{"id":"lidocaine-hydrochloride","rwe":[{"pmid":"41791701","year":"2026","title":"Cannabidiol reduces the latency for the behavioral effect of escitalopram in chronically stressed male mice: involvement of NAPE-PLD expressed in parvalbumin-positive interneurons and the prefrontal cortex.","finding":"","journal":"Neuropharmacology","studyType":"Clinical Study"},{"pmid":"41782152","year":"2026","title":"Effects of ultrasound-guided stellate ganglion block in poststroke bulbar palsy: a double-blind placebo-controlled trial.","finding":"","journal":"BMC medicine","studyType":"Clinical Study"},{"pmid":"41694983","year":"2026","title":"Effect of Surface Anesthetics on Tongue Sensory Function.","finding":"","journal":"Cureus","studyType":"Clinical Study"},{"pmid":"41684952","year":"2026","title":"A Biomass-Inspired Hydrogel Patch for Intelligent Pain Monitoring and On-Demand Analgesia.","finding":"","journal":"Research (Washington, D.C.)","studyType":"Clinical Study"},{"pmid":"41653461","year":"2026","title":"Biocompatible Glue-Enabled Drug Localization and Mechanical Reinforcement of Lyophilized Microneedle Systems.","finding":"","journal":"Small (Weinheim an der Bergstrasse, Germany)","studyType":"Clinical Study"}],"_fda":{"id":"10e6f471-d23a-2a9a-e063-6394a90acd55","set_id":"0050d05a-b8e9-c544-e063-6294a90a0243","openfda":{"upc":["0368071344905"],"unii":["V13007Z41A"],"route":["ORAL","TOPICAL"],"rxcui":["1010739"],"spl_id":["10e6f471-d23a-2a9a-e063-6394a90acd55"],"brand_name":["Lidocaine Hydrochloride"],"spl_set_id":["0050d05a-b8e9-c544-e063-6294a90a0243"],"package_ndc":["68071-3449-2"],"product_ndc":["68071-3449"],"generic_name":["LIDOCAINE HYDROCHLORIDE"],"product_type":["HUMAN PRESCRIPTION DRUG"],"substance_name":["LIDOCAINE HYDROCHLORIDE"],"manufacturer_name":["NuCare Pharmaceuticals,Inc."],"application_number":["ANDA088802"],"original_packager_product_ndc":["0054-3500"]},"version":"2","warnings":["WARNINGS EXCESSIVE DOSAGE, OR SHORT INTERVALS BETWEEN DOSES, CAN RESULT IN HIGH PLASMA LEVELS AND SERIOUS ADVERSE EFFECTS. PATIENTS SHOULD BE INSTRUCTED TO STRICTLY ADHERE TO THE RECOMMENDED DOSAGE AND ADMINISTRATION GUIDELINES AS SET FORTH IN THIS PACKAGE INSERT. THE MANAGEMENT OF SERIOUS ADVERSE REACTIONS MAY REQUIRE THE USE OF RESUSCITATIVE EQUIPMENT, OXYGEN, AND OTHER RESUSCITATIVE DRUGS. Lidocaine should be used with extreme caution if the mucosa in the area of application has been traumatized, since under such conditions there is the potential for rapid systemic absorption. Life-threatening and fatal events in infants and young children Postmarketing cases of seizures, cardiopulmonary arrest, and death in patients under the age of 3 years have been reported with use of Lidocaine Viscous 2% when it was not administered in strict adherence to the dosing and administration recommendations. In the setting of teething pain, Lidocaine Viscous 2% should generally not be used. For other conditions, the use of the product in patients less than 3 years of age should be limited to those situations where safer alternatives are not available or have been tried but failed. Methemoglobinemia Cases of methemoglobinemia have been reported in association with local anesthetic use. Although all patients are at risk for methemoglobinemia, patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended. Signs of methemoglobinemia may occur immediately or may be delayed some hours after exposure, and are characterized by a cyanotic skin discoloration and/or abnormal coloration of the blood. Methemoglobin levels may continue to rise; therefore, immediate treatment is required to avert more serious central nervous system and cardiovascular adverse effects, including seizures, coma, arrhythmias, and death. Discontinue Lidocaine Viscous 2% and any other oxidizing agents. Depending on the severity of the signs and symptoms, patients may respond to supportive care, i.e., oxygen therapy, hydration. A more severe clinical presentation may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen."],"pregnancy":["Pregnancy Teratogenic Effects Pregnancy Category B: Reproduction studies have been performed in rats at doses up to 6.6 times the human dose and have revealed no evidence of harm to the fetus caused by lidocaine. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used in pregnancy only if clearly needed."],"overdosage":["OVERDOSAGE Acute emergencies from local anesthetics are generally related to high plasma levels encountered during therapeutic use of local anesthetics. (See ADVERSE REACTIONS , WARNINGS , and PRECAUTIONS ) Management of Local Anesthetic Emergencies The first consideration is prevention, best accomplished by careful and constant monitoring of cardiovascular and respiratory vital signs and the patient’s state of consciousness after each local anesthetic administration. The first step in the management of convulsions consist of immediate attention to the maintenance of a patent airway and assisted or controlled ventilation with oxygen. In situations where trained personnel are readily available, ventilation should be maintained and oxygen should be delivered by a delivery system capable of permitting immediate positive airway pressure by mask. Immediately after the institution of these ventilatory measures, the adequacy of the circulation should be evaluated, keeping in mind that drugs used to treat convulsions sometimes depress the circulation when administered intravenously. Should convulsions persist despite adequate respiratory support, and if the status of the circulation permits, small increments of an ultra-short acting barbiturate (such as thiopental or thiamylal) or a benzodiazepine (such as diazepam) may be administered intravenously. The clinician should be familiar, prior to use of local anesthetics, with these anticonvulsant drugs. Supportive treatment of circulatory depression may require administration of intravenous fluids and, when appropriate, a vasopressor as indicated by the clinical situation (e.g., ephedrine). If not treated immediately, both convulsions and cardiovascular depression can result in hypoxia, acidosis, bradycardia, arrhythmias and cardiac arrest. If cardiac arrest should occur, standard cardiopulmonary resuscitative measures should be instituted. Dialysis is of negligible value in the treatment of acute overdosage with lidocaine. The oral LD 50 of lidocaine in non-fasted female rats is 459 (346 to 773) mg/kg (as the salt) and 214 (159 to 324) mg/kg (as the salt) in fasted female rats."],"description":["DESCRIPTION Lidocaine Viscous 2% (Lidocaine Hydrochloride Oral Topical Solution USP) contains a local anesthetic agent and is administered topically. Lidocaine Viscous 2% (Lidocaine Hydrochloride Oral Topical Solution USP) contains lidocaine hydrochloride, which is chemically designated as acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)-,monohydrochloride, and has the following structural formula: The molecular formula of lidocaine is C 14 H 22 N 2 O. The molecular weight is 234.34. Composition of Solution : Each mL contains 20 mg (2%) of lidocaine hydrochloride USP and the following inactive ingredients: carboxymethylcellulose sodium, flavoring, methylparaben, propylparaben, purified water and saccharin sodium. chem-structure.jpg"],"precautions":["PRECAUTIONS Information for Patients Parents and caregivers should be cautioned about the following: For patients under 3 years of age, special care must be given to accurately measuring the prescribed dose and not administering the product more often than prescribed. To ensure accuracy, we recommend you use a measuring device to carefully measure the correct volume. The product should only be used for the prescribed indication. To reduce the risk of accidental ingestion, the product container should be tightly closed and the product should be stored well out of reach of all children immediately after each use. If the patient shows signs of systemic toxicity (e.g., lethargy, shallow breathing, seizure activity) emergency medical attention should besought immediately and no additional product should be administered. Unused product should be discarded in a manner that prevents possible exposure to children and pets. All patients should be aware that when topical anesthetics are used in the mouth or throat, the production of topical anesthesia may impair swallowing and thus enhance the danger of aspiration. For this reason, food should not be ingested for 60 minutes following use of local anesthetic preparations in the mouth or throat area. This is particularly important in children because of their frequency of eating. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma. For this reason food and/or chewing gum should not be used while the mouth or throat area is anesthetized. Inform patients that use of local anesthetics may cause methemoglobinemia, a serious condition that must be treated promptly. Advise patients or caregivers to seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue. General The safety and effectiveness of lidocaine depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies (see WARNINGS and ADVERSE REACTIONS ). The lowest dosage that results in effective anesthesia should be used to avoid high plasma levels and serious adverse effects. Repeated doses of lidocaine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug and/or its metabolites. Tolerance varies with the status of the patient. Debilitated, elderly patients, acutely ill patients, and children should be given reduced doses commensurate with their age, weight and physical condition. Lidocaine should also be used with caution in patients with severe shock or heart block. Lidocaine should be used with caution in persons with known drug sensitivities. Patients allergic to paraaminobenzoic acid derivatives (procaine, tetracaine, benzocaine, etc.) have not shown cross sensitivity to lidocaine. Drug Interactions Patients who are administered local anesthetics are at increased risk of developing methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics: Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitroglycerin, nitroprusside, nitric oxide, nitrous oxide Local anesthetics benzocaine, lidocaine, bupivacaine, mepivacaine, tetracaine, prilocaine, procaine, articaine, ropivacaine Antineoplastic agents cyclophosphamide, flutamide, rasburicase, ifosfamide, hydroxyurea Antibiotics dapsone, sulfonamides, nitrofurantoin, para-aminosalicylic acid Antimalarials chloroquine, primaquine Anticonvulsants phenytoin, sodium valproate, phenobarbital Other drugs acetaminophen, metoclopramide, sulfasalazine, quinine Carcinogenesis, Mutagenesis, Impairment of Fertility Studies of lidocaine in animals to evaluate the carcinogenic and mutagenic potential or the effect on fertility have not been conducted. Pregnancy Teratogenic Effects Pregnancy Category B: Reproduction studies have been performed in rats at doses up to 6.6 times the human dose and have revealed no evidence of harm to the fetus caused by lidocaine. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used in pregnancy only if clearly needed. Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when lidocaine is administered to nursing women. Pediatric Use Dosage in children should be reduced, commensurate with age, body weight and physical conditions. See DOSAGE AND ADMINISTRATION ."],"how_supplied":["HOW SUPPLIED Lidocaine Viscous 2% (Lidocaine Hydrochloride Oral Topical Solution USP) The 2% oral topical solution is supplied as a clear, colorless, viscous solution . NDC 68071-3449-0: Squeeze Bottle of 100 mL Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.] Dispense in a child-resistant container as defined in the USP/NF. SHAKE WELL BEFORE USE. Distr. by: West-Ward Pharmaceuticals Corp. Eatontown, NJ 07724 4055408//11 Revised October 2018"],"boxed_warning":["WARNING: Life-threatening and fatal events in infants and young children Postmarketing cases of seizures, cardiopulmonary arrest, and death in patients under the age of 3 years have been reported with use of Lidocaine Viscous 2% when it was not administered in strict adherence to the dosing and administration recommendations. In the setting of teething pain, Lidocaine Viscous 2% should generally not be used. For other conditions, the use of the product in patients less than 3 years of age should be limited to those situations where safer alternatives are not available or have been tried but failed. To decrease the risk of serious adverse events with use of Lidocaine Viscous 2%, instruct caregivers to strictly adhere to the prescribed dose and frequency of administration and store the prescription bottle safely out of reach of children."],"pediatric_use":["Pediatric Use Dosage in children should be reduced, commensurate with age, body weight and physical conditions. See DOSAGE AND ADMINISTRATION ."],"effective_time":"20240208","nursing_mothers":["Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when lidocaine is administered to nursing women."],"adverse_reactions":["ADVERSE REACTIONS Adverse experiences following the administration of lidocaine are similar in nature to those observed with other amide local anesthetic agents. These adverse experiences are, in general, dose-related and may result from high plasma levels caused by excessive dosage or rapid absorption, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature. The following types are those most commonly reported: Central Nervous System CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest. Drowsiness following the administration of lidocaine is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption. Cardiovascular System Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest. Allergic Allergic reactions are characterized by cutaneous lesions, urticaria, edema or anaphylactoid reactions. Allergic reactions may occur as a result of sensitivity either to the local anesthetic agent or to the methylparaben and/or propylparaben used in this formulation. Allergic reactions as a result of sensitivity to lidocaine are extremely rare and, if they occur, should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value."],"contraindications":["CONTRAINDICATIONS Lidocaine is contraindicated in patients with a known history of hypersensitivity to local anesthetics of the amide type, or to other components of the solution."],"drug_interactions":["Drug Interactions Patients who are administered local anesthetics are at increased risk of developing methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics: Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitroglycerin, nitroprusside, nitric oxide, nitrous oxide Local anesthetics benzocaine, lidocaine, bupivacaine, mepivacaine, tetracaine, prilocaine, procaine, articaine, ropivacaine Antineoplastic agents cyclophosphamide, flutamide, rasburicase, ifosfamide, hydroxyurea Antibiotics dapsone, sulfonamides, nitrofurantoin, para-aminosalicylic acid Antimalarials chloroquine, primaquine Anticonvulsants phenytoin, sodium valproate, phenobarbital Other drugs acetaminophen, metoclopramide, sulfasalazine, quinine"],"precautions_table":["
ClassExamples
Nitrates/Nitritesnitroglycerin, nitroprusside, nitric oxide, nitrous oxide
Local anestheticsbenzocaine, lidocaine, bupivacaine, mepivacaine, tetracaine, prilocaine, procaine, articaine, ropivacaine
Antineoplastic agentscyclophosphamide, flutamide, rasburicase, ifosfamide, hydroxyurea
Antibioticsdapsone, sulfonamides, nitrofurantoin, para-aminosalicylic acid
Antimalarialschloroquine, primaquine
Anticonvulsants phenytoin, sodium valproate, phenobarbital
Other drugsacetaminophen, metoclopramide, sulfasalazine, quinine
"],"general_precautions":["General The safety and effectiveness of lidocaine depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies (see WARNINGS and ADVERSE REACTIONS ). The lowest dosage that results in effective anesthesia should be used to avoid high plasma levels and serious adverse effects. Repeated doses of lidocaine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug and/or its metabolites. Tolerance varies with the status of the patient. Debilitated, elderly patients, acutely ill patients, and children should be given reduced doses commensurate with their age, weight and physical condition. Lidocaine should also be used with caution in patients with severe shock or heart block. Lidocaine should be used with caution in persons with known drug sensitivities. Patients allergic to paraaminobenzoic acid derivatives (procaine, tetracaine, benzocaine, etc.) have not shown cross sensitivity to lidocaine."],"clinical_pharmacology":["CLINICAL PHARMACOLOGY Mechanism of Action Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action. Hemodynamics Excessive blood levels may cause changes in cardiac output, total peripheral resistance, and mean arterial pressure. These changes may be attributable to a direct depressant effect of the local anesthetic agent on various components of the cardiovascular system. The net effect is normally a modest hypotension when the recommended dosages are not exceeded. Pharmacokinetics and Metabolism Lidocaine is absorbed following topical administration to mucous membranes, its rate and extent of absorption being dependent upon concentration and total dose administered, the specific site of application, and duration of exposure. In general, the rate of absorption of local anesthetic agents following topical application occurs most rapidly after intratracheal administration. Lidocaine is also well-absorbed from the gastrointestinal tract, but little intact drug appears in the circulation because of biotransformation in the liver. The plasma binding of lidocaine is dependent on drug concentration, and the fraction bound decreases with increasing concentration. At concentrations of 1 to 4 mcg of free base per mL, 60 to 80 percent of lidocaine is protein bound. Binding is also dependent on the plasma concentration of the alpha-1-acid glycoprotein. Lidocaine crosses the blood-brain and placental barriers, presumably by passive diffusion. Lidocaine is metabolized rapidly by the liver, and metabolites and unchanged drug are excreted by the kidneys. Biotransformation includes oxidative N-dealkylation, ring hydroxylation, cleavage of the amide linkage, and conjugation. N-dealkylation, a major pathway of biotransformation, yields the metabolites monoethylglycinexylidide and glycinexylidide. The pharmacological/toxicological actions of these metabolites are similar to, but less potent than, those of lidocaine. Approximately 90% of lidocaine administered is excreted in the form of various metabolites, and less than 10% is excreted unchanged. The primary metabolite in urine is a conjugate of 4-hydroxy-2, 6-dimethylaniline. The elimination half-life of lidocaine following an intravenous bolus injection is typically 1.5 to 2 hours. Because of the rapid rate at which lidocaine is metabolized, any condition that affects liver function may alter lidocaine kinetics. The half-life may be prolonged two-fold or more in patients with liver dysfunction. Renal dysfunction does not affect lidocaine kinetics but may increase the accumulation of metabolites. Factors such as acidosis and the use of CNS stimulants and depressants affect the CNS levels of lidocaine required to produce overt systemic effects. Objective adverse manifestations become increasingly apparent with increasing venous plasma levels above 6 mcg free base per mL. In the rhesus monkey arterial blood levels of 18 to 21 mcg/mL have been shown to be threshold for convulsive activity."],"indications_and_usage":["INDICATIONS AND USAGE Lidocaine is indicated for the production of topical anesthesia of irritated or inflamed mucous membranes of the mouth and pharynx. It is also useful for reducing gagging during the taking of X-ray pictures and dental impressions."],"drug_interactions_table":["
ClassExamples
Nitrates/Nitritesnitroglycerin, nitroprusside, nitric oxide, nitrous oxide
Local anestheticsbenzocaine, lidocaine, bupivacaine, mepivacaine, tetracaine, prilocaine, procaine, articaine, ropivacaine
Antineoplastic agentscyclophosphamide, flutamide, rasburicase, ifosfamide, hydroxyurea
Antibioticsdapsone, sulfonamides, nitrofurantoin, para-aminosalicylic acid
Antimalarialschloroquine, primaquine
Anticonvulsants phenytoin, sodium valproate, phenobarbital
Other drugsacetaminophen, metoclopramide, sulfasalazine, quinine
"],"information_for_patients":["Information for Patients Parents and caregivers should be cautioned about the following: For patients under 3 years of age, special care must be given to accurately measuring the prescribed dose and not administering the product more often than prescribed. To ensure accuracy, we recommend you use a measuring device to carefully measure the correct volume. The product should only be used for the prescribed indication. To reduce the risk of accidental ingestion, the product container should be tightly closed and the product should be stored well out of reach of all children immediately after each use. If the patient shows signs of systemic toxicity (e.g., lethargy, shallow breathing, seizure activity) emergency medical attention should besought immediately and no additional product should be administered. Unused product should be discarded in a manner that prevents possible exposure to children and pets. All patients should be aware that when topical anesthetics are used in the mouth or throat, the production of topical anesthesia may impair swallowing and thus enhance the danger of aspiration. For this reason, food should not be ingested for 60 minutes following use of local anesthetic preparations in the mouth or throat area. This is particularly important in children because of their frequency of eating. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma. For this reason food and/or chewing gum should not be used while the mouth or throat area is anesthetized. Inform patients that use of local anesthetics may cause methemoglobinemia, a serious condition that must be treated promptly. Advise patients or caregivers to seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue."],"spl_unclassified_section":["Rx only A topical anesthetic for the mucous membranes of the mouth and pharynx."],"dosage_and_administration":["DOSAGE AND ADMINISTRATION Adult The maximum recommended single dose of lidocaine for healthy adults should be such that the dose of lidocaine does not exceed 4.5 mg/kg or 2 mg/lb body weight and does not in any case exceed a total of 300 mg. For symptomatic treatment of irritated or inflamed mucous membranes of the mouth and pharynx, the usual adult dose is 15 mL undiluted. For use in the mouth, the solution should be swished around in the mouth and spit out. For use in the pharynx, the undiluted solution should be gargled and may be swallowed. This dose should not be administered at intervals of less than three hours, and not more than eight doses should be given in a 24-hour period. The dosage should be adjusted commensurate with the patient’s age, weight and physical condition (see PRECAUTIONS ). Pediatric Care must be taken to ensure correct dosage in all pediatric patients as there have been cases of overdose due to inappropriate dosing. It is difficult to recommend a maximum dose of any drug for children since this varies as a function of age and weight. For children over 3 years of age who have a normal lean body mass and normal body development, the maximum dose is determined by the child’s weight or age. For example: in a child of 5 years weighing 50 lbs., the dose of lidocaine should not exceed 75 to 100 mg (3.7 to 5 mL of lidocaine). For infants and in children under 3 years of age, the solution should be accurately measured and no more than 1.2 mL be applied to the immediate area with a cotton-tipped applicator. Wait at least 3 hours before giving the next dose; a maximum of four doses may be given in a 12-hour period. Lidocaine should only be used if the underlying condition requires treatment with a volume of product that is less than or equal to 1.2 mL."],"spl_product_data_elements":["Lidocaine Hydrochloride Lidocaine Hydrochloride METHYLPARABEN PROPYLPARABEN SACCHARIN SODIUM CARBOXYMETHYLCELLULOSE SODIUM, UNSPECIFIED FORM WATER LIDOCAINE HYDROCHLORIDE LIDOCAINE LIDOCAINE HYDROCHLORIDE ANHYDROUS"],"package_label_principal_display_panel":["Package/Label Display Panel pdp"],"carcinogenesis_and_mutagenesis_and_impairment_of_fertility":["Carcinogenesis, Mutagenesis, Impairment of Fertility Studies of lidocaine in animals to evaluate the carcinogenic and mutagenic potential or the effect on fertility have not been conducted."]},"tags":[{"label":"Amide Local Anesthetic","category":"class"},{"label":"Small Molecule","category":"modality"},{"label":"Sodium channel protein type 4 subunit 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Local","category":"pharmacology"},{"label":"Anti-Arrhythmia Agents","category":"pharmacology"},{"label":"Cardiovascular Agents","category":"pharmacology"},{"label":"Central Nervous System Agents","category":"pharmacology"},{"label":"Central Nervous System Depressants","category":"pharmacology"},{"label":"Membrane Transport Modulators","category":"pharmacology"},{"label":"Peripheral Nervous System Agents","category":"pharmacology"},{"label":"Sensory System Agents","category":"pharmacology"},{"label":"Sodium Channel Blockers","category":"pharmacology"},{"label":"Voltage-Gated Sodium Channel Blockers","category":"pharmacology"}],"phase":"marketed","fdaNDC":[{"route":["INTRAVENOUS"],"labeler":"ProPharma Distribution","brandName":"Lidocaine Hydrochloride and Dextrose","packaging":[{"ndc":"84549-594-20","description":"250 mL in 1 CONTAINER (84549-594-20)","marketingStartDate":"20260119"}],"dosageForm":"INJECTION, SOLUTION","genericName":"LIDOCAINE HYDROCHLORIDE ANHYDROUS and DEXTROSE MONOHYDRATE","productType":"HUMAN PRESCRIPTION DRUG","activeIngredients":[{"name":"DEXTROSE MONOHYDRATE","strength":"5 g/100mL"},{"name":"LIDOCAINE HYDROCHLORIDE ANHYDROUS","strength":".4 g/100mL"}],"marketingCategory":"NDA"},{"route":["EPIDURAL","INFILTRATION","INTRACAUDAL","PERINEURAL"],"labeler":"Hospira, Inc.","brandName":"Lidocaine Hydrochloride","packaging":[{"ndc":"0409-4282-01","description":"5 CELLO PACK in 1 PACKAGE (0409-4282-01) / 5 AMPULE in 1 CELLO PACK (0409-4282-25) / 2 mL in 1 AMPULE (0409-4282-11)","marketingStartDate":"20050914"},{"ndc":"0409-4282-02","description":"25 AMPULE in 1 CARTON (0409-4282-02) / 10 mL in 1 AMPULE (0409-4282-12)","marketingStartDate":"20060106"}],"dosageForm":"INJECTION, SOLUTION","genericName":"LIDOCAINE HYDROCHLORIDE","productType":"HUMAN PRESCRIPTION DRUG","activeIngredients":[{"name":"LIDOCAINE HYDROCHLORIDE","strength":"20 mg/mL"}],"marketingCategory":"ANDA"},{"route":["TOPICAL"],"labeler":"Cannanumb LLC","brandName":"CANNA NUMB Roll 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It stabilizes neuronal membranes by inhibiting ionic fluxes required for impulse initiation and conduction, with rapid hepatic metabolism and renal excretion. Contraindicated in patients with hypersensitivity to amide-type local anesthetics; concurrent use with methemoglobinemia-inducing drugs increases risk of this serious adverse effect. Modest hypotension may occur with excessive blood levels, but adverse effects are generally minimal when recommended dosages are not exceeded.","brandName":"Lignospan Forte","ecosystem":[{"indication":"Hemorrhoids","otherDrugs":[{"name":"cortisone acetate","slug":"cortisone-acetate","company":""},{"name":"ferric oxide","slug":"ferric-oxide","company":""},{"name":"hydrocortisone","slug":"hydrocortisone","company":"Merck"},{"name":"hydrocortisone acetate","slug":"hydrocortisone-acetate","company":"Merck"}],"globalPrevalence":null},{"indication":"Infestation by Phthirus pubis","otherDrugs":[{"name":"lindane","slug":"lindane","company":"Reed And Carnrick"},{"name":"permethrin","slug":"permethrin","company":""},{"name":"piperonyl butoxide","slug":"piperonyl-butoxide","company":"Bayer Healthcare Llc"},{"name":"pyrethrins","slug":"pyrethrins","company":"Bayer Healthcare Llc"}],"globalPrevalence":null},{"indication":"Infestation by Sarcoptes scabiei var hominis","otherDrugs":[{"name":"crotamiton","slug":"crotamiton","company":"Ranbaxy"},{"name":"lindane","slug":"lindane","company":"Reed And Carnrick"},{"name":"permethrin","slug":"permethrin","company":""}],"globalPrevalence":null},{"indication":"Itching of skin","otherDrugs":[{"name":"alimemazine","slug":"alimemazine","company":"Allergan Herbert"},{"name":"allantoin","slug":"allantoin","company":""},{"name":"ammonium lactate","slug":"ammonium-lactate","company":"Ranbaxy"},{"name":"antazoline","slug":"antazoline","company":"Novartis"}],"globalPrevalence":null},{"indication":"Local Anesthesia for Endotracheal Intubation","otherDrugs":[],"globalPrevalence":null},{"indication":"Local Anesthesia for Ophthalmologic Procedure","otherDrugs":[{"name":"bupivacaine","slug":"bupivacaine","company":"Hospira"},{"name":"proparacaine","slug":"proparacaine","company":""},{"name":"tetracaine","slug":"tetracaine","company":"Galen Specialty"}],"globalPrevalence":null},{"indication":"Local Anesthesia for Urethral Pain","otherDrugs":[],"globalPrevalence":null},{"indication":"Local anesthesia","otherDrugs":[{"name":"amobarbital","slug":"amobarbital","company":""},{"name":"benzalkonium","slug":"benzalkonium","company":""},{"name":"benzocaine","slug":"benzocaine","company":""},{"name":"bupivacaine","slug":"bupivacaine","company":"Hospira"}],"globalPrevalence":null}],"mechanism":{"target":"neuronal membrane ionic channels","novelty":"First-in-class","targets":[{"gene":"SCN4A","source":"DrugCentral","target":"Sodium channel protein type 4 subunit alpha","protein":"Sodium channel protein type 4 subunit alpha"},{"gene":"SCN3A","source":"DrugCentral","target":"Sodium channel protein type 3 subunit alpha","protein":"Sodium channel protein type 3 subunit alpha"},{"gene":"CHRNA1","source":"DrugCentral","target":"Acetylcholine receptor","protein":"Acetylcholine receptor subunit alpha"},{"gene":"CHRNB1","source":"DrugCentral","target":"Acetylcholine receptor","protein":"Acetylcholine receptor subunit beta"},{"gene":"CHRND","source":"DrugCentral","target":"Acetylcholine receptor","protein":"Acetylcholine receptor subunit delta"},{"gene":"SCN5A","source":"DrugCentral","target":"Sodium channel protein type 5 subunit alpha","protein":"Sodium channel protein type 5 subunit alpha"},{"gene":"SCN9A","source":"DrugCentral","target":"Sodium channel protein type 9 subunit alpha","protein":"Sodium channel protein type 9 subunit alpha"},{"gene":"HCN4","source":"DrugCentral","target":"Potassium/sodium hyperpolarization-activated cyclic nucleotide-gated channel 4","protein":"Potassium/sodium hyperpolarization-activated cyclic nucleotide-gated channel 4"},{"gene":"HTR3A","source":"DrugCentral","target":"5-hydroxytryptamine receptor 3A","protein":"5-hydroxytryptamine receptor 3A"},{"gene":"SCN10A","source":"DrugCentral","target":"Sodium channel protein type 10 subunit alpha","protein":"Sodium channel protein type 10 subunit alpha"}],"modality":"membrane stabilizer","drugClass":"local anesthetic, amide type","explanation":"Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action. Excessive blood levels may cause changes in cardiac output, total peripheral resistance, and mean arterial pressure, attributable to a direct depressant effect on various cardiovascular system components. The net effect is normally a modest hypotension when recommended dosages are not exceeded.","oneSentence":"Lidocaine stabilizes neuronal membrane by inhibiting ionic fluxes required for impulse initiation and conduction.","technicalDetail":"Lignospan Forte binds to the sodium channel protein type 4 subunit alpha, inhibiting the influx of sodium ions and thereby blocking the initiation and transmission of nerve impulses."},"chemblData":{"prodrug":0,"chemblId":"CHEMBL1200409","maxPhase":"4.0","chirality":2,"parenteral":true,"availability":1,"moleculeType":"Small molecule","withdrawnFlag":false,"naturalProduct":0,"blackBoxWarning":1,"oralBioavailable":true},"commercial":{"launchDate":"1948","_launchSource":"DrugCentral (FDA 1948-11-19, FRESENIUS KABI USA)"},"fdaRecalls":[{"date":"20131223","reason":"Presence of Particulate Matter- Confimed customer complaint of particulates embedded in glass container and in contact with product solution.","status":"Terminated","distribution":"Nationwide","classification":"Class I"},{"date":"20140729","reason":"Presence of Particulate Matter: The product was discolored and contained visible particulates (iron oxide) in the solution and embedded in the glass vial.","status":"Terminated","distribution":"Nationwide","classification":"Class I"},{"date":"20231002","reason":"Presence of Particulate Matter: identified as glass.","status":"Terminated","distribution":"Nationwide in the US and Puerto Rico. The products were not distributed to government accounts or foreign consignees.","classification":"Class I"},{"date":"20130916","reason":"Presence of Particulate Matter: Oxidized stainless steel found in vial of 1% Lidocaine Hydrochloride Injection, USP.","status":"Terminated","distribution":"Nationwide","classification":"Class I"},{"date":"20211130","reason":"Superpotent Drug: Minimally superpotent","status":"Ongoing","distribution":"Distributed to a wholesaler in CO who further distributed Nationwide in the USA","classification":"Class II"},{"date":"20150825","reason":"Presence of Particulate Matter: particulate matter identified as iron oxide, was found embedded in the neck of glass vials.","status":"Ongoing","distribution":"Nationwide","classification":"Class II"},{"date":"20141016","reason":"Presence of particulate matter: A returned customer sample was evaluated and found to have human hair attached to a pinched area of the stopper.","status":"Terminated","distribution":"Nationwide","classification":"Class I"},{"date":"20210625","reason":"Low out of specification results for epinephrine assay.","status":"Terminated","distribution":"Distributed Nationwide in the USA","classification":"Class II"},{"date":"20190328","reason":"Presence of Particulate Matter: One vial was found to contain a hair.","status":"Terminated","distribution":"Product is being held at a distributor site in Mexico, Asheboro, NC, Charlotte, NC and Santa Teresa, NM and not further distributed in the U.S. Market.","classification":"Class I"},{"date":"20140418","reason":"Presence of Particulate Matter: Confirmed customer complaint that orange and black particulates, identified as iron oxide, were found embedded within the glass vial and floating in solution.","status":"Terminated","distribution":"Nationwide.","classification":"Class I"}],"overdosage":"OVERDOSAGE Acute emergencies from local anesthetics are generally related to high plasma levels encountered during therapeutic use of local anesthetics. (See ADVERSE REACTIONS , WARNINGS , and PRECAUTIONS ) Management of Local Anesthetic Emergencies The first consideration is prevention, best accomplished by careful and constant monitoring of cardiovascular and respiratory vital signs and the patient’s state of consciousness after each local anesthetic administration. The first step in the management of convulsions consist of immediate attention to the maintenance of a patent airway and assisted or controlled ventilation with oxygen. In situations where trained personnel are readily available, ventilation should be maintained and oxygen should be delivered by a delivery system capable of permitting immediate positive airway pressure by mask. Immediately after the institution of these ventilatory measures, the adequacy of the circulation should be evaluated, keeping in mind that drugs u","references":[{"id":1,"url":"https://drugcentral.org/drugcard/1579","fields":["approvals","synonyms","ATC","PK","indications","contraindications","DDIs","targets","patents","FAERS"],"source":"DrugCentral"},{"id":2,"url":"https://clinicaltrials.gov/search?intr=Lidocaine%20Hydrochloride","fields":["trials"],"source":"ClinicalTrials.gov"},{"id":3,"url":"https://pubmed.ncbi.nlm.nih.gov/?term=Lidocaine Hydrochloride","fields":["publications"],"source":"PubMed/NCBI"},{"id":4,"url":"https://www.fda.gov/drugs/drug-approvals-and-databases/orange-book-data-files","fields":["patents","exclusivity","genericManufacturers"],"source":"FDA Orange Book"}],"_enrichedAt":"2026-03-30T02:08:40.118759","_validation":{"fieldsValidated":6,"lastValidatedAt":"2026-04-20T08:35:20.877759+00:00","fieldsConflicting":0,"overallConfidence":0.95},"biosimilars":[],"competitors":[{"drugName":"mexiletine","drugSlug":"mexiletine","fdaApproval":"1985-12-30","genericCount":9,"patentStatus":"Off-patent — generic available","relationship":"same-class"},{"drugName":"tocainide","drugSlug":"tocainide","fdaApproval":"1984-11-09","patentStatus":"Unknown","relationship":"same-class"}],"dataSources":[{"url":"https://data.medicaid.gov/dataset/4j6z-xnwq","name":"CMS National Average Drug Acquisition Cost (NADAC)","fields":["pricing"],"retrievedDate":"2026-04-07"}],"genericName":"lidocaine hydrochloride","howSupplied":"HOW SUPPLIED Lidocaine Viscous 2% (Lidocaine Hydrochloride Oral Topical Solution USP) The 2% oral topical solution is supplied as a clear, colorless, viscous solution . NDC 68071-3449-0: Squeeze Bottle of 100 mL Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.] Dispense in a child-resistant container as defined in the USP/NF. SHAKE WELL BEFORE USE. Distr. by: West-Ward Pharmaceuticals Corp. Eatontown, NJ 07724 4055408//11 Revised October 2018","indications":{"approved":[{"name":"Hemorrhoids","source":"DrugCentral","snomedId":70153002,"regulator":"FDA","eligibility":"temporary relieves minor pain, no specific eligibility criteria mentioned"},{"name":"Infestation by Phthirus pubis","source":"DrugCentral","snomedId":71011005,"regulator":"FDA","eligibility":"temporary relieves minor pain, no specific eligibility criteria mentioned"},{"name":"Infestation by Sarcoptes scabiei var hominis","source":"DrugCentral","snomedId":128869009,"regulator":"FDA","eligibility":"temporary relieves minor pain, no specific eligibility criteria mentioned"},{"name":"Itching of skin","source":"DrugCentral","snomedId":418363000,"regulator":"FDA","eligibility":"temporary relieves minor pain, no specific eligibility criteria mentioned"},{"name":"Local Anesthesia for Endotracheal Intubation","source":"DrugCentral","snomedId":"","regulator":"FDA","eligibility":"no specific eligibility criteria 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