Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus PARACAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus PARACAINE.
LIDOCAINE HYDROCHLORIDE W/ EPINEPHRINE vs PARACAINE
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.
Local anesthetic that reversibly blocks sodium channels in neuronal membranes, inhibiting 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.
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
moderateTerminal 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.
2.5 hours; prolonged to 8 hours in cirrhosis due to reduced hepatic metabolism
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: 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."