Each mL contains Lidocaine Hydrochloride USP 20 mg.

Z-LIDOCAINEis  a  sterile,  non-pyrogenic,  aqueous  solution  which  contains  Lidocaine Hydrochloride.  It  is  a  local  anaesthetic  of  the  amide  type  and  has  a  fast  onset  and  an intermediate  duration  of  action.  The  onset  of  action  ranges  from  5  minutes  for  infiltration anaesthesia to 20 minutes for regional anaesthesia. The duration of action is approximately 1 hour. Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, there by effecting local anaesthetic action.

  ♦ As a local anaesthetic for use in infiltration blockade and intravenous regional analgesia.
  ♦ For the prevention and treatment of vetricular tachyarrhythmias.

In estimating the safe dosage of this drug, it is important to take account of the rate at which it is absorbed and excreted as well as its potency. The patient’s age, weight, physique and clinical condition, the degree of vascularity of the area to which the drug is to be applied and the  durationof  administration  are  other  factors  which  must  be  taken  into  account.  The  dosage is adjusted  according to the response of the patient and site of administration

. The lowest concentration and smallest dose producing the required effect should be given.

Local anaesthesia
Adult :For healthy adults, the maximum individual should not exceed 4.5 mg/kg of body weight and in general it is recommended that the maximum total dose not exceed 300 mg.Recommended doses given in the following table serve only as a guide to the amount of anaesthetic required for most routine porcedures.

Dose  determined  by  number  of  dermatomes  to  be  anesthetized  (2-3  ml/dermatome).  
Children and eldely or debilitated patients require smaller doses, commensurate with age
and physical status

Antiarrhythmic treatment

An intravenous dose of 1 mg/kg may be given over 2 minutes and repeated after 5 minutes but giving an infusion of 2-4 mg/min to produce a plasma level of 2-4 mg. To avoid a long delay in achieving a steady state, a loading dose of approximately 1 mg/kg-1 is usually given
intravenously over 2 minutes at the outset

Lidocaine for infiltration and nerve block should be employed only by clinicians who are well versed in diagnosis and management of dose-related toxicity. The safety and effectiveness of  lidocaine  depends  on  proper  dosage,  correct  technique,  adequate  precautions  and  readiness for emergencies. Standard text books should be consulted for specific techniques and  precautions  for  various  regional  anaesthetic  procedures.  Resuscitative  equipment, oxygen and other resuscitative drugs should be available for immediate use. It should be used  cautiously  in  patients  with  epilepsy,  impaired  cardiac  conduction,  bradycardia, impaired respiratory function and in patients with impaired hepatic function, if the dose or site of administration is likely to result in high blood levels.  The effect of local anaesthetics may be reduced if an injection is made into an inflamed of infected area. Repeated doses of lidocaine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug or its metabolites. Tolerance to elevated blood levels varies with  the  status  of  the  patient.  Careful  and  constant  monitoring  of  cardiovascular  and respiratory vital signs and the patient’s state of consciousness should be accomplished after each local anaesthetic injection

Known hypersensitivity to anaesthetics of the amide type

Although there is no evidence from animal studies of harm to the foetus, as with all drugs. It should not be given during early pregnancy unless the benefits are considered to outweigh the risks. Caution should be exercised when it is administered to a nursing woman

50 mL vial in unit box.

In common with other local anaesthetics, adverse reactions to lidocaine are rare and are usually the result of excessively high blood concentrations due to inadvertent intravascular injection, excessive dosage, rapid absorption occasionally hypersensitivity, idiosyncracy or diminished tolerance on the part of the patient. In such circumstances systemic effects occur involving the central nervous system and/or depressant and may be characterized by nervousness, dizziness, blurred vision and tremors, followed by drowsiness, convulsions, unconsciousness and possibly respiratory arrest. cardiovascular reactions are hypotension, myocardial depression, bradycardia and possibly cardiac arrest. Allergic reactions are extremely rare. They may be characterized by cutaneous lesions, urticaria, oedema or anaphylactic reactions

Cimetidine can impair the metabolism of lidocaine absorbed into the circulation. Elimination will be delayed and the risk of adverse reactions increased. Singificant increases in plasma-lidocaine concentration have occurred during concomitant therapy with beta blockers such as propranolol, metoprolol. It prolongs the duration of action of suxametonium

Cimetidine can impair the metabolism of lidocaine absorbed into the circulation. Elimination will  be  delayed  and  the  risk  of  adverse  reactions  increased. Singificant  increases  in plasma-lidocaine  concentration  have  occurred  during  concomitant  therapy  with  beta  blockers such as propranolol, metoprolol. It prolongs the duration of action of suxametoniu

Dosages in children should be reduced, commensurate with age, body-weight and physical condition

Store below 25°C in a dry place, away from light. Keep out of the reach of children