Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 2 IN DEXTROSE 5 IN PLASTIC CONTAINER versus POSIMIR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 2 IN DEXTROSE 5 IN PLASTIC CONTAINER versus POSIMIR.
LIDOCAINE HYDROCHLORIDE 0.2% IN DEXTROSE 5% IN PLASTIC CONTAINER vs POSIMIR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a sodium channel blocker that stabilizes the neuronal membrane by inhibiting the ionic fluxes required for initiation and conduction of impulses, resulting in local anesthetic and antiarrhythmic effects.
Bupivacaine, the active ingredient in POSIMIR, is an amide-type local anesthetic that blocks voltage-gated sodium channels in nerve cell membranes, inhibiting the generation and conduction of nerve impulses. POSIMIR is a bupivacaine extended-release liposomal formulation designed for sustained release at the surgical site.
Intravenous infusion: 1-4 mg/min (0.2% solution = 2 mg/mL) for antiarrhythmic therapy; loading dose 1-1.5 mg/kg IV bolus, then infusion. Maximum infusion rate 4 mg/min.
Posimir (bupivacaine) is administered as a single intra-articular injection into the subacromial space following arthroscopic shoulder surgery. The recommended adult dose is 5 mL (66 mg) of the 1.32% solution.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5–2 hours (mean 1.8 h) in adults with normal hepatic function; may be prolonged in patients with hepatic impairment (e.g., cirrhosis) or heart failure (up to 10 h), and in neonates (3–6 h).
Terminal elimination half-life is approximately 27 hours (range 16-38 hours), supporting once-daily dosing in clinical use.
Renal excretion of unchanged drug and metabolites accounts for >95% of elimination, with ~10% as unchanged lidocaine and ~90% as metabolites (primarily 4-hydroxy-2,6-xylidine, with minor contribution from monoethylglycinexylidide and glycinexylidide). Biliary/fecal excretion is minimal (<1%).
Primarily hepatic metabolism via CYP3A4 and CYP1A2 to inactive metabolites; <5% excreted unchanged in urine. Biliary/fecal excretion accounts for >90% of total clearance.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic