Lidocaine/Adrenaline (Epinephrine) Laboratoire Aguettant (Epinephrine, Lidocaine Hydrochloride)

Lidocaine/Epinephrine is used in the local anesthetic pathway to provide targeted numbness during various procedures.

• Surgical procedures: delivers localized anesthesia and reduces bleeding during minor and major surgeries.
• Obstetric labor: enables epidural analgesia for pain relief during childbirth.
• Diagnostic interventions: facilitates infiltration anesthesia for minor diagnostic or therapeutic procedures.

• Lidocaine blocks voltage‑gated sodium channels on neuronal membranes, preventing the initiation and propagation of nerve impulses and thereby producing local anesthesia. Epinephrine stimulates alpha‑ and beta‑adrenergic receptors, causing vasoconstriction at the injection site, which slows systemic absorption of lidocaine, prolongs its effect, and reduces bleeding.

Adverse reactions may occur following administration of lidocaine/epinephrine.

Common Side Effects

• Transient burning or stinging at the injection site.
• Mild dizziness or light‑headedness.
• Nausea or mild vomiting.
• Temporary tachycardia.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis) with rash, swelling, or airway compromise.
• Cardiac arrhythmias, including ventricular tachycardia.
• Seizures due to systemic lidocaine toxicity.
• Methemoglobinemia presenting with cyanosis and dyspnea.

Before using lidocaine/epinephrine, consider the following safety measures.

• Allergy assessment: verify no known hypersensitivity to lidocaine, epinephrine, or amide‑type anesthetics.
• Cardiovascular status: avoid in patients with uncontrolled hypertension or significant cardiac disease.
• Dosage limits: adhere to maximum recommended lidocaine dose to prevent systemic toxicity.
• Concurrent MAO inhibitors: use caution as epinephrine effects may be potentiated.
• Pregnancy and lactation: use only if the benefit outweighs the potential risk, as safety data are limited.
• Store at room temperature: keep in the original container, protect from light and moisture.

Lidocaine/epinephrine may interact with other medicines; monitor patients accordingly.

Major Interactions (Avoid)

• Class I antiarrhythmics (e.g., quinidine, procainamide): may increase lidocaine plasma levels.
• Beta‑blockers (e.g., propranolol): can potentiate epinephrine‑induced hypertension.
• Monoamine oxidase inhibitors (MAOIs): may cause exaggerated epinephrine effects.

Moderate Interactions (Monitor Closely)

• CYP3A4 inhibitors (e.g., erythromycin): may modestly raise lidocaine concentrations.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may increase bleeding risk when combined with epinephrine‑induced vasoconstriction.
• Diuretics (e.g., furosemide): may enhance lidocaine toxicity.