Comparative Pharmacology
Head-to-head clinical analysis: ALPHACAINE HYDROCHLORIDE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALPHACAINE HYDROCHLORIDE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
ALPHACAINE HYDROCHLORIDE vs LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Local anesthetic that reversibly blocks sodium ion channels in neuronal membranes, preventing the generation and propagation of action potentials.
Lidocaine is a sodium channel blocker that stabilizes neuronal membranes and inhibits action potentials, providing local anesthesia. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, prolonging lidocaine's effect and reducing systemic absorption.
1–2% solution via local infiltration or nerve block, up to a maximum of 4.5 mg/kg (or 300 mg) without epinephrine; with epinephrine, maximum 7 mg/kg (or 500 mg).
Local anesthesia: 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg) in adults; administer by infiltration or nerve block, not to exceed 1 hour between doses.
None Documented
None Documented
Terminal half-life 2.5-3.5 hours in adults; prolonged to 4-6 hours in hepatic impairment or elderly.
Lidocaine: terminal elimination half-life is approximately 1.5–2.0 hours. With continuous infusion or hepatic impairment, half-life may be prolonged (up to 4–6 hours). Epinephrine: plasma half-life is about 2–3 minutes due to rapid uptake and metabolism.
Primarily renal excretion of unchanged drug and metabolites (70-80%); minor biliary elimination (10-15%); fecal excretion <5%.
Lidocaine is primarily metabolized in the liver; approximately 90% of a dose is excreted in the urine as metabolites (including monoethylglycinexylidide and glycinexylidide), with less than 10% excreted unchanged. Epinephrine is metabolized by catechol-O-methyltransferase and monoamine oxidase, with metabolites excreted in urine.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)