Comparative Pharmacology
Head-to-head clinical analysis: CHIROCAINE versus LICART.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHIROCAINE versus LICART.
CHIROCAINE vs LICART
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Chirocaine (levobupivacaine) is a long-acting local anesthetic of the amide type. It blocks sodium channels, inhibiting nerve impulse initiation and conduction, thereby producing local anesthesia.
Licart is a fibrin sealant containing human fibrinogen and thrombin. When applied, thrombin converts fibrinogen to fibrin, forming a stable clot that mimics the final stage of coagulation. It also contains factor XIII and aprotinin to cross-link fibrin and inhibit fibrinolysis, respectively.
0.5% to 0.75% solution; epidural: 10-20 mL of 0.5% solution (50-100 mg) as initial dose; for surgical anesthesia, 15-20 mL of 0.75% solution (112.5-150 mg); repeat doses of 0.25% to 0.5% solution at 40-60 minute intervals as needed. Maximum single dose: 225 mg.
Adults: 50 mg orally once daily.
None Documented
None Documented
Terminal elimination half-life is 0.5–1.5 hours (adults) and 1–2 hours (neonates). Clinically, this short half-life limits accumulation with repeated doses.
Terminal elimination half-life of 6-8 hours in adults with normal renal function. Prolonged in renal impairment (up to 20-24 hours in ESRD), requiring dose adjustment in CrCl <30 mL/min.
Renal excretion accounts for approximately 95% of the dose, with most being eliminated as metabolites (mainly p-aminobenzoic acid and other conjugates) and less than 5% as unchanged drug. Biliary/fecal excretion is minimal (<5%).
Primarily renal excretion (80-85% as unchanged drug), with 10-15% biliary/fecal elimination. Less than 5% metabolized to inactive glucuronide conjugate.
Category C
Category C
Local Anesthetic
Local Anesthetic