Lidocaine (injectable local anesthetic)
Pronunciation: pronunciation varies by local usage.
- Generic name
- lidocaine hydrochloride
- Drug class
- Amide local anesthetic
- Form
- Injectable solution: 1% (10 mg/mL) and 2% (20 mg/mL) in 2 mL, 5 mL, and 30 mL single-dose vials
- Route
- Injectable (infiltration, peripheral nerve block, epidural, caudal, intravenous regional)
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What lidocaine hydrochloride is and how it works
Lidocaine hydrochloride injection is an amide local anesthetic used by, or under the supervision of, a healthcare professional to produce local or regional anesthesia/analgesia for surgical, dental, diagnostic, therapeutic, and obstetrical procedures. (1)
This information covers the injectable local-anesthetic product only. Other lidocaine-containing formulations (topical products, intravenous antiarrhythmic preparations) have separate indications, dosing, and safety information. The injection is administered in a clinical setting; the dose, technique, and monitoring are determined by the responsible clinician.
Mechanism of action: how lidocaine hydrochloride works
Lidocaine is an amide local anesthetic that blocks sodium ion channels in neuronal membranes, inhibiting nerve impulse initiation and conduction and producing reversible local or regional anesthesia/analgesia. (1)
What lidocaine hydrochloride is used for
Local or regional anesthesia/analgesia
Used in adult and pediatric patients for surgical, dental and oral surgery, diagnostic and therapeutic, and obstetrical procedures. The exact technique (infiltration, peripheral nerve block, epidural, caudal, intravenous regional) and dose are selected by the clinician according to the procedure, patient factors, and whether an epinephrine-containing formulation is chosen. (1)
Before taking lidocaine hydrochloride
Do not take / not appropriate for
- Do not receive lidocaine injection if you have a known hypersensitivity to lidocaine, to other local anesthetics of the amide type, or to any other component of the product. (all products) (1)
Tell your clinician about
- Any known allergy to lidocaine, other amide-type local anesthetics, or any medicine or product ingredient.
- History of heart problems, including impaired cardiovascular function, heart block, arrhythmias, or hypotension.
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency, or if the patient is an infant under 6 months of age.
- Liver disease or impaired liver function.
- Pregnancy, plans for pregnancy, or breastfeeding status.
- All current medicines, especially other local anesthetics, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, ergot-type oxytocic medicines, nonselective beta-blockers, methemoglobinemia-associated drugs (e.g., nitrates, nitrites, certain antineoplastic agents, antibiotics, antimalarials, anticonvulsants), or potent inhalation anesthetics.
How to take lidocaine hydrochloride
- Lidocaine injection is administered by a healthcare professional in a clinical setting. The dose, route, and technique are determined by the clinician based on the procedure, patient age, body weight, physical condition, and whether an epinephrine-containing formulation is used.
- The product is a single-dose injectable; there is no at-home self-administration or repeated self-dosing instruction.
- Do not attempt to self-administer, adjust, or request a specific dose or technique.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Not applicable — this is a single-dose injectable formulation administered by a healthcare professional in a clinical setting.
Overdose
Overdose or excessive blood levels can cause central nervous system excitation progressing to depression, convulsions, cardiovascular collapse, and respiratory arrest. Management is provided by the treating clinical team and may include immediate airway support with oxygen and ventilation, circulatory evaluation, seizure control with intravenous benzodiazepines if required, vasopressor support, and standard cardiopulmonary resuscitation if cardiac arrest occurs. Dialysis is of negligible value. Because administration occurs in a healthcare setting, emergency support is immediately available. (1)
Side effects
Side effects vary with the dose, injection site, technique, and patient characteristics. Careful monitoring of cardiovascular and respiratory vital signs is performed after each injection.
Central nervous system effects
What to notice: Lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, tremors, or—at higher levels—convulsions and respiratory depression or arrest.
What to do: These effects are monitored by the healthcare professional during and after the procedure; report any new sensations promptly during monitoring. (1)
Cardiovascular effects
What to notice: Bradycardia, hypotension, cardiovascular collapse, or arrhythmias.
What to do: The clinical team continuously monitors cardiovascular vital signs and responds to changes. (1)
Neurologic effects (epidural/caudal use)
What to notice: Headache, backache, paresthesia, high spinal block, or paralysis of the lower extremities.
What to do: These are procedure-specific risks that are managed and assessed by the responsible anesthesia provider. (1)
Allergic reactions
What to notice: Cutaneous lesions, urticaria, edema, or anaphylactoid reactions.
What to do: Report any rash, swelling, or breathing difficulty immediately to the clinical team. (1)
Methemoglobinemia
What to notice: Cyanotic skin discoloration or abnormal blood coloration.
What to do: The clinical team assesses for this in at-risk patients and initiates supportive care as needed. (1)
New or worsening neurological or cardiovascular symptoms after discharge
What to notice: Persistent severe headache, new back pain, leg weakness or numbness, fainting, chest pain, or difficulty breathing that begins after leaving the clinical setting.
What to do: Contact the treating clinician or seek medical attention promptly. (1)
Serious warnings
Dose-related systemic toxicity — emergency
Symptoms: Restlessness, anxiety, incoherent speech, lightheadedness progressing to convulsions, cardiovascular depression, and respiratory arrest.
Action: The clinical team monitors continuously and intervenes immediately. If symptoms occur after discharge, seek emergency care. (1)
Methemoglobinemia — urgent
Symptoms: Cyanotic (bluish) skin discoloration and abnormal blood coloration, particularly in patients with G6PD deficiency, infants under 6 months, or those on oxidizing medicines.
Action: The treating team will assess and provide supportive care, which may include oxygen, methylene blue, or hyperbaric oxygen. Seek medical attention if signs appear after discharge. (1)
Unintended intravascular or intrathecal injection — emergency
Symptoms: Systemic toxicities, central nervous system or cardiorespiratory depression, and coma.
Action: The clinician uses aspiration and test-dose precautions to avoid this. Management occurs immediately in the clinical setting. (1)
Chondrolysis after intra-articular infusion — warning
Symptoms: Post-marketing reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics.
Action: Intra-articular infusions are not an approved use of this product; administration decisions are made by the responsible clinician. (1)
Head and neck block toxicity — emergency
Symptoms: Confusion, convulsions, respiratory depression or arrest, even with small doses in head/neck nerve-block procedures.
Action: Managed by the clinical team during and after the procedure. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Other local anesthetics | Additive toxic effects; increased risk of neurologic and cardiovascular toxicity. | The anesthesia provider reviews all anesthetics used. Monitor for toxicity. (1) |
| MAOIs and tricyclic antidepressants | Risk of severe, prolonged hypertension. | Give the anesthesia provider a complete medication history; the anesthesia provider determines whether concurrent use is appropriate. (1) |
| Ergot-type oxytocic medicines | Risk of severe, persistent hypertension or cerebrovascular accidents. | Inform the clinician of all current medicines; the clinician determines whether concurrent use is appropriate. (1) |
| Nonselective beta-blockers | Risk of severe hypertension and bradycardia. | The clinician reviews current medicines and determines whether concurrent use is appropriate. (1) |
| Methemoglobinemia-associated drugs (nitrates, nitrites, certain antineoplastic agents, antibiotics, antimalarials, anticonvulsants) | Increased risk of methemoglobinemia. | The clinician reviews the full medication list before administration. (1) |
| Potent inhalation anesthetics | Risk of serious cardiac arrhythmias when lidocaine is used with epinephrine-containing preparations. | The anesthesia team coordinates the selection and dosing of all agents. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pediatric patients
Dosages are reduced according to age, body weight, and physical condition. For intravenous regional anesthesia, dilute solutions (0.25–0.5%) are recommended, not exceeding 3 mg/kg. A clinician determines the exact pediatric dose for each procedure. (1)
Pregnancy
No drug-associated risk for major birth defects or miscarriage has been identified in clinical use. Local anesthetics may cause maternal or fetal toxicity affecting central nervous system and cardiovascular function. The obstetric anesthesia provider balances the benefits of regional anesthesia against these considerations. (1)
Breastfeeding
Lidocaine and its metabolites are present in human milk in low amounts, with poor oral bioavailability. The benefits of breastfeeding should be weighed against potential infant exposure in discussion with the clinician. (1)
Hepatic impairment
Reduced dosing and increased monitoring for systemic toxicity should be considered, especially with repeat doses. The half-life of lidocaine may be prolonged two-fold or more in patients with liver dysfunction. (1)
Renal impairment
Renal dysfunction does not significantly affect lidocaine kinetics but may increase accumulation of metabolites. The clinician adjusts the plan based on individual factors. (1)
Elderly or debilitated patients
Reduced doses are recommended. The clinician assesses cardiovascular and overall status before selecting the dose. (1)
Monitoring
Before starting
- Confirm the procedure, indication, and patient-specific eligibility.
- Review hypersensitivity history to lidocaine, amide-type anesthetics, and product components.
- Assess cardiovascular status, hepatic and renal function, G6PD deficiency risk, age, pregnancy/lactation status, and complete medication and comorbidity history.
- Select the appropriate concentration, volume, total dose, route, and whether an epinephrine-containing formulation is needed.
During treatment
- Continuous monitoring of cardiovascular and respiratory vital signs after each injection.
- Monitor level of consciousness for early CNS toxicity signs (restlessness, anxiety, incoherent speech, lightheadedness).
- Aspirate for blood or cerebrospinal fluid before injection to avoid intravascular or intrathecal administration; use a test dose for epidural blocks.
- Monitor heart rate; an increase of 20 bpm or more may serve as an intravascular test-dose indicator.
- Monitor blood pressure for transient systolic rise.
- Assess for signs of spinal block (decreased sensation, leg paresis) when relevant.
- Obtain ECG in settings of cardiovascular compromise.
- Watch for signs of methemoglobinemia in high-risk patients.
Storage
Store at 20°C to 25°C (68°F to 77°F), controlled room temperature. Protect from light. Single-dose vials only; discard unused portion after initial use. This is handled by the healthcare facility.
Study the drug class: Class I antiarrhythmics
Professional information
Clinician-facing context only. Use the current local product label and institutional protocol for dose selection, technique, monitoring, and emergency management.
United States (FDA label)
Indication: Local or regional anesthesia/analgesia
Dose summary: Adults without epinephrine: maximum 4.5 mg/kg, not to exceed 300 mg total. Adults with epinephrine: maximum 7 mg/kg, not to exceed 500 mg. Procedure-specific ranges: infiltration 5–300 mg; peripheral nerve blocks 20–300 mg; epidural 200–300 mg; epidural/caudal with epinephrine not to exceed 500 mg total. Pediatric: age- and weight-based reduction; example from label — a 5-year-old child weighing 23 kg should not exceed 75–100 mg. Intravenous regional: dilute solutions (0.25–0.5%) not exceeding 3 mg/kg.
Renal context: Renal dysfunction does not significantly affect lidocaine kinetics but may increase accumulation of metabolites; the clinical team adjusts the plan individually. (1)
Non-US regions
Indication: Local or regional anesthesia/analgesia
Hepatic guidance
Reduced dosing and increased monitoring for systemic toxicity should be considered in hepatic impairment, especially with repeat doses. Half-life may be prolonged two-fold or more.
Overdose note
Plasma levels above 6 mcg/mL produce CNS excitation progressing to depression, convulsions, cardiovascular collapse, and respiratory arrest. Management includes immediate airway support with oxygen and ventilatory support, circulatory evaluation and support, intravenous benzodiazepines for persistent convulsions, vasopressors as indicated, and standard CPR if cardiac arrest occurs. Dialysis is of negligible value. (1)
Frequently asked questions
Can I use topical lidocaine products the same way as the injection?
No. This information covers the injectable local-anesthetic product only. Topical lidocaine patches, gels, creams, and OTC products have different indications, dosing, and safety profiles and are not interchangeable with the injectable formulation. Follow the specific product label or consult the clinician or pharmacist. (1)
Will I administer lidocaine injection myself at home?
No. Lidocaine injection is administered by a healthcare professional in a clinical setting. You will not be expected to inject this medicine yourself. (1)
What should I do if I feel strange or unwell after a lidocaine injection procedure?
The clinical team monitors you during and after the procedure. If you develop persistent severe headache, new back pain, leg weakness, numbness, fainting, chest pain, or difficulty breathing after leaving the clinical setting, contact the treating clinician or seek medical attention promptly. (1)
What is the mechanism of action of lidocaine hydrochloride?
Lidocaine is an amide local anesthetic that blocks sodium ion channels in neuronal membranes, inhibiting nerve impulse initiation and conduction and producing reversible local or regional anesthesia/analgesia. (1)
What is the generic name of Lidocaine (injectable local anesthetic)?
The generic name is lidocaine hydrochloride. (1)
What class of drug is lidocaine hydrochloride?
Lidocaine (injectable local anesthetic) is classed as: Amide local anesthetic. (1)
References
- LIDOCAINE HYDROCHLORIDE injection, solution — prescribing informationU.S. Food and Drug Administration · United States · dated not specified · accessed 2026-08-05 · source 1
- LIDONEX (LIDOCAINE HCL, MENTHOL) LIQUID [ALDAMA PHARMACEUTICALS, INC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Lidocaine Injection (antiarrhythmic) — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- DCH Hemorrhoidal — FDA approval record (Drugs@FDA M015)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- lidocaine — RxNorm normalized drug concept (RXCUI 142440)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient lidocaine hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Burn20 mg/mL, .02 g/g, .64 g27g, 5 mg/g, 2 mg00mL, 40 mg/g, 20 g/L, .5 g00g · jhk inc
- PAIN RELIEF PATCHES4 g00g · ahold u.s.a., inc,
- Xylocaine20 mg/mL, 10 mg/mL, 5 mg/mL · asclemed usa, inc.
- Sunburn Relief5 mg/g · rite aid corporation
- PAIN RELIEVING.04 g/g, 5 mg/g · shanghai chuangshi medical technology (group) co., ltd.
- NUMBING4 g00g, 4 mg00mL, 5 g00mL, 40 mg/g · walgreen company
- Lidocaine Pain Relief Roll on3.4 g/85g, 4 g00mL · neilmed pharmaceuticals inc
- Lidocaine Pain Relieving Patch.04 g/g, .04 g, 4 g00g, 40 mg/g · guangzhou zhupuyou e-commerce co., ltd
- Xylocaine MPF15 mg/mL, 20 mg/mL, 10 mg/mL, 5 mg/mL · fresenius kabi usa, llc
- Lidocaine HCI20 mg/mL, 10 mg/mL, 5 mg/mL, 40 mg/g · hf acquisition co llc, dba healthfirst
Canada
- XYLOCAINE
- LIDODAN
- LIDODAN JELLY
- MAXILENE
- SOLARCAINE FIRST AID LIDOCAINE
- XYLOCAINE ENDOTRACHEAL
- LIDODAN VISCOUS
- AFTERBURN
- XYLOCAINE VISCOUS
- XYLOCAINE JELLY