Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus MARCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus MARCAINE HYDROCHLORIDE.
LIDOCAINE HYDROCHLORIDE W/ EPINEPHRINE vs MARCAINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a sodium channel blocker that inhibits voltage-gated sodium channels, preventing depolarization and conduction of nerve impulses. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, reducing systemic absorption of lidocaine and prolonging local anesthetic effect.
Bupivacaine is an amide-type local anesthetic that blocks voltage-gated sodium channels in nerve cell membranes, reversibly inhibiting nerve impulse propagation, particularly in sensory fibers.
Local anesthesia: 1-5 mL of 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg without epinephrine, 7 mg/kg with epinephrine) per procedure. Intravenous: 1-1.5 mg/kg bolus for ventricular arrhythmias, followed by continuous infusion 1-4 mg/min.
Adults: 0.5% solution infiltrated up to 175 mg (35 mL) for minor procedures; for major procedures, up to 225 mg (45 mL) with epinephrine. Repeat doses at 3-hour intervals. Maximum dose 400 mg with epinephrine.
None Documented
None Documented
Terminal half-life 1.5-2 hours (single dose), prolonged to 2-3 hours with continuous infusion; in heart failure or hepatic cirrhosis, half-life may exceed 5 hours.
Terminal elimination half-life is approximately 2.5 to 3.5 hours in adults; may be prolonged in neonates (8-12 hours) or patients with hepatic impairment.
Renal: unchanged drug <10%, major metabolites (MEGX and GX) ~70% renal; biliary: <10% fecal; total clearance ~10-20 mL/min/kg. Renal impairment prolongs elimination of metabolites.
Primarily hepatic metabolism; less than 5% excreted unchanged in urine. Metabolites are excreted renally, with a small amount in feces via biliary elimination.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic