Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5 versus MEPIVACAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5 versus MEPIVACAINE HYDROCHLORIDE.
LIDOCAINE HYDROCHLORIDE 0.4% IN DEXTROSE 5% vs MEPIVACAINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a class IB antiarrhythmic agent that blocks voltage-gated sodium channels, inhibiting phase 0 depolarization and decreasing automaticity in ventricular myocardial cells. It also has local anesthetic properties by blocking nerve impulse conduction.
Mepivacaine hydrochloride is an amide-type local anesthetic that reversibly blocks nerve impulse propagation by binding to sodium channels in the neuronal cell membrane, thereby stabilizing the membrane and preventing depolarization.
Intravenous infusion: 1-4 mg/min (0.25-1 mL/min of 0.4% solution) after a loading dose of 1-1.5 mg/kg IV bolus for ventricular arrhythmias. Maximum total dose: 3 mg/kg.
1-2% solution, 5-20 mL local infiltration or nerve block, maximum 400 mg per procedure.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5-2 hours (mean 1.8 h) in healthy adults. In patients with hepatic impairment or heart failure, half-life may be prolonged to >3 hours. In neonates, half-life can be 3-6 hours.
Terminal elimination half-life approximately 2 hours (range 1.5–3 hours). In neonates and patients with hepatic dysfunction, half-life may be prolonged up to 8–10 hours.
Renal excretion of metabolites (primarily monoethylglycinexylidide and glycinexylidide) accounts for >90% of elimination. Less than 10% excreted unchanged in urine. Biliary/fecal excretion is negligible.
Primarily hepatic metabolism via amidase enzymes; ~95% excreted as metabolites in bile and feces, <5% unchanged in urine.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic