Comparative Pharmacology
Head-to-head clinical analysis: ISOCAINE HYDROCHLORIDE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ISOCAINE HYDROCHLORIDE versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
ISOCAINE HYDROCHLORIDE vs LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Isocaine hydrochloride is a local anesthetic that stabilizes neuronal membranes by blocking voltage-gated sodium channels, thereby inhibiting the initiation and propagation of action potentials.
Lidocaine is a sodium channel blocker that stabilizes neuronal membranes and inhibits action potentials, providing local anesthesia. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, prolonging lidocaine's effect and reducing systemic absorption.
1-2% solution infiltrated subcutaneously or locally, maximum dose 4.5 mg/kg (with epinephrine) or 3.0 mg/kg (without epinephrine), not to exceed 300 mg.
Local anesthesia: 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg) in adults; administer by infiltration or nerve block, not to exceed 1 hour between doses.
None Documented
None Documented
Terminal elimination half-life is approximately 2.5 hours in healthy adults. In patients with hepatic impairment, half-life may be prolonged to 6–8 hours; in severe renal impairment, half-life may extend to 4–6 hours.
Lidocaine: terminal elimination half-life is approximately 1.5–2.0 hours. With continuous infusion or hepatic impairment, half-life may be prolonged (up to 4–6 hours). Epinephrine: plasma half-life is about 2–3 minutes due to rapid uptake and metabolism.
Renal: Approximately 90% of the dose is excreted as metabolites (primarily conjugated with glucuronic acid) in urine. Fecal: About 10% eliminated unchanged or as metabolites in feces. Biliary excretion is negligible.
Lidocaine is primarily metabolized in the liver; approximately 90% of a dose is excreted in the urine as metabolites (including monoethylglycinexylidide and glycinexylidide), with less than 10% excreted unchanged. Epinephrine is metabolized by catechol-O-methyltransferase and monoamine oxidase, with metabolites excreted in urine.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)