Comparative Pharmacology
Head-to-head clinical analysis: CHIROCAINE versus LIDOCAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHIROCAINE versus LIDOCAINE.
CHIROCAINE vs LIDOCAINE
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.
Lidocaine is a sodium channel blocker that inhibits the influx of sodium ions into cardiac Purkinje fibers and myocytes, thereby stabilizing the neuronal membrane and decreasing automaticity. It also exhibits local anesthetic effects by reversibly binding to voltage-gated sodium channels in nerve cell membranes, blocking impulse conduction.
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.
For ventricular arrhythmias: IV bolus 1-1.5 mg/kg, then continuous infusion 1-4 mg/min. For local anesthesia: 0.5-2% solution, max 4.5 mg/kg (300 mg) without epinephrine, 7 mg/kg (500 mg) with epinephrine.
None Documented
None Documented
Clinical Note
moderateLidocaine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Lidocaine is combined with Fluticasone propionate."
Clinical Note
moderateLidocaine + Tenofovir disoproxil
"The metabolism of Tenofovir disoproxil can be decreased when combined with Lidocaine."
Clinical Note
moderateLidocaine + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Lidocaine."
Clinical Note
moderateLidocaine + Erythromycin
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 1.5-2 hours (normal hepatic function). In CHF or hepatic impairment, prolonged to 6-8 hours; in neonates, 3-6 hours. Context: rapid redistribution after IV bolus (alpha half-life ~8 min) accounts for brief clinical effect, while terminal half-life determines accumulation with infusion.
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%).
Renal excretion of metabolites: 4-hydroxyxylidine (70-80% renal, 10-20% biliary/fecal), unchanged lidocaine <10% renal. Total renal elimination ~90% (as metabolites), biliary/fecal ~10%.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)
"The metabolism of Erythromycin can be decreased when combined with Lidocaine."