Lidocaine

Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia. 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. Lidocaine mixtures may also be applied directly to the skin or mucous membranes to numb the area. It is often used mixed with a small amount of adrenaline (epinephrine) to prolong its local effects and to decrease bleeding.

Lidocaine
Clinical data
PronunciationLidocaine /ˈldəˌkn/
Lignocaine /ˈlɪɡnəˌkn/
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
  • AU: S5, S4, and S2
  • UK: GSL, P, and POM
  • US: ℞-only
Pharmacokinetic data
Bioavailability35% (by mouth)
3% (topical)
MetabolismLiver, 90% CYP3A4-mediated
Onset of actionwithin 1.5 min (IV)
Elimination half-life1.5 h to 2 h
Duration of action10 min to 20 min(IV), 0.5 h to 3 h (local)
ExcretionKidney
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
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) Y
  • Key:NNJVILVZKWQKPM-UHFFFAOYSA-N Y
  (verify)

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

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

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