Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE versus MEPIVACAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE versus MEPIVACAINE HYDROCHLORIDE.
LIDOCAINE HYDROCHLORIDE vs MEPIVACAINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine hydrochloride is a sodium channel blocker that inhibits voltage-gated sodium channels in neuronal and cardiac cell membranes, stabilizing the membrane and preventing depolarization, thereby blocking nerve impulses and exerting local anesthetic and antiarrhythmic effects.
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.
IV: 1-1.5 mg/kg bolus, then 1-4 mg/min continuous infusion. Max: 3 mg/kg (300 mg) loading dose. For ventricular arrhythmias.
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 1.5–2 hours in adults. In patients with heart failure, hepatic cirrhosis, or those on CYP-inhibitors, half-life may be prolonged to ≥3 hours; in neonates, up to 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.
Primarily hepatic metabolism (90% CYP3A4, also CYP1A2) to inactive metabolites (monoethylglycinexylidide, glycinexylidide); <10% excreted unchanged in urine. Renal elimination accounts for the majority of metabolite clearance.
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