Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus PARACAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus PARACAINE.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE vs PARACAINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Local anesthetic that reversibly blocks sodium channels in neuronal membranes, inhibiting nerve impulse conduction.
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.
10-20 mg orally every 4-6 hours as needed; maximum 80 mg/day.
None Documented
None Documented
Clinical Note
moderateProparacaine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Fluticasone propionate."
Clinical Note
moderateProparacaine + Clemastine
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Clemastine."
Clinical Note
moderateProparacaine + Venlafaxine
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Venlafaxine."
Clinical Note
moderateLidocaine: 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.
2.5 hours; prolonged to 8 hours in cirrhosis due to reduced hepatic metabolism
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.
Renal: 90% (70% unchanged, 20% as paracainol glucuronide); Biliary/Fecal: 10%
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic
Proparacaine + Nefazodone
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Nefazodone."