Class: Local Anesthetic
Dosage Forms. Topical Patch: 5%
Common FDA Label Indication, Dosing, and Titration.
1. Postherpetic neuralgia: 1-3 patches topically simultaneously for up to 12 h within a 24-h period
Off-Label Uses.
1. Diabetic neuropathy: 1-3 patches topically simultaneously for up to 12 h within a 24-h period
MOA. Lidocaine is an amide-type local anesthetic agent and is suggested to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. The penetration of lidocaine in patch form into intact skin is sufficient to produce an analgesic effect, but less than the amount necessary to produce a complete sensory block.
Drug Characteristics: Lidocaine Topical Patch
Medication Safety Issues: Lidocaine Topical Patch
Drug Interactions: Lidocaine Topical Patch. Minimal systemic absorption, none known.
Adverse Reactions: Lidocaine Topical Patch
Efficacy Monitoring Parameters. Relief from pain.
Toxicity Monitoring Parameters. Application of too many patches, for too long a period of time, and/or without adequate drug-free period may increase toxicity; application to broken skin or covering with occlusive dressing may lead to toxicity, particularly cardiac dysfunction.
Key Patient Counseling Points. Instruct patients on the appropriate application process. Leave patches on skin for no more than 12 h within a 24-h period. Caution patients to administer only as directed, to intact skin, without covering with occlusive dressing or tight clothes.
Clinical Pearls. Patches may be cut into smaller sizes prior to removal of release liner to refine dose to meet patients’ needs. Patients should be instructed to fold used patches after removal so that the adhesive side sticks to itself and safely discard used patches or pieces of cut patches where children and pets cannot get to them. Accidental ingestion of used patches can lead to serious adverse effects.