Lidocaine is a local anesthetic used to make medical procedures like cystoscopy or endoscopy, and dental treatments such as tartar removal, more comfortable. It temporarily blocks sensation and reduces friction from instruments on skin or mucous membranes.
At pharmacies, lidocaine is available as topical ointments, gels, or sprays for skin or mucous membrane use only. Products may be sold under brand names or as generic “lidocaine hydrochloride,” and should be used only with medical guidance.
Lidocaine is also available as an injectable medication used in hospitals or medical clinics for local or regional anesthesia. These injections are administered by trained healthcare professionals and may be used for peripheral nerve blocks or epidural anesthesia.
Main uses
Lidocaine serves as a local anesthetic available in ointment, gel, or spray forms used for:
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Medical procedures, such as cystoscopy, proctoscopy (rigid sigmoidoscopy), insertion of urinary catheters, endoscopy, endotracheal intubation, or maxillary sinus puncture;
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Dental procedures, such as tartar removal, numbing the gums before an anesthetic injection, or X-rays;
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Relief of pain or discomfort caused by sunburn, shingles, cold sores, cracked nipples, hemorrhoids, or anal fissures;
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Treatment of pain caused by cystitis or urethritis.
Lidocaine gel, ointment, or spray numbs the mucous membranes or skin quickly and effectively, generally starting to work about 30 seconds to 5 minutes after application. At the same time, it lubricates and reduces friction on the skin and mucous membranes.
Injectable lidocaine is indicated for local or regional anesthesia, or for procedures such as peripheral nerve blocks or lumbar epidural blocks. It should only be used in a hospital or medical clinic setting and is administered by a physician or nurse.
How to apply
Lidocaine should be applied only to the skin or mucous membranes. Different formulations include:
1. Lidocaine 5% ointment
Lidocaine 5% ointment (50 mg/g) should be applied to the affected skin or mucous membrane using the smallest amount possible, just enough to cover the area, to numb the skin or relieve pain, as directed by a healthcare provider. Do not cover the area unless instructed to do so.
When used for cracked nipples from breastfeeding, the breasts should be washed before the next nursing session to completely remove the ointment.
For medical exams, the ointment is applied by a nurse under medical supervision.
This ointment may be used by adults or children aged 5 years and older with medical guidance. It should not be applied to the eyes.
2. Flavored lidocaine 5% for dental procedures
Flavored 5% lidocaine ointments (50 mg/g) can be used for dental procedures in adults and children aged 5 years and older. Dentists apply a thin layer after thoroughly drying the gum mucosa..
3. Lidocaine 10% spray
Lidocaine 10% spray is used only in hospitals or medical clinics and is applied by a nurse in the doses directed by a doctor.
4. Lidocaine 2% gel
A nurse applies lidocaine 2% gel (20 mg/g) into the urethra in a hospital setting, using doctor-recommended doses. This gel is typically used before procedures like cystoscopy, catheterization, or urinary catheter insertion, or to relieve pain from cystitis and urethritis.
Side effects
The most common side effects from lidocaine are irritation, burning, a stinging sensation on the skin or mucous membrane, swelling, or redness at the application site.
Other side effects may include headache, vomiting, nervousness, dizziness, drowsiness, blurred vision, low blood pressure, confusion, speech problems, ringing in the ears, seizures, loss of consciousness, a slower heartbeat, or even respiratory arrest.
Lidocaine may also cause severe allergic reactions that require immediate medical attention. Stop using it and seek emergency care if symptoms such as difficulty breathing, a sensation of throat tightness, swelling of the mouth, tongue, or face, or hives occur.
Contraindications for use
Lidocaine should not be used by children under 5 years old or by anyone who is allergic to any component of the formula.
People who are pregnant or breastfeeding and those with a history of epilepsy, heart disease, or liver disease should consult a healthcare provider before use.
Avoid applying lidocaine to large skin areas or using more than your healthcare provider recommends. Excessive amounts can be absorbed through the skin, raising the risk of side effects.