Xylocaine Jelly Special Precautions

Excessive doses of lidocaine or short intervals between doses, can result in high plasma levels and serious adverse effects. Patients should be instructed to adhere strictly to the recommended dosage (the management of serious adverse reactions may require the use of resuscitative equipment, oxygen and other resuscitative drugs). (See Overdosage.)
Absorption from wound surfaces and mucous membranes is relatively high and especially high in the bronchial tree. The absorption of lidocaine jelly from the nasopharynx is variable but usually lower than with other lidocaine products. Following instillation in the urethra and bladder, adsorption is low. Lidocaine jelly should be used with caution in patients with traumatized mucosa and/or sepsis in the region of the proposed application.
The oropharyngeal use of topical anaesthetic agents may interfere with swallowing and thus, enhance the danger of aspiration. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma.
When used for endotracheal tube lubrication, care should be taken to avoid introduction of the jelly into the lumen of the tube. The jelly may dry on the inner surface leaving a residue which tends to clump with flexion, narrowing the lumen. There have been rare reports in which this residue has caused the lumen to occlude.
If the dose or administration is likely to result in high blood levels, some patients require special attention to prevent potentially dangerous side effects eg, patients with partial or complete heart block, the elderly and patients in poor general health and patients with advanced liver disease or severe renal dysfunction.
Xylocaine jelly 20 mg/mL is probably porphyrinogenic and should only be prescribed to patients with acute porphyria on strong or urgent indications. Appropriate precautions should be taken for all porphyric patients.
Effects on the Ability to Drive or Operate Machinery: Depending on the dose, local anaesthetics may have a very mild effect on mental function and may temporarily impair locomotion or coordination.
Use in pregnancy & lactation: It is reasonable to assume that a large number of pregnant women and women of childbearing age have been given lidocaine. No specific disturbances to the reproductive process have so far been reported eg, no increased incidence of malformations.
Like other local anaesthetics, lidocaine may enter the mother's milk but in such small amounts that there is generally no risk of this affecting the neonate.