Comparative Pharmacology
Head-to-head clinical analysis: LIDOCATON versus XYLOCAINE DENTAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCATON versus XYLOCAINE DENTAL.
LIDOCATON vs XYLOCAINE DENTAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a class IB antiarrhythmic agent that blocks voltage-gated sodium channels, inhibiting the inward sodium current, thereby stabilizing cardiac membranes, decreasing automaticity, and increasing the fibrillation threshold. It also acts as a local anesthetic by reversibly blocking nerve impulse propagation.
Lidocaine is an amide-type local anesthetic that stabilizes the neuronal membrane by inhibiting sodium ion influx, thereby blocking the initiation and conduction of nerve impulses.
Lidocaine: Initial IV bolus 1-1.5 mg/kg, then IV infusion 1-4 mg/min. Adjust for arrhythmia suppression.
Xylocaine Dental (lidocaine HCl 2% with epinephrine 1:100,000 or 1:50,000): For infiltration/inferior alveolar nerve block, maximum dose 3.4 mg/kg (4.5 mg/kg with epinephrine 1:100,000) not to exceed 300 mg; usual adult dose: 1–5 mL (20–100 mg) administered via oral submucosal injection.
None Documented
None Documented
Terminal half-life 1.5–2 hours (adults); prolonged in heart failure (up to 4–6 hours) or hepatic impairment (up to 8 hours).
1.5–2 hours in adults with normal hepatic function. Prolonged to 2–3 hours in patients with hepatic impairment or congestive heart failure; may exceed 5 hours in severe hepatic disease.
Renal: ~90% as metabolites (major metabolite 4-hydroxyxylidine) and ~10% unchanged. Biliary/fecal: <5%.
Renal excretion of unchanged drug and metabolites accounts for >95% of the dose. Approximately 70% is excreted as the metabolite 4-hydroxy-2,6-xylidine; less than 10% is unchanged lidocaine. Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Local Anesthetic
Local Anesthetic