Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE AND PRILOCAINE versus NOVOCAIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE AND PRILOCAINE versus NOVOCAIN.
LIDOCAINE AND PRILOCAINE vs NOVOCAIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine and prilocaine are amide-type local anesthetics that stabilize neuronal membranes by inhibiting sodium ion channels, thereby blocking the initiation and conduction of nerve impulses.
Procaine, an ester-type local anesthetic, reversibly binds to the intracellular portion of voltage-gated sodium channels, inhibiting sodium influx and blocking nerve impulse conduction.
Apply 2.5 g cream (lidocaine 25 mg/prilocaine 25 mg) to intact skin under occlusive dressing; maximum single application area 400 cm², maximum application time 4 hours. For genital mucous membranes: apply 5-10 g for 5-10 minutes without occlusion. Not recommended for dental use.
Local infiltration: 0.5% solution, up to 20 mL (100 mg) per dose; nerve block: 1-2% solution, 5-10 mL (50-200 mg); maximum single dose: 7 mg/kg or 350 mg (without epinephrine).
None Documented
None Documented
Lidocaine: 1.5-2 hours; prilocaine: 1.5-2 hours. In hepatic impairment, half-life may be prolonged up to 2-3 times.
Plasma half-life: approximately 30–60 seconds due to rapid hydrolysis by pseudocholinesterases; clinical effects short-lived.
Renal excretion of metabolites (lidocaine: 70-80% as 4-hydroxy-2,6-xylidine and conjugates; prilocaine: 85-95% as o-toluidine metabolites and conjugates). Less than 10% of parent drugs excreted unchanged.
Renal excretion of para-aminobenzoic acid (PABA) and diethylaminoethanol as major metabolites; <2% excreted unchanged in urine. Biliary/fecal: minimal.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic