Comparative Pharmacology
Head-to-head clinical analysis: IONTOCAINE versus LIDOCAINE HYDROCHLORIDE W EPINEPHRINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONTOCAINE versus LIDOCAINE HYDROCHLORIDE W EPINEPHRINE.
IONTOCAINE vs LIDOCAINE HYDROCHLORIDE W/ EPINEPHRINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Iontocaine (lidocaine 2% and epinephrine 0.01%) combines a sodium channel blocker (lidocaine) to inhibit nerve impulse propagation, producing local anesthesia, with epinephrine causing vasoconstriction to reduce systemic absorption and prolong effect.
Lidocaine is a sodium channel blocker that inhibits voltage-gated sodium channels, preventing depolarization and conduction of nerve impulses. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, reducing systemic absorption of lidocaine and prolonging local anesthetic effect.
IONTOCAINE is not a recognized drug. No standard dosing available.
Local anesthesia: 1-5 mL of 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg without epinephrine, 7 mg/kg with epinephrine) per procedure. Intravenous: 1-1.5 mg/kg bolus for ventricular arrhythmias, followed by continuous infusion 1-4 mg/min.
None Documented
None Documented
Terminal elimination half-life is 2.5-3.0 hours; prolonged in renal impairment (up to 6-8 hours).
Terminal half-life 1.5-2 hours (single dose), prolonged to 2-3 hours with continuous infusion; in heart failure or hepatic cirrhosis, half-life may exceed 5 hours.
Primarily renal excretion of unchanged drug (70-80%) and glucuronide conjugate (15-20%); less than 10% fecal.
Renal: unchanged drug <10%, major metabolites (MEGX and GX) ~70% renal; biliary: <10% fecal; total clearance ~10-20 mL/min/kg. Renal impairment prolongs elimination of metabolites.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)