Comparative Pharmacology
Head-to-head clinical analysis: CHIROCAINE versus LIDODERM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHIROCAINE versus LIDODERM.
CHIROCAINE vs LIDODERM
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 an amide-type local anesthetic that blocks voltage-gated sodium channels (Nav1.7) in nerve cell membranes, inhibiting depolarization and conduction of nerve impulses, thereby producing both local anesthesia and systemic analgesia.
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.
Apply 1 to 3 patches (5% lidocaine) to intact skin over most painful area for up to 12 hours within a 24-hour period; maximum 3 patches at once.
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 is 3–5 hours after topical application; after intravenous administration, half-life is 1.5–2 hours. Clinical context: Systemic accumulation possible with prolonged use on inflamed skin.
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 (primarily 4-hydroxy-2,6-xylidine glucuronide) accounts for >85% of elimination; <3% excreted unchanged; biliary/fecal elimination minimal (<10%).
Category C
Category C
Local Anesthetic
Local Anesthetic