Adult: Lidocaine 0.5% and epinephrine 1:200,000 solution for inj Lidocaine 1% and epinephrine 1:100,000 solution for inj Lidocaine 1% and epinephrine 1:200,000 solution for inj Lidocaine 1.5% and epinephrine 1:200,000 solution for inj Lidocaine 2% and epinephrine 1:100,000 solution for inj Lidocaine 2% and epinephrine 1:200,000 solution for inj
Dosage is individualised based on the procedure, degree or duration of anaesthesia required, vascularity of tissue, and the patient's weight and physical condition. Use the lowest dose and concentration that will produce the desired effect. Max lidocaine dose: 7 mg/kg (up to 500 mg). Dosage and treatment recommendations may vary among countries and between individual products (refer to local or specific product guidelines). Elderly: Dose reduction may be required. Child: Same as adult dose.
Adult: Lidocaine 2% and epinephrine 1:50,000 solution for inj Lidocaine 2% and epinephrine 1:80,000 solution for inj Lidocaine 2% and epinephrine 1:100,000 solution for inj
Dosage is individualised based on the patient's physical status, vascularity of oral tissues, area of oral cavity to be anaesthetised, and technique of anaesthesia used. Initially, 1-5 mL. Max lidocaine dose: 7 mg/kg (up to 500 mg). Use the lowest dose that will produce the desired effect. Dosage and treatment recommendations may vary among countries and between individual products (refer to local or specific product guidelines). Elderly: Dose reduction may be required. Child: Lidocaine 2% and epinephrine 1:50,000 solution for inj Lidocaine 2% and epinephrine 1:80,000 solution for inj Lidocaine 2% and epinephrine 1:100,000 solution for inj
Dose is individualised based on the age, weight and physical status of the patient, the vascularity of the oral tissues, the area of the oral cavity to be anaesthetised, and the technique of anaesthesia used. Max lidocaine dose: 7 mg/kg. Dosage and treatment recommendations may vary among countries and between individual products (refer to local or specific product guidelines).
What are the brands available for Lidocaine + Epinephrine in Indonesia?
Pehacain
Special Patient Group
Debilitated patients: Dose reduction may be required.
Special Precautions
Patient with congenital or idiopathic methaemoglobinaemia, G6PD deficiency, exposure to oxidising agents or their metabolites; bradycardia, severe shock, heart block, impaired CV function, peripheral vascular disease, hypertensive vascular disease; cerebrovascular insufficiency, hypovolaemia, diabetes, poorly controlled hyperthyroidism, epilepsy, impaired respiratory function, known drug sensitivities. Use in areas of the body supplied by end arteries or having otherwise compromised blood supply. Avoid intravascular inj. Not indicated for continuous intra-articular infusion after arthroscopic and other surgical procedures. Hepatic and severe renal impairment. Children, elderly, and debilitated patients. Pregnancy and lactation.
Monitor vital signs, state of consciousness (after each administration); ECG (during test dose administration). Assess for signs and symptoms of CNS toxicity.
Overdosage
Lidocaine: Symptoms: Lightheadedness, tinnitus, numbness of the tongue, visual disturbances, circumoral paraesthesia, dysarthria, muscular twitching, tremors, unconsciousness, grand mal convulsions, hypercapnia, hypoxia. In severe cases, apnoea, hypotension, bradycardia, arrhythmia, and cardiac arrest may occur. Management: Ensure appropriate airway/respiratory support, oxygenation and ventilation and circulatory support. Administer anticonvulsants to treat convulsions. Employ immediate cardiopulmonary resuscitation if circulatory arrest occurs. IV fluids and vasopressor may be given if circulatory depression occurs.
Drug Interactions
Lidocaine: May cause additive systemic toxic effects with other local anaesthetics or agents structurally related to amide-type local anaesthetics (e.g. mexiletine). Increased plasma concentration with cimetidine or β-blockers. Increased risk of methaemoglobinaemia with other agents associated with methaemoglobinaemia (e.g. nitric oxide, prilocaine, dapsone).
Epinephrine: Increased risk of severe, prolonged hypertension with TCAs and MAOIs. May cause hypotension and tachycardia with phenothiazines and butyrophenones. Increased risk of serious cardiac arrhythmias with inhalational anaesthetic agents (e.g. halothane). May cause dose-dependent hypertension and bradycardia with non-cardioselective β-blockers (e.g. propranolol, timolol). Concomitant use with ergot-type oxytocic agents may cause severe, persistent hypertension or cerebrovascular accidents.
Action
Description: Mechanism of Action: Lidocaine is an amide-type local anaesthetic agent. It inhibits the initiation and conduction of nerve impulses through a reduction in the permeability of neuronal membrane to Na ions, resulting in inhibition of depolarisation with resultant conduction blockade.
Epinephrine is a direct-acting sympathomimetic agent. By causing vasoconstriction, it slows the vascular absorption of lidocaine which leads to increased duration of action of lidocaine. Synonym(s): Lidocaine: Lignocaine.
Epinephrine: Adrenaline. Onset: Dental: ≤2-4 minutes. Duration: Dental: Approx 2-5 hours (infiltration); 3-3.25 hours (nerve block); depends on the dose and anaesthetic procedure. Pharmacokinetics: Absorption: Lidocaine: Rapidly absorbed from the inj site. Distribution: Crosses the placenta.
Lidocaine: Rapidly and widely distributed into highly perfused tissues, then redistributed into skeletal muscle and adipose tissue; crosses the blood-brain barrier. Enters breast milk. Plasma protein binding: 60-80% to α1-acid glycoprotein. Metabolism: Lidocaine: Metabolised in the liver by CYP1A2 and CYP3A4 isoenzymes into the active metabolites, monoethylglycinexylidide and glycinexylidide. Undergoes extensive first-pass metabolism.
Epinephrine: Undergoes uptake into adrenergic neurons and metabolised by monoamine oxidase (MAO) and COMT. Excretion: Lidocaine: Via urine (approx 90% as metabolites, <10% as unchanged drug). Elimination half-life: 1.5-2 hours.
Epinephrine: Via urine (as metabolites, mainly glucuronide and ethereal sulfate conjugates). Elimination half-life: <5 minutes (IV).
Chemical Structure
Lidocaine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 3676, Lidocaine. https://pubchem.ncbi.nlm.nih.gov/compound/Lidocaine. Accessed Apr. 30, 2025.
Epinephrine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5816, Epinephrine. https://pubchem.ncbi.nlm.nih.gov/compound/Epinephrine. Accessed Aug. 22, 2023.
Storage
Store between 20-25°C. Protect from light. Certain products recommend storage between 2-8°C. Refer to specific product guidelines for further information on storage recommendations.
Sign Out
Lanjutkan dengan Google