In order to eliminate pain, use a variety of anesthetics. If the pain syndrome needs to be removed directly from the body area, topical preparations are used. These are mainly sprays, ointments, gels. Lidocaine has various forms of release. To relieve pain from the affected area, it is most often used in the form of 5% ointment.
Composition and form of release of "Lidocaine"
"Lidocaine" (ointment) is created exclusively for external use. The composition of the drug includes such active substances as lidocaine hydrochloride and chlorhexidine dihydrochloride. The medicine also contains additional components, such as hyetellose (hydroxyethyl cellulose) and glycerol.
The drug is a clear gel.
In turn, the product is packaged in aluminum tubes of 15 and 30 g and 25 g each in dark glass jars. Instructions are enclosed in a cardboard box along with Lidocaine ointment.
This drug is available not only in the form of an ointment, but also in the form of a spray, and in ampoules intended for injection.
The drug should be stored in a cool, dry place and out of the reach of children. The shelf life of the ointment is three years, after it the drug can not be used.
Pharmacological action of the drug
The drug belongs to the antiarrhythmic IB class. Acts as a local anesthetic and is a derivative of acetanilide. It is characterized by membrane stabilizing activity.
Means "Lidocaine" (ointment) reduces the duration of the exposure potential and the effective period in Purkinje fibers, inhibits their independent activity. The drug blocks the electrical activity of depolarized, arrhythmogenic zones, but at the same time it affects the electrical work of normal tissues to the smallest extent.
When used in moderate doses, the drug does not significantly affect myocardial contractility and does not slow down AV conduction. If Lidocaine is used as an antiarrhythmic drug and is administered iv, the onset of its action occurs after 45-90 seconds, and the effect lasts about 10-20 minutes. With the / m introduction of the drug, the effect can be felt after 5-15 minutes, and its duration is 60-90 minutes.
The drug is intended for terminal, infiltration and conduction anesthesia.
The drug can be applied externally to the problem area several times a day. The recommended number of applications is 3-4 times a day.
Quite often they use 2% Lidocaine gel to insert a medical instrument into the esophagus or larynx. The drug is applied with a special medical stick. If anesthesia did not work or the effect of the drug was negligible, the procedure for applying the drug is repeated.
In the same concentration, the ointment is used in studies in the urological field for women, where it lubricates the mucous membrane of the urethra. In this case, the individual structure of the urethra affects the flow of medication. Another gel is used when a catheter is inserted into the urethra in men, while up to 100 mg of the drug is consumed.
To reduce pain in inflammatory processes in the bladder, patients are administered a single dose of the ointment along with other medicines once. Such therapy lasts up to five days.
The gel with lidocaine is also used during the examination of the bladder with an endoscope. So, in order to fill and enlarge the urethra, use up to 30 ml of this drug. This dose is administered in two stages with a short interval. The urethra is pinched for a short time.
Also used in cosmetology "Lidocaine" (ointment) - for hair removal of bikini and other sensitive areas of the body.
After intramuscular administration of the drug, it is absorbed almost completely. It is quickly distributed. Its interaction with proteins is affected by the concentration of the active component in the blood, which is 60-80%. The drug is metabolized mainly in the liver, while it provokes the appearance of active metabolites that affect the therapeutic and toxic effects, especially after the infusion (during the day or more).
The half-life of the drug tends to be biphasic with a distribution phase of 7-9 minutes. It depends on the dose of administration and is equal to 1-2 hours, gradually increases to three hours or more during prolonged iv infusions (more than 24 hours). It is excreted by the kidneys in the form of metabolites, only 10% comes out unchanged.
Ointment "Lidocaine": application
Lidocaine ointment (5%) has only local use. It reduces pain in areas of damage to the skin (wounds, bruises) and on the mucous membranes of the mouth. It is applied in the perianal area.
Contraindications
The use of Lidocaine gel (the instructions should be read before use) practically does not cause negative reactions, but, despite this, the remedy cannot be used if the mucous membrane is damaged. In this case, the absorption of the anesthetic increases, which may lead to the occurrence of systemic toxicity.
You should not use the drug in childhood (up to two years) and with hypersensitivity to lidocaine.
"Lidocaine" (ointment): instructions for use
The amount of the drug used to treat the skin depends on the condition of the patient and the area that needs to be treated, the vascularity of the tissues. The ointment consumption is affected by the individual tolerance of the components. After all, you can use the medicine in minimal doses or for a certain time to abandon its use.
Lidocaine-ointment (the instruction tells in detail in which cases this drug cannot be used) is prescribed if there are certain indications for adults and children, starting from the age of twelve.
To alleviate the pain, the ointment should be applied in a dose of 1-2 grams several times a day. Optimal - 3-4 application.
Children under twelve years of age should use the gel with caution. Here you need to pay attention to the fact that in children of this age the bioavailability is 100%. Therefore, the maximum allowable dose should not exceed 0.1 g / kg of the child’s weight, which means 5 mg of lidocaine per kilogram of body weight. The interval between applications of the ointment should not be less than eight hours.
The drug is applied to the mucosa during procedures such as diagnosing the trachea, larynx and esophagus. Also, ointment tools are often lubricated with examination ointment. Processing tools "Lidocaine" is carried out during the event. At this time, 0.2-2 g of ointment is consumed. If such anesthesia did not give a result, then after 2-3 minutes the procedure is repeated again.
The maximum daily dose for an adult is 300 mg (6 g of gel). Ladies in the urology department process the urethral mucosa 3-5 ml of the drug. For men, an ointment is used immediately before catheterization in an amount of 5-10 ml. The maximum daily dose for children is 4.5 mg / kg.
In dentistry, an ointment is applied to the oral mucosa for subsequent anesthesia. The interval between applying the ointment is 2-3 minutes. Another gel is used to remove tartar. To do this, the drug is rubbed into the edge of the gums and the neck of the teeth for 2-3 minutes. Apply applications from the ointment to the mucous membrane of the oral cavity with the formation of aphthae and erosion.
Often use "Lidocaine" (ointment) for hair removal. This preparation is especially suitable for hair removal of a bikini zone. As a local anesthetic, the medicine is used 3-3.5 hours before the hair removal procedure. First, the gel is applied to the surface of the skin, and then wrap the desired area with cling film.
Side effects
"Lidocaine" (ointment) in some cases can cause skin irritation, since the drug, in addition to lidocaine, also contains propylene glycol. The appearance of such side effects as urticaria, edema is also possible. In quite rare cases, anaphylactic shock was observed.
When systemic toxicity occurs due to the use of external painkillers, side effects are observed in the central nervous and cardiovascular systems.
Symptoms of the central nervous system are manifested in the form of anxiety, nervousness, anxiety, agitation and loss of orientation. In some cases, confusion of thoughts, tinnitus, blurred vision, miosis, nausea and vomiting reflex, cramps, tremors. There were manifestations of signs of irritation, loss of sensitivity of the tongue and the area around the oral cavity.
On the part of the cardiovascular system, in some cases, inhibition of myocardial function, as well as peripheral vasodilation, which occurred after hypertension and bradycardia, were recorded. A similar picture can cause arrhythmia and, as a result, cardiac arrest. Very rarely, methemoglobinemia occurs.
Interaction with other drugs
Lidocaine (ointment) when combined with antiarrhythmic drugs can cause paralysis or cardiac arrest. This condition was observed in patients who used lidocaine with amiodarone, tocainide, or procaine.
Antiepileptic drugs in combination with lidocaine can reduce the concentration of the drug in the blood. "Phenytoin", administered intravenously, is able to increase the cardiodepressive properties of the active substance.
The combination with beta-blockers increases the concentration of lidocaine in the blood. A similar effect causes "Nadolol."
H2 antagonists, such as Cimetidine, increase the hepatic metabolism of the active component, which increases the degree of toxicity of lidocaine.
Hypokalemia, which was triggered by the use of "Acetazolamide", diuretics, prevents the action of lidocaine.
The simultaneous use of the drug with vasoconstrictors causes side effects.
Special instructions
Do not apply Lidocaine (5% ointment) on the mucous membrane of the oral cavity if there is inflammation or sepsis is detected in the patient.
To avoid systemic absorption, it is necessary to use the medicine with extreme caution in case of anemia, methemoglobinemia, as well as with a lack of glucose-6-phosphate dehydrogenase.
If you are allergic to ointment, you should immediately stop its use and deal with the elimination of side effects.
"Lidocaine" is not prescribed for patients suffering from hypovolemia, as well as having blockade of the heart muscles and other malfunctions of cardiac conduction.
Use a medicine with caution if congestive heart failure occurs, bradycardia, or respiratory depression is observed.
Subject to the instructions, the risk of side effects from the central nervous system is minimal. If there is a special sensitivity in patients to the drug "Lidocaine", the medicine is used with extreme caution. In an allergic reaction to para-aminobenzoic acid derivatives, cross-susceptibility to lidocaine was not detected.
The drug should be used with extreme caution during pregnancy, since studies showing the effect of the active substance on the future fetus have not been conducted. Experts recommend in the first trimester of pregnancy, if possible, to refrain from using the drug.
“Lidocaine” passes into breast milk in the smallest doses, which does not negatively affect the development of the baby.
Renal failure does not cause significant changes in pharmacokinetics when using Lidocaine (5% ointment).
In the presence of liver failure, you must either completely abandon the application of the drug, or reduce the use to the minimum doses. When applying the product to the face, it is necessary to ensure that the medicine does not get into the eyes.
An overdose of the drug may occur due to systemic toxicity of local anesthetics and is due to high concentrations of the active substance in the blood. It provokes the appearance of side effects associated with the action of the central nervous and cardiovascular systems.
In this situation, appropriate treatment is carried out. They provide airway patency, try to get rid of carbon dioxide. Oxygen is injected into the patient's body or artificial respiration is done.
If there are convulsions, then they are removed by introducing succinylcholine in an amount of 50-100 mg and / or diazepam in a dose of 5-15 mg. In some cases, short-acting barbiturates are used. Dialysis in this situation does not give the desired effect and therefore is not applied.
Analogues of Lidocaine
If for some reason “Lidocaine” (ointment) did not fit during hair removal or for other purposes, do not despair, just pay attention to the drugs replacing this drug, among which stand out:
- "Naropin";
- “Bulivacaine”;
- "Ultracain DS";
- "Novocaine";
- cream "Emla";
- "Midokalm";
- "Zaldiar";
- "Artifrin";
- "Nalbufin";
- "Diprofool."
The use of each drug has its own characteristics, so only a doctor should replace it. Only in this case can we count on the competent selection of a medication.
Reviews of women about the use of ointment for depilation
The drug "Lidocaine" (ointment) receives many reviews. Epilation with this agent has ceased to be painful. It removes pain well, relieves sensitivity, which allows you to make the hair removal procedure quite safe and as comfortable as possible. Women apply the cream to the entire area that will be processed, and lay polyethylene on top and hold for up to 2-3 hours. After such manipulations, as a rule, pain during hair removal is no longer felt even in the most sensitive parts of the body.
But not everyone is happy with the effect of the drug "Lidocaine" (ointment). Negative reviews say that this is a completely useless tool, and it practically does not remove the pain. In some women, the gel eliminated the pain, but a slight sensitivity was still observed during the hair removal procedure. Many people prefer to use Lidocaine spray and say that it acts several times more effective than ointment. This is due to the individual characteristics of the body.