Lidocaine (Systemic)
Drug class: Antineoplastic Agents
Usage of Lidocaine (Systemic)
Ventricular Arrhythmias
Alternative to other antiarrhythmic drugs (e.g., amiodarone, procainamide, sotalol) for the acute treatment of life-threatening ventricular arrhythmias such as those that occur following MI or during cardiac manipulative procedures such as cardiac surgery.
Used during cardiac arrest for treatment of refractory (i.e., resistant to CPR, defibrillation, and a vasopressor [epinephrine]) VF or pulseless VT. Considered an alternative to amiodarone for this use in current ACLS guidelines in adults; in pediatric patients, current evidence supports use of either amiodarone or lidocaine.
Alternative to other antiarrhythmic agents or synchronized electrical cardioversion in the treatment of hemodynamically stable monomorphic VT; however, other agents (e.g., procainamide, sotalol, amiodarone) preferred.
Status Epilepticus
Treatment of status epilepticus† [off-label], as a last resort.
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How to use Lidocaine (Systemic)
General
Ventricular Arrhythmias
Administration
Administer IV. Has been administered IM (IM formulation no longer commercially available in the US).
Also has been administered via endotracheal tube† [off-label] or by intraosseous (IO) injection† [off-label] during cardiac resuscitation when IV administration is not possible. Although endotracheal† [off-label] administration also is possible, IV or IO† [off-label] administration is preferred because of more predictable drug delivery and pharmacologic effect. (See Absorption under Pharmacokinetics.)
IV Administration
For solution and drug compatibility information, see Compatibility under Stability.
Administer as a bolus IV injection for initial treatment of ventricular arrhythmias. Maintenance IV infusions may be required to maintain normal sinus rhythm if oral antiarrhythmic therapy is not feasible.
Injections containing preservatives should not be given IV.
Do not introduce additives into solutions of lidocaine in 5% Dextrose, since dosage is titrated to response.
Do not add to blood transfusion assemblies.
Do not use commercially available solutions of lidocaine in 5% dextrose in series connections with other plastic containers; such use could result in air embolism.
Rate of AdministrationAdminister IV bolus dose at a rate of 25–50 mg/minute.
Administer maintenance infusions at a rate of 1–4 mg/minute (14–57 mcg/kg per minute) in adults or 10–50 mcg/kg per minute in pediatric patients.
For other populations, see Special Populations under Dosage and Administration.
Endotracheal Administration
For endotracheal administration in adults, dilute dose in 5–10 mL of 0.9% sodium chloride injection or sterile water.
In pediatric patients, flush with 5 mL of 0.9% sodium chloride injection after dose is administered.
Dilution in sterile water may increase absorption of lidocaine.
Dosage
Available as lidocaine hydrochloride; dosage is expressed in terms of the salt.
Pediatric Patients
Ventricular Arrhythmias IVControlled clinical studies to establish pediatric dosing have not been performed.
Some clinicians have suggested initial dose of 0.5–1 mg/kg as a rapid IV injection (i.e., bolus); dose may be repeated according to patient response, up to a maximum total dose of 3–5 mg/kg. Maintenance infusion of 10–50 mcg/kg per minute.
Pediatric Resuscitation IV/IO†For shock-refractory VF or pulseless VT: 1 mg/kg initially, followed by maintenance infusion of 20–50 mcg/kg per minute. If time between initial bolus dose and onset of IV infusion >15 minutes, repeat bolus dose.
Endotracheal†Optimal dose not established, but usually 2–2.5 times the recommended IV dosage.
Adults
Ventricular Arrhythmias IVUsual initial dose is 50–100 mg administered as a direct IV injection. If desired response is not achieved, a second dose may be administered 5 minutes after completion of the first injection.
For hemodynamically stable monomorphic VT: AHA recommends initial dose of 1–1.5 mg/kg, followed by 0.5–0.75 mg/kg repeated at 5- to 10-minute intervals as necessary, up to a maximum total dose of 3 mg/kg.
ACLS IV/IO†For refractory VF or pulseless VT: 1–1.5 mg/kg as initial loading dose, then 0.5–0.75 mg/kg repeated at 5- to 10-minute intervals as necessary, up to a total of 3 doses (or up to 3 mg/kg).
Endotracheal†Optimal dose not established, but usually 2–2.5 times the recommended IV dosage.
Status Epilepticus† IVInitially, 1 mg/kg. After 2 minutes, administer 0.5 mg/kg if seizure is not terminated. Maintenance infusion of 30 mcg/kg per minute for prevention of seizure recurrence.
Prescribing Limits
Adults
Ventricular Arrhythmias IVMaximum total dose of 200–300 mg over a 1-hour period.
Special Populations
Hepatic Impairment
Careful and individualized dosing recommended.
Renal Impairment
Dosage modification not required.
Decreased Cardiac Output
Smaller bolus doses may be required.
Some clinicians recommend infusion rates <30 mcg/kg per minute in patients with CHF.
Patients Requiring Prolonged Therapy
Possible increased half-life following infusions lasting>24 hours; reduce dosage accordingly (e.g., by 50%) to avoid accumulation of the drug and potential toxicity.
Warnings
Contraindications
Warnings/Precautions
Warnings
Cardiac MonitoringConstant ECG monitoring is necessary during IV administration. Discontinue infusion if signs of excessive cardiac depression occur (e.g., prolongation of PR interval and QRS complex, appearance or aggravation of arrhythmias).
Severe ReactionsResuscitative equipment and drugs should be immediately available for the management of severe adverse cardiovascular, respiratory, or CNS effects. Discontinue therapy if severe reactions occur; institute emergency resuscitative procedures and other supportive measures as required.
Severe reactions may be preceded by somnolence and paresthesia.
Sensitivity Reactions
HypersensitivityPossible hypersensitivity reactions (e.g., skin lesions, urticaria, edema, anaphylactoid reactions).
General Precautions
Prolonged TherapyPossible increased half-life following infusions lasting >24 hours; reduce dosage accordingly (see Patients Requiring Prolonged Therapy under Dosage and Administration).
If maintenance therapy is necessary, an oral antiarrhythmic agent is recommended.
Nervous System EffectsPossible muscle twitching or tremors, seizures, unconsciousness, and coma; may be associated with high doses or overdosage.
Cardiovascular EffectsPossible hypotension, arrhythmias, heart block, cardiovascular collapse, and bradycardia, which may lead to cardiac arrest in patients with high plasma lidocaine concentrations or myocardial conduction defects.
Possible serious ventricular arrhythmias or heart block in patients with sinus bradycardia.
Possible increased sensitivity to cardiac depressant effects in patients with a diseased or abnormal sinus node.
Possible increased ventricular rate in patients with atrial fibrillation.
Possible increased coronary blood flow in patients with recent MI.
Possible myocardial and circulatory depression.
Cautious use recommended in patients with any form of heart block, CHF, marked hypoxia, severe respiratory depression, hypovolemia, or shock.
Respiratory EffectsPossible respiratory depression and arrest; may be associated with high doses or overdosage.
Local EffectsPossible local thrombophlebitis in patients receiving prolonged IV infusions.
Tissue infiltration may lead to local ischemia, tissue injury, and ulceration.
Laboratory Test InterferencePossible increased serum CK (CPK) concentrations associated with IM injections. Isoenzyme separation is necessary when CK determinations are used in the diagnosis of acute MI.
Specific Populations
PregnancyCategory B.
LactationDistributed into milk. Use with caution.
Pediatric UseSafety and efficacy not established in controlled clinical studies; however, lidocaine has been used for treatment of ventricular arrhythmias in infants and children.
Hepatic ImpairmentUse with caution. (See Pharmacokinetics and also see Hepatic Impairment under Dosage and Administration.)
Renal ImpairmentUse with caution in severe renal impairment. (See Elimination: Special Populations, under Pharmacokinetics.)
Common Adverse Effects
Adverse CNS effects (e.g., drowsiness, dizziness, disorientation, confusion, lightheadedness, tremulousness, psychosis, nervousness, apprehension, agitation, euphoria, tinnitus, visual disturbances, paresthesia, difficulty swallowing, dyspnea, slurred speech, sensations of heat, cold, or numbness), nausea, vomiting.
What other drugs will affect Lidocaine (Systemic)
Antiarrhythmic Agents
Potential pharmacologic interaction (additive or antagonistic cardiac effects and additive toxicity) with concomitant administration of antiarrhythmic agents (e.g., phenytoin, procainamide, propranolol, quinidine).
Specific Drugs
Drug
Interaction
Comments
Cimetidine
Decreased lidocaine clearance
Monitor serum lidocaine concentrations and observe closely for signs of lidocaine toxicity
Phenytoin
Possible increased lidocaine metabolism
Clinical importance unknown
Propranolol
Decreased lidocaine clearance
Monitor serum lidocaine concentrations and observe closely for signs of lidocaine toxicity
Succinylcholine
Increased neuromuscular blocking effect
Appears to be important only at lidocaine doses higher than those used clinically
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