Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE AND PRILOCAINE versus TETRACAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE AND PRILOCAINE versus TETRACAINE HYDROCHLORIDE.
LIDOCAINE AND PRILOCAINE vs TETRACAINE HYDROCHLORIDE
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.
Tetracaine hydrochloride is a local anesthetic of the ester type that reversibly blocks nerve conduction by decreasing sodium ion permeability across the neuronal membrane, thereby stabilizing the membrane and preventing the initiation and transmission of nerve impulses.
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.
Topical: 0.5-2% solution or ointment applied to affected area up to 4 times daily as needed. Maximum single dose: 20 mL of 2% solution (400 mg). Spinal anesthesia: 0.5% solution, 2-3 mL (10-15 mg) injected intrathecally.
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.
Terminal elimination half-life is approximately 1.5–3 minutes in plasma due to rapid hydrolysis; clinical effect duration is dose-dependent (15–30 minutes for topical anesthesia).
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.
Primarily metabolized by plasma pseudocholinesterase; renal excretion of metabolites accounts for >95% of elimination, with <2% excreted unchanged in urine. Biliary/fecal elimination is negligible.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic