Effects Upon Admin
Effects vary with route of administration. Many effects are dose related.
Cardiovascular: Arrhythmia, decreased heart rate, arterial spasms, cardiovascular collapse, defibrillator threshold increased, edema, flushing, heart block, hypotension, sinus node suppression, vascular insufficiency (periarticular injections)
Central nervous system: Agitation, anxiety, nervousness, coma, confusion, disorientation, dizziness, drowsiness, euphoria, hallucinations, headache, hyperesthesia, hypoesthesia, lethargy, lightheadedness, nervousness, psychosis, seizure, slurred speech, somnolence, and unconsciousness
Dermatologic: Angioedema, bruising, contact dermatitis, depigmentation (transdermal system), edema of the skin, itching, petechia (transdermal system), pruritus, rash, urticaria
Gastrointestinal: Metallic taste, nausea, vomiting
Local: Burning (ophthalmic), irritation (transdermal system), thrombophlebitis
Neuromuscular & Skeletal: Pain worsening (transdermal system), paresthesia, transient radicular pain (subarachnoid administration; up to 1.9%), tremor, twitching, weakness
Ocular: Conjunctival hyperemia (ophthalmic), corneal epithelial changes (ophthalmic), diplopia, visual changes
Otic: Tinnitus
Respiratory: Bronchospasm, dyspnea, respiratory depression or arrest
Miscellaneous: Allergic reactions, anaphylactoid reaction, sensitivity to temperature extremes
Following spinal anesthesia: Positional headache (3%), shivering (2%) nausea, peripheral nerve symptoms, respiratory inadequacy and double vision (<1%), hypotension, cauda equina syndrome
Postmarketing and/or case reports: ARDS (inhalation), asystole, chondrolysis (continuous intra-articular administration), disorientation, methemoglobinemia, skin reaction
Drug Interactions
Amiodarone: May decrease the metabolism of Lidocaine. Risk C: Monitor therapy
Bendamustine: CYP1A2 Inhibitors (Strong) may increase the serum concentration of Bendamustine. Concentrations of the active metabolites of bendamustine may be decreased.
Beta-Blockers: May decrease the metabolism of Lidocaine. Exceptions: Levobunolol; Metipranolol.
Colchicine: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Colchicine. Management: Reduce colchicine (adult) dose as directed when using with a moderate CYP3A4 inhibitor, and increase monitoring for colchicine-related toxicity. Use extra caution in patients with impaired renal and/or hepatic function. Risk D: Consider therapy modification
Dietary Considerations
Premixed injection may be comprised with corn-derived dextrose and its use is contraindicated in patients with allergy to corn-related products.
