Comparative Pharmacology
Head-to-head clinical analysis: CHIROCAINE versus XYLOCAINE DENTAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHIROCAINE versus XYLOCAINE DENTAL.
CHIROCAINE vs XYLOCAINE DENTAL
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 stabilizes the neuronal membrane by inhibiting sodium ion influx, thereby blocking the initiation and conduction of nerve impulses.
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.
Xylocaine Dental (lidocaine HCl 2% with epinephrine 1:100,000 or 1:50,000): For infiltration/inferior alveolar nerve block, maximum dose 3.4 mg/kg (4.5 mg/kg with epinephrine 1:100,000) not to exceed 300 mg; usual adult dose: 1–5 mL (20–100 mg) administered via oral submucosal injection.
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.
1.5–2 hours in adults with normal hepatic function. Prolonged to 2–3 hours in patients with hepatic impairment or congestive heart failure; may exceed 5 hours in severe hepatic disease.
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 unchanged drug and metabolites accounts for >95% of the dose. Approximately 70% is excreted as the metabolite 4-hydroxy-2,6-xylidine; less than 10% is unchanged lidocaine. Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Local Anesthetic
Local Anesthetic