Comparative Pharmacology
Head-to-head clinical analysis: LIDODERM versus MARCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDODERM versus MARCAINE HYDROCHLORIDE.
LIDODERM vs MARCAINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is an amide-type local anesthetic that blocks voltage-gated sodium channels (Nav1.7) in nerve cell membranes, inhibiting depolarization and conduction of nerve impulses, thereby producing both local anesthesia and systemic analgesia.
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.
Apply 1 to 3 patches (5% lidocaine) to intact skin over most painful area for up to 12 hours within a 24-hour period; maximum 3 patches at once.
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 elimination half-life is 3–5 hours after topical application; after intravenous administration, half-life is 1.5–2 hours. Clinical context: Systemic accumulation possible with prolonged use on inflamed skin.
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 excretion of metabolites (primarily 4-hydroxy-2,6-xylidine glucuronide) accounts for >85% of elimination; <3% excreted unchanged; biliary/fecal elimination minimal (<10%).
Primarily hepatic metabolism; less than 5% excreted unchanged in urine. Metabolites are excreted renally, with a small amount in feces via biliary elimination.
Category C
Category C
Local Anesthetic
Local Anesthetic