Comparative Pharmacology
Head-to-head clinical analysis: ALPHACAINE versus LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALPHACAINE versus LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5.
ALPHACAINE vs LIDOCAINE HYDROCHLORIDE 0.4% IN DEXTROSE 5%
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ALPHACAINE is a local anesthetic that binds to the intracellular portion of voltage-gated sodium channels, blocking sodium influx and preventing depolarization and conduction of nerve impulses.
Lidocaine is a class IB antiarrhythmic agent that blocks voltage-gated sodium channels, inhibiting phase 0 depolarization and decreasing automaticity in ventricular myocardial cells. It also has local anesthetic properties by blocking nerve impulse conduction.
10-20 mg IM or IV every 4-6 hours as needed; maximum 80 mg/day.
Intravenous infusion: 1-4 mg/min (0.25-1 mL/min of 0.4% solution) after a loading dose of 1-1.5 mg/kg IV bolus for ventricular arrhythmias. Maximum total dose: 3 mg/kg.
None Documented
None Documented
Terminal elimination half-life: 3.5-5.0 hours (prolonged in hepatic impairment; requires dose adjustment in Child-Pugh B or C).
Terminal elimination half-life is approximately 1.5-2 hours (mean 1.8 h) in healthy adults. In patients with hepatic impairment or heart failure, half-life may be prolonged to >3 hours. In neonates, half-life can be 3-6 hours.
Renal: ~60-70% unchanged; Hepatic metabolism: ~20-30% via CYP3A4 and CYP2C9; Fecal: <10%.
Renal excretion of metabolites (primarily monoethylglycinexylidide and glycinexylidide) accounts for >90% of elimination. Less than 10% excreted unchanged in urine. Biliary/fecal excretion is negligible.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)