Comparative Pharmacology
Head-to-head clinical analysis: CARBOCAINE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CARBOCAINE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
CARBOCAINE vs LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Mepivacaine, the active ingredient in Carbocaine, is an amide-type local anesthetic that blocks sodium ion channels in nerve cell membranes, thereby inhibiting the initiation and conduction of nerve impulses.
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% to 2% solution, 5-20 mL local infiltration or nerve block; maximum dose 400 mg (or 7 mg/kg) per 90-minute period.
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
2.0–3.5 hours in adults; prolonged in patients with hepatic impairment (up to 8–10 hours) or renal dysfunction.
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.
Renal excretion of unchanged drug and metabolites accounts for approximately 95% of elimination, with less than 5% excreted in feces via biliary elimination.
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)