which may lead to cardiac arrest.
Contra-Indications:
Hypersensitivity to amide local aneathetics, Stokes-Adams syndrome, Wolff-Parkinson White syndrome, severe degrees of sinoatrial, atrioventricular(AV) or intraventricular block in the absence of an artificial pacemaker.
Special precautions:
Malignant hyperthermia- safety of amide local anesthetics in patients with genetic predisposition of malignant hyperthermia has not been established. Use lidocaine with caution in such patients
Dosages/ Overdosage Etc:
Indications:
Acute management of ventricular arrhythmias occuring during cardiac manupulation, viz. cardiac surgery, acute myocardial infraction
Dosage:
IM- 300mg- the deltoid muscle is preferred- avoid intramuscular injection.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Lidocaine, flecinide, torcainide, or anesthetics.
2.Pregnancy-
Lidocaine has not been studied in pregnant women. However,this medicine may
reduce the blood supply to the unborn baby.
3. Breast-feeding-
It is known whether lidocaine passes into breast milk. However, this medicine
is not expected to cause problems in nursing babies
4.Children-
Although there is no specific information comparing use of lidocaine in children
with use in other age groups, this medicine is not expected to cause different
side effects or problems in children than it does in adults.
5.Older adults-
This medicine may increase the chance of side effects during treatment.
6. Other medicines-
Tell your doctor if you are using any of the following -
Ethotoin or
Mephenytoin or
Phenytoin - risk of slow heart beat may be increased
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Congestive heart failure or
Kidney disease or
Liver disease - effects may be increased because of slower removal
of lidocaine from the body.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Lidocaine increases the electrical stimulation threshold of the ventricle during diastole. In therapeutic doses, lidocaine produces no change in myocardial contractility, systolic arterial blood pressure or absolute refractory period.
Pregnancy and lactation:
Pregnancy:
Use during pregnancy when needed.
Lactation:
Excercise caution when administering to a nursing woman.
