Lidocaine
Lidocaine is a versatile medication used both as a local anesthetic for minor surgical and dental procedures, and as an antiarrhythmic agent for treating irregular heartbeats, particularly ventricular arrhythmias. It works by blocking sodium channels in nerve cells and cardiac tissue, preventing the transmission of pain signals and stabilizing abnormal electrical activity in the heart.
Lidocaine is a local anesthetic and antiarrhythmic drug that blocks nerve signals and treats heart rhythm disorders.
Key facts at a glance
- ATC
- D04AB01
- RxNorm
- 6387
- Generic
- Lidocaine
- Class
- atc-c01
- Brands
- LMX, Ana-Lex, Regenecare, Lidum, Cutiecaine, Burn Jel Plus, Hexa-Caine, Band-Aid Hurt-Free, Keepan, Recticare, Lidopatch, Sonacaine, Zcaine, Derma Numb, Medi-Derm with Lidocaine
- Availability
- otc
- Pregnancy
- B
- Lactation
- caution
- Half-life (h)
- 2
- Onset (min)
- 5
- Duration (h)
- 2
- Routes
- topical, oral, rectal, ophthalmic, otic
- Forms
- cream, gel, ointment, patch, spray, solution, jelly, lotion
- Regions
- United States, Canada, European Union, United Kingdom, Australia
- Monitoring
- none
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
11 groupspregnancy
first trimesteruse lowest effective dose
avoid IV lidocaine in pregnancy; topical and local administration acceptable with caution
fetal heart rate monitoring if used systemically
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse lowest effective dose, avoid prolonged use
avoid use during labor if possible; may prolong second stage of labor
fetal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment needed
compatible with breastfeeding; minimal excretion into breast milk
no specific monitoring required
geriatric
elderlyreduce dose for IV use, use lower concentrations
increased sensitivity to CNS and cardiac effects; start with lower doses
cardiac monitoring for IV use, observe for CNS toxicity
Use with caution and monitor for adverse effects.
pediatric_age
neonates infantsweight-based dosing, avoid high concentrations
use lowest effective concentration; max 5mg/kg without epinephrine
monitor for signs of toxicity
Use with caution and monitor for adverse effects.
pediatric_age
children adolescentsweight-based dosing
use age-appropriate formulations; avoid teething gels with high concentrations
standard monitoring
renal_impairment
mild moderateno adjustment for topical; reduce IV dose
monitor for metabolite accumulation with IV use; topical use generally safe
monitor renal function and for signs of toxicity
Use with caution and monitor for adverse effects.
renal_impairment
severereduce IV dose by 50%, avoid repeated doses
use caution with IV lidocaine; metabolites (MEGX) can accumulate
close monitoring for CNS and cardiac toxicity
Use with caution and monitor for adverse effects.
hepatic_impairment
mildno adjustment for topical; use caution with IV
reduced metabolism; monitor for prolonged effect
monitor for signs of toxicity
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate severeavoid IV use; topical with caution
significantly reduced metabolism; increased risk of toxicity
close cardiac and CNS monitoring if use is unavoidable
Use of this medication in this population requires careful consideration of risks and benefits.
alcohol_users
chronic alcohol usereduce dose
increased risk of CNS toxicity; may have cross-tolerance
monitor for CNS depression and cardiac effects
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Classification as amide-type local anesthetic and antiarrhythmic agent
Mechanism of action
Blocks sodium channels to prevent nerve impulse transmission
Common uses
Primary therapeutic applications in clinical practice
First FDA approval
Historical FDA approval timeline for lidocaine
Lidocaine is used for local and regional anesthesia during surgical, dental, and diagnostic procedures, as well as for the treatment of ventricular arrhythmias including ventricular tachycardia and ventricular fibrillation. It is also found in various topical formulations for pain relief from conditions like postherpetic neuralgia.
As a local anesthetic, lidocaine works by blocking voltage-gated sodium channels in nerve fibers, preventing the generation and conduction of nerve impulses and thereby numbing the targeted area. As an antiarrhythmic, it suppresses automaticity in cardiac tissue and raises the threshold for ventricular fibrillation by stabilizing myocardial cell membranes.
Lidocaine should be used with caution in patients with heart block, severe bradycardia, or liver impairment. Systemic absorption can lead to CNS effects such as dizziness, confusion, or seizures at high doses. It is typically administered by healthcare professionals for IV antiarrhythmic use, while topical and injectable formulations are available for localized pain management.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 26, 2026. · Read our editorial policy