Comparative Pharmacology
Head-to-head clinical analysis: LICART versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LICART versus LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE.
LICART vs LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Licart is a fibrin sealant containing human fibrinogen and thrombin. When applied, thrombin converts fibrinogen to fibrin, forming a stable clot that mimics the final stage of coagulation. It also contains factor XIII and aprotinin to cross-link fibrin and inhibit fibrinolysis, respectively.
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.
Adults: 50 mg orally once daily.
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 of 6-8 hours in adults with normal renal function. Prolonged in renal impairment (up to 20-24 hours in ESRD), requiring dose adjustment in CrCl <30 mL/min.
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.
Primarily renal excretion (80-85% as unchanged drug), with 10-15% biliary/fecal elimination. Less than 5% metabolized to inactive glucuronide conjugate.
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)