Lidocaine + epinephrine

Hypersensitivity to lidocaine or other anaesthetics of the amide type, para-amino benzoic acid (PABA) and epinephrine.

Patient with hypovolaemia; G6PD deficiency, congenital or idiopathic methaemoglobinaemia, exposure to oxidizing agents or their metabolites, bradycardia, severe shock, heart block, impaired CV or respiratory function, diabetes, poorly controlled hyperthyroidism; neurological disease, spinal deformities, septicaemia, and severe hypertension (if used as epidural anaesthesia). Debilitated and acutely ill patients. Hepatic or severe renal impairment. Children. Pregnancy and lactation. Not intended for intravascular inj. Use with caution in areas of the body supplied by end arteries or having otherwise compromised blood supply and when there is inflammation and/or sepsis in the region of the proposed inj. Patient counselling This drug may temporarily impair mental alertness or locomotion; if affected, do not drive or operate machinery. Monitoring Parameters Monitor CV and respiratory vital signs and state of patient's consciousness constantly. Perform ECG during administration of test dose. Monitor for signs and symptoms of methaemoglobinaemia (e.g. cyanosis, headache, rapid pulse, shortness of breath, light-headedness, fatigue) and CNS toxicity.

Significant: Cardiac depression (e.g. hypotension, bradycardia); CNS toxicity (e.g. dizziness, blurred vision, tinnitus, tremors, drowsiness, restlessness, anxiety, or depression). Cardiac disorders: Rarely, arrhythmia. Gastrointestinal disorders: Nausea, vomiting. Nervous system disorders: Paraesthesia. Vascular disorders: Hypertension.
Potentially Fatal: Methaemoglobinaemia. Rarely, cardiac or respiratory arrest, anaphylaxis.

Epinephrine: Enhanced vasopressor effect with MAOIs, TCAs, non-selective β-blockers (e.g. propranolol). Diminished vasoconstricting effect with butyrophenones (e.g. haloperidol) and phenothiazines (e.g. promethazine). Concomitant use with ergot-type oxytocic agents may result in severe, persistent hypertension and possibly cerebrovascular and cardiac accidents. Increased risk of serious cardiac arrythmias with inhalational anaesthetics (e.g. halothane, enflurane). Lidocaine: Enhanced adverse effect with other local anaesthetics. Increased serum concentration with amiodarone. Reduced clearance with cimetidine and β-blockers.

Anaesthetics- local & general

R02AD02 - lidocaine ; Belongs to the class of local anesthetics used in throat preparations.
C01BB01 - lidocaine ; Belongs to class Ib antiarrhythmics.
B02BC09 - epinephrine ; Belongs to the class of local hemostatics. Used in the treatment of hemorrhage.
D04AB01 - lidocaine ; Belongs to the class of topical anesthetics used in the treatment of pruritus.
A01AD01 - epinephrine ; Belongs to the class of other agents for local oral treatment.
N01BB02 - lidocaine ; Belongs to the class of amides. Used as local anesthetics.
R03AA01 - epinephrine ; Belongs to the class of adrenergic inhalants, alpha- and beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
C01CA24 - epinephrine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.
S01HA07 - lidocaine ; Belongs to the class of local ophthalmologic anesthetics.
S01EA01 - epinephrine ; Belongs to the class of sympathomimetics used in the treatment of glaucoma.
C05AD01 - lidocaine ; Belongs to the class of local anesthetics. Used in the topical treatment of hemorrhoids and anal fissures.
R01AA14 - epinephrine ; Belongs to the class of topical sympathomimetic agents used as nasal decongestants.
S02DA01 - lidocaine ; Belongs to the class of analgesic and anesthetic agents used as otologicals.