Lignocaine

Also known as: Lidocaine

Drug #418

Lignocaine is a sodium channel blocking agent, used as a local anesthetic and antiarrhythmic agent. It stabilizes nerve cell membranes to prevent impulse conduction. Used topically or by injection for local anaesthesia in minor operations.Intravenous injection or infusion used to treat abnormal heart rhythms. Excessive doses also block motor impulses and normal cardiac conduction. It has a low incidence of toxicity and a high degree of effeciveness in arrhythmias. Lignocaine is one of the least cardiotoxic drug of the currently used sodium channel blocker.

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Primary Characteristics

Lignocaine is also known as Lidocaine, Lidocaine (HCl), Lignocaine (HCl).

It is of Synthetic origin and belongs to Amide.

It belongs to Na-Channel Local Anesthetic antagonist pharmacological group on the basis of mechanism of action and also classified in Analgesic pharmacological group.

Molecular Weight: 234.3 · pK_a: 7.86 · Solubility in Water: Insoluble · Solubility in Alcohol: very soluble · Non-proprietary name: Lignocaine · pH: 4.3 · Isotonic value: 4.

Pharmacokinetics

Absorption: Lignocaine has an oral bioavailability is 17.5% (±17.5%), pre-systemic (first-pass) metabolism accounts for 67.5% (±2.5%).

Distribution: Lignocaine has a volume of distribution is 1.3 l/kg. plasma protein binding is 64%.

Elimination: it is metabolised via Hepatic, plasma half-life is 1-2hr, renal excretion is <10%.

Indications

Lignocaine is primarily indicated in conditions like Anesthesia, Caudal anaesthesia, Epidural anaesthesia, Headache associated with migraine, Infilteration anaesthesia, Intravenous regional anaesthesia, Local anaesthesia, Neuropathic pain, Obstetric anaesthesia, Severe hiccup, Toothache, Transtracheal anaesthesia, Urethral anesthesia, Ventricular arrhythmias, Ventricular arrhythmias, especially after myocardial infarction, Ventricular fibrillation.

Lignocaine is also indicated for secondary conditions like Itching, Pain.

Contraindications

Lignocaine is contraindicated in conditions like Heart block, Bradycardia, Congestive heart failure, Hypersensitivity.

Dosage

Lignocaine's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
175 mg	175 mg	—	IV Inf	Max of 4mg/kg
75 mg	75 mg	—	IV Inj	For ventricular arrythmias.
4.5 mg/ kg /dose	4.5 mg/ kg /dose	—	SC	Dose vary with procedure. do not repeat within two hours.
1.5 %	1.5 %	Every 3h	Topical	As Required
5 %	5 %	—	Topical	For spinal Anestheria as hyperbaric.
Paediatric Dosage (20kg)
35 ug/kg.min	35 ug/kg.min	—	IV Infusion	Maintenance, As Required
0.75 mg/kg	0.75 mg/kg	—	Slow IV	Initially, As Required
2 %	2 %	Every 3h	Topical	As Required
Neonatal Dosage (3kg)
35 ug/kg.min	35 ug/kg.min	—	IV Infusion	Maintenance, As Required
0.75 mg/kg	0.75 mg/kg	—	Slow IV	Initially, As Required
2 %	2 %	Every 3h	Topical	As Required

Drug Interactions

Unknown16 interactions

2 interactions

Major1 interaction

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Lignocaine in overdosage may give rise to further complications which include Allergy , Bronchospasm , Tissue necrosis , Sinus bradycardia , Blurred vision , Hypotension , Coma , Angina , Respiratory depression , Tremors , Neonatal depression, Seizures , Hypertension , Malignant hyperthermia, Cardiovascular depression.

Lignocaine produces potentially life-threatening effects which include Respiratory depression, Bradycardia , Convulsions , Hypersensitivity , CNS toxicity, Cardiac Arrest , Tonic & clonic convulsion, Medullary depression. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Lignocaine are Bradycardia, Hypotension, Apnea, Death , Seizures, Respiratory arrest, Decrease cardiac output, Cardiovascular collapse.

Lignocaine is known to cause more or less tolerable side effects which are usually transient. These include Abdominal discomfort, Abdominal pain, Anxiety, Confusion, Dizziness, Drowsiness, Headache, Nausea, nervousness, Nystagmus , Palpitation, Restlessness, Tinnitus, Tremor, Twitching, Vomiting .

Warnings / Precautions

Lignocaine should be used with caution in patients receiving anti-coagulant therapy, with genetic predisposition of malignant hyperthermia, hypovolemia, shock and all types of heart block, congestive heart failure, bradycardia, respiratory depression or impaired liver or renal function. The injection of lignocaine should not be administered in areas of inflammation or infection. It should be avoided if plasma cholinesterase concentration is low.

Available Brands

Click on a strength to view available brands.

Single Ingredient

Gel

2 %w/w 20 mg/ml 5 %w/w

Inj

10 mg/ml 2 %w/w 20 mg/ml

Liquid

Oint

Soln

Soln

Multi-Ingredient Combinations

Ear Drops

50 mg/ml

Eye Oint

4 %w/w

Gel

0.6 %w/w

Inj

10 mg/3ml 10 mg/ml 2 %w/w 20 mg 20 mg/2ml 20 mg/3ml 20 mg/ml 50 mg/3ml

Inj-IM

20 mg/2ml 20 mg/ml

Oint

0.5 %w/w 4 %w/w 5 %w/w

Soap

0.6 %w/w

Soln

1 %w/v

Storage Conditions

Lignocaine should be stored Inj, Soln, Gel.

Drug Classification

1.1.2 — Local anesthetics
2.12.2 — Antiarrhythmic drugs
3.28 — Otic drugs

Manufacturers

Manufacturers of Lignocaine in Pakistan: