Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus NOVOCAIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus NOVOCAIN.
LIDOCAINE HYDROCHLORIDE W/ EPINEPHRINE vs NOVOCAIN
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.
Procaine, an ester-type local anesthetic, reversibly binds to the intracellular portion of voltage-gated sodium channels, inhibiting sodium influx and blocking nerve impulse conduction.
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.
Local infiltration: 0.5% solution, up to 20 mL (100 mg) per dose; nerve block: 1-2% solution, 5-10 mL (50-200 mg); maximum single dose: 7 mg/kg or 350 mg (without 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.
Plasma half-life: approximately 30–60 seconds due to rapid hydrolysis by pseudocholinesterases; clinical effects short-lived.
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.
Renal excretion of para-aminobenzoic acid (PABA) and diethylaminoethanol as major metabolites; <2% excreted unchanged in urine. Biliary/fecal: minimal.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic