Minims Lidocaine & Fluorescein

Minims*

Lidocaine and Fluorescein

4% w/v Lidocaine hydrochloride and 0.25% w/v Fluorescein Sodium

About your eye drops

The name of this medicine is Minims Lidocaine & Fluorescein. Each Minims unit contains a solution of 4% w/v Lidocaine hydrochloride with 0.25% w/v fluorescein sodium.

One of the active ingredients in this medicine is lidocaine hydrochloride. This is the new name for lignocaine hydrochloride. The ingredient itself has not changed.

It also contains purified water, povidone and hydrochloric acid. Each Minims unit is a sterile, single-use container which holds approximately 0.5ml of solution. Each carton holds 20 Minims units. Lidocaine is a local anaesthetic which temporarily numbs the surface of the eye. Fluorescein temporarily colours your eyes orange or green and helps your doctor or eye specialist to examine them.

Who makes your eye drops?

Minims Lidocaine and Fluorescein are manufactured by

Laboratoire Chauvin S.A. ZI Ripotier 07200/Aubenas France

The Marketing Authorisations for Minims Lidocaine and Fluorescein (PL 0033/0073 & PA 118/24/1) are held by

Chauvin Pharmaceuticals Ltd. 106 London Road Kingston-Upon-Thames KT2 6TN England What are your eye drops for?

Your eye drops are used to numb and stain the surface of the eye, for a short time only, to allow the doctor or eye specialist to examine your eye.

Most often, your eye drops are used to allow the pressure inside your eyes to be measured.

Before using your eye drops

You should not use this product if you are allergic to fluorescein or Lidocaine and other similar types of local anaesthetic.

This product should be used with care in eyes that are inflamed (red and painful).

Your eye drops are not intended for long term use. Frequent use of local anaesthetic in the eye over long periods of time may affect your eyesight.

Using your eye drops

The doctor or eye specialist will put the drops in for you. You may be asked to press on the inner corners of your eyes for a minute to stop the solution draining into your nose and throat through the tear ducts.

It is important to protect your eye from dust during the time your eye is numb. Your doctor or eye specialist will make sure that your eye is properly protected.

The Minims unit should be thrown away after a single use, even if some solution remains.

It is unlikely that you will suffer an overdose from Minims Lidocaine & Fluorescein, but if you do suddenly feel unwell after receiving the drops, tell your doctor or eye specialist.

Following administration of Minims Lidocaine & Fluorescein you may experience very rare side effects which includes redness and irriatation of the eye, swelling around the eye, rarely difficulty in breathing and symptoms of shock and itchy skin rash with raised red blotches.

After using your eye drops

Tell your doctor or eye specialist if you suffer from any unwanted effects after using Minims Lidocaine & Fluorescein, that are not mentioned in this leaflet.

Storing your eye drops

The expiry date is printed on each Minims unit overwrap and printed on the carton label. Do not use it after this date.

Your eye drops should be stored below 25°C and in original container to protect from light. Do not allow to freeze.

This leaflet applies only to Minims Lidocaine & Fluorescein, but does not contain all the

If you have any questions or are not sure about anything, ask a doctor, eye specialist or pharmacist.

Date of (Partial) Revision of Text:

August 2005.

* Trade Mark

Chauvin Pharmaceuticals Ltd. 106 London Road Kingston-Upon-Thames KT2 6TN England Tel:020 8781 2900 Fax:020 8781 2901

Art. 76441 0504128/4

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Lidocaine Injection BP with Preservative 1 %

Read all of this leaflet carefully before you start taking this medicine. Keep this leaflet. You may need to read it again. If you have further questions, please ask your doctor or your pharmacist. This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours. In this leaflet: 1. What your medicine is and what it is used for 2. Before you receive it 3. How it is administered 4. Possible side effects 5. Storing it

Lidocaine Injection with Preservative 1%

The active ingredient in this medicine is lidocaine hydrochloride. This is the new name for lignocaine hydrochloride. The ingredient itself has not changed.

This injection contains the active ingredient lidocaine hydrochloride 1%. Each ml contains 10 mg of lidocaine hydrochloride.

This injection also contains the following inactive ingredients:

Sodium chloride, methylhydroxybenzoate (E218), propylhydroxybenzoate (E216) and water for injections.

Holder of the Marketing Authorisation: hameln pharmaceuticals ltd Gloucester United Kingdom Manufacturer: hameln pharmaceuticals gmbh Langes Feld 13 31789 Hameln Germany What your medicine is and what it is used for

Lidocaine Injection with Preservative 1% is a clear, colourless, sterile and isotonic solution supplied in 20 and 50 ml clear glass vials, only intended to be given by injection under your skin (subcutaneously or SC).

Lidocaine is a local anaesthetic of the amide group. When injected into the skin, it causes loss of feeling before or during surgery. Lidocaine allows doctors to sew up cuts in the skin and to undertake operations without any pain even though the patient is awake.

Before you receive your medicine You should tell your doctor if: you think you are allergic to either lidocaine or the preservatives used in this injection. The preservatives are often known just as benzoates or hydroxy-benzoates. (See also section 4. Possible side effects for further information). you suffer from epilepsy or have fits you suffer from heart, lung or breathing disorders you have kidney or liver disease you suffer from myasthenia gravis (loss of muscle function and weakness) you are pregnant, likely to become pregnant or breast-feeding you have inflammation or infection in the area to be injected you are taking cimetidine (for stomach ulcer or heartburn) or beta-blockers, for example, propranolol (for angina, high blood pressure or other heart problems)

Please inform your doctor or pharmacist if you are taking or have recently taken any other medicines, even those not prescribed.

Driving and operating machinery: Depending on where and how lidocaine is used, it may affect your ability to drive or operate machinery. Ask your doctor about when it would be safe to drive or operate machines.

How your medicine is administered

The dose of a local anaesthetic will be different for different patients. Your healthcare professional will decide on the right amount for you, depending on:

Your age; your general physical condition; the reason the local anaesthetic is being given and other medicines you are taking or will receive before or after the local anaesthetic is given.

Adults: As a guide, 20 ml (equivalent to 200 mg) of Lidocaine Injection with Preservative 1% is the usual maximum dose. Your doctor will decide on the most appropriate dose for you. A smaller dose may be used if you are elderly or weak.

Children: A smaller dose is usually used for children depending on their age, physical condition and the procedure to be performed.

Possible side effects

Like all medicines, Lidocaine Injection with Preservative 1% can have side effects:

Lidocaine is generally well tolerated, but along with its needed effects, all medicine can cause unwanted effects. Lidocaine may occasionally cause the following side effects:

pain, inflammation or numbness at the site of injection after the effects of the injection should have worn off nervousness tremor blurred or double vision dizziness or drowsiness convulsions (seizures) nausea or vomiting breathing problems slowed heart beat or low blood pressure

Allergic reactions to lidocaine hydrochloride are rare, but tell your doctor immediately if you get any difficulty with your breathing, a rash or itchy skin.

Methylhydroxybenzoate (E218) and propylhydroxybenzoate (E216) may cause allergic reactions (possibly delayed), and exceptionally, bronchospasm.

If you notice any side effects not mentioned in this leaflet, please inform your doctor or pharmacist.

For patients going home before the numbness or loss of feeling caused by a local anaesthetic wears off:

During the time that the injected area feels numb, serious injury can occur without your knowing about it. Be especially careful to avoid injury until the anaesthetic wears off or feeling returns to the area.

Storing your medicine

Your doctor will store the vials in the outer carton in order to protect from light, between 10°C and 25°C and out of reach and sight of children.

Use by date

Your doctor will not use the drug after the expiry date shown on the vial and carton.

This leaflet was last updated on July 13th, 2004.

PL 01502/0035

43870/18/04

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Lidocaine Hydrochloride BP Laryngojet 4% (International Medication Systems)

Lidocaine Hydrochloride BP

Laryngojet 4%W/V

Please read this leaflet. It contains important information about your medicine. If you have any questions, please ask your doctor or nurse.

What is this medicine?

This medicine is called Lidocaine Hydrochloride BP Laryngojet 4% w/v. It is a sterile solution which comes in a glass vial and contains 160mg lidocaine hydrochloride in 4ml as the active ingredient. It also contains sodium hydroxide and water.

The active ingredient in this medicine is Lidocaine hydrochloride. This is the new name for Lidocaine (Lignocaine) hydrochloride. The ingredient itself has not changed.

There is one 4ml vial in each carton.

It is a local anaesthetic. It numbs the area it is applied to.

Who makes it? Marketing Authorisation Holder: International Medication Systems (UK) Limited 208 Bath Road Slough Berkshire SL1 3WE UK Manufacturer: International Medication Systems (UK) Ltd. Unit 14 Foster Avenue Woodside Park Dunstable Beds LU5 5TA UK What is it used for?

It is used to numb parts of the body, such as the mouth, throat and lungs, before some medical procedures which would otherwise be uncomfortable or painful. Examples of the kind of procedures lidocaine is used for are putting a breathing tube in during an operation, putting a tube into the lungs to examine them (bronchoscopy), or taking a specimen from the mouth, throat or lungs.

Before you are given lidocaine You should not be given lidocaine and should tell your doctor immediately if: You suffer from porphyria You are allergic to any of the ingredients or to other local anaesthetics You should tell your doctor if: You have epilepsy, any heart problems including heart failure, slow heart beat or delayed heart signals (heart block), very poor breathing, myasthenia gravis, shock, low oxygen levels or low blood volume The area to be anaesthetised is infected or cut You are pregnant, likely to become pregnant, or breast feeding You are taking any other medicines at all, especially ones for your heart (eg. propranolol, and medicines to treat an irregular heartbeat) or ulcers (eg. cimetidine) You are going to have a general anaesthetic where suxamethonium will be used. How much is given?

The lowest dose possible will be given. The usual adult dose is 4ml (160mg). The elderly may need a lower dose. Children can be given up to 3mg for every kg they weigh (so if they weigh 10kg, they could have 3 x 10 = 30mg).

The solution can be sprayed, instilled or applied with a swab to the area to be numbed. It usually works within 5 minutes.

Since this medicine will usually be given to you by a doctor it is unlikely that you will be given too much.

However, if you are worried that you have been given too much, please tell the doctor.

Are there any side effects?

Very rarely, a patient may have an allergic reaction including rashes, swelling (particularly of the lips, face, eyelids, tongue and throat), breathlessness and collapse.

If applied in the mouth it may be difficult to swallow properly until the effect has worn off.

Other side effects may include light headedness, drowsiness, dizziness, mood changes, ringing in your ears, fear, vision difficulties such as blurred or double vision or quivering eyeballs, sickness, sensations of heat, cold or numbness, twitching, fits, shaking, unconsciousness, shallow breathing, stopping breathing, low blood pressure (feeling faint), slow heart beat, collapse including the heart stopping.

If you feel drowsy, dizzy or suffer from blurred or double vision after having lidocaine, do not drive or operate machinery.

The doctor treating you will be watching to see if these effects occur and will have the equipment to treat them.

If you think this medicine has upset you in ANY way, please tell your doctor.

How to store this medicine

Do not use this medicine after the expiry date shown on the carton and vial label.

Do not store above 25°C.

KEEP THIS AND ALL MEDICINES OUT OF THE REACH AND SIGHT OF CHILDREN

Date of preparation: January 2004

Further Information

This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor (or pharmacist), who will have access to further information.

YOU MAY WANT TO READ THIS LEAFLET AGAIN. PLEASE DO NOT THROW IT AWAY IMMEDIATELY.

This leaflet only applies to Lidocaine Hydrochloride BP Laryngojet 4%w/v

6963001C

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Petco Lidocaine

Dosage Form: FOR ANIMAL USE ONLY
Drug Facts

    PETCO

   Itch Relief Spray

PETCO Itch Relief is a colorless, odorless, non-sticky, non-staining, water based formula containing the following ingredients which provide temporary relief of pain and itching from minor skin problems:

Lidocaine - An anesthectic to instantly calm pain and itching Aloe Vera and Allantoin - To soothe irritated skin Glycerin - A humectant to help moisturize the skin Denatonium Benzoate - A non-toxic bittering agent to deter chewing and licking of skin irritations
Active Ingredients

2% Lidocaine HCL, 0.01% Benzalkonium Chloride

Uses Provides temporary relief of pain and itching from minor skin problems such as insect bites, cuts, scrapes, and burns.
Warnings

Should irritation develop, persist or increase, discontinue use and consult a veterinarian. Keep this product out of reach of children and pets to avoid unintended consumption.

Directions

For use on dogs over six weeks old. Hold sprayer 6-8 inches from animal and thoroughly wet affected area making sure spray contacts the skin. Avoid spraying in eyes, nose, ears or mouth.

other Information

Store at 20-25C (68-77F)

Inactive Ingredients

Water, glycerin, Aloe Vera, Allantoin, Denatonium Benzoate.

FOR QUESTIONS CALL 1-877-473-8465

PETCO
Itch Relief
Spray
For Dogs
Medicated Spray Helpstemporarily relieve itching Helps aid in the temporary relief of minor skin problems Veterinarian Approved
NET 8 FL. OZ. (236mL)
PETCO 
lidocaine hydrochloride  liquid Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 27102-806 Route of Administration TOPICAL DEA Schedule      Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength LIDOCAINE HYDROCHLORIDE (LIDOCAINE) LIDOCAINE HYDROCHLORIDE 4.72 g  in 236 g Inactive Ingredients Ingredient Name Strength Water   GLYCERIN   ALOE VERA LEAF   ALLANTOIN   DENATONIUM BENZOATE   BENZALKONIUM CHLORIDE   Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains          Packaging # NDC Package Description Multilevel Packaging 1 27102-806-07 236 g In 1 BOTTLE, SPRAY None
Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 01/01/2001
Labeler - PETCO (028364727) Registrant - United Pet Group (931135730) Establishment Name Address ID/FEI Operations JUNGLE LABORATORIES CORPORATION 032615270 manufacture Revised: 03/2010PETCO

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Pro Pet Dr Jeff

Dosage Form: FOR ANIMAL USE ONLY
Drug Facts Active Ingredient

2% Lidocaine HCL

Uses

Uses: Provides temporary relief of pain and itching from minor skin problems. For use on dogs and cats.

Warnings Should irritation develop, persist, or increase, discontinue use and consult a veterinarian. Do not apply to wounds or damaged skin Do not bandage tightly Keep this product out of reach of children and pets to avoid unintended consumption
Directions For use on dogs over six weeks old Hold sprayer 6-8 inches from animal and thoroughly wet affected area making sure spray contacts the skin Avoid spraying in eyes, nose ears or mouth.
Other Information

Store at 20C-25C (68F-77F)

Inactive Ingredients

Water, Glycerin, Aloe Vera, Allantoin, Denatonium Benzoate.

PRO PET

Skin Relief

Medicated Spray

Relieves minor pain, itching and other skin discomfort With Lidocaine and Aloe Vera Veterinarian Approved      Dr. Jeff Werber, D.V.M.
Net Wt.
8 Fl. oz.
(236 ml)

Skin Relief Medicated Spray

Provides temporary relief from skin discomfort associated with scrapes, insect bites, minor cuts, burns, skin irritations, and sunburn. With Lidocaine, an anesthetic to calm itching and minor pain, and moisturizing conditioners to nourish skin. Bitter taste discourages chewing and licking of irritated area.
PRO PET DR. JEFF 
anti itch spray  spray Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 24730-626 Route of Administration TOPICAL DEA Schedule      Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength LIDOCAINE HYDROCHLORIDE (LIDOCAINE) LIDOCAINE HYDROCHLORIDE 4.72 g  in 236 g Inactive Ingredients Ingredient Name Strength Water   ALLANTOIN   ALOE VERA LEAF   BENZALKONIUM CHLORIDE   GLYCERIN   DENATONIUM BENZOATE   Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains          Packaging # NDC Package Description Multilevel Packaging 1 24730-626-07 236 g In 1 BOTTLE, SPRAY None
Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 01/01/2001
Labeler - United Pet Group (931135730) Establishment Name Address ID/FEI Operations JUNGLE LABORATORIES CORPORATION 032615270 manufacture Revised: 01/2010United Pet Group

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UAD Caine

Generic Name: lidocaine injection (LYE doe kane)
Brand Names: Anestacaine, UAD Caine, Xylocaine HCl, Xylocaine-MPF

What is UAD Caine (lidocaine injection)?

Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine injection is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgery, needle punctures, or insertion of a catheter or breathing tube.

Lidocaine injection is also given in an epidural (spinal block) to reduce the discomfort of contractions during labor.

Lidocaine injection is sometimes used to treat irregular heart rhythms that may signal a possible heart attack.

Lidocaine injection may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about UAD Caine (lidocaine injection)? You should not receive this medication if you are allergic to lidocaine or any other type of numbing medicine.

Before you receive lidocaine injection, tell your doctor if you have liver or kidney disease, heart disease, coronary artery disease, circulation problems, or a history of malignant hyperthermia.

To treat irregular heart rhythms, your doctor may prescribe a LidoPen auto-injector. This is a prefilled automatic injection device to be used in an emergency. Keep the device with you at all times.

Your doctor will describe the signs and symptoms to watch for when deciding when it's time to use lidocaine injection at home. Never use the LidoPen auto-injector without first calling your doctor.

With the LidoPen auto-injector you will also receive a CardioBeeper to transmit your heart rate and rhythm to your doctor over a telephone. Read all provided instructions and practice using the CardioBeeper.

Lidocaine can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after using this medication What should I discuss with my healthcare provider before receiving UAD Caine (lidocaine injection)? You should not receive this medication if you are allergic to lidocaine or any other type of numbing medicine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use lidocaine injection:

liver disease; kidney disease;

heart disease;

coronary artery disease, circulation problems; or

a history of malignant hyperthermia.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether lidocaine injection passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How is lidocaine injection given?

Lidocaine is given as an injection through a needle placed into a vein or directly into the body area to be numbed. Your doctor, nurse, or other healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving lidocaine injection in a hospital setting.

To treat irregular heart rhythms, you may be shown how to use your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

The LidoPen auto-injector is a prefilled automatic injection device to be used in an emergency. Keep the device with you at all times. Your doctor will describe the signs and symptoms to watch for when deciding when it's time to use the injection.

Never use the LidoPen auto-injector without first calling your doctor.

Do not use the auto-injector in or near a vein or into your buttocks. Inject the medication only in your upper thigh or upper arm.

With the LidoPen auto-injector you will also receive a CardioBeeper. This device is used to transmit your heart rate and rhythm to your doctor over a telephone. Read all provided instructions and practice using the CardioBeeper so you will be able to quickly use it in an emergency.

Store the LidoPen auto-injector at room temperature away from moisture and extreme hot or cold. What happens if I miss a dose?

Since lidocaine injection is used only when needed, you are not likely to be on a dosing schedule.

Never use the LidoPen auto-injector without first calling your doctor.

What happens if I overdose? Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include drowsiness, confusion, nervousness, ringing in your ears, blurred vision, feeling hot or cold, numbness, muscle twitches, uneven heartbeats, seizure (convulsions), slowed breathing, or respiratory failure (breathing stops).

What should I avoid while receiving UAD Caine (lidocaine injection)? Lidocaine can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after using this medication

Avoid eating or chewing within 1 hour after lidocaine injection is used to numb your mouth or throat. You may have trouble swallowing which could lead to choking. You may also accidentally bite the inside of your mouth if you are still numb an hour after treatment with lidocaine injection.

UAD Caine (lidocaine injection) side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have any of these serious side effects:

feeling anxious, shaky, dizzy, restless, or depressed;

drowsiness, vomiting, ringing in your ears, blurred vision;

confusion, twitching, seizure (convulsions);

fast heart rate, rapid breathing, feeling hot or cold;

weak or shallow breathing, slow heart rate, weak pulse; or

feeling like you might pass out.

Less serious side effects include:

mild bruising, redness, itching, or swelling where the medication was injected;

mild dizziness;

nausea;

numbness in places where the medicine is accidentally applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect UAD Caine (lidocaine injection)?

There may be other drugs that can interact with lidocaine injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More UAD Caine resources UAD Caine Side Effects (in more detail) UAD Caine Use in Pregnancy & Breastfeeding UAD Caine Drug Interactions UAD Caine Support Group 0 Reviews for UAD Caine - Add your own review/rating Lidocaine Aerosol MedFacts Consumer Leaflet (Wolters Kluwer) lidocaine Intradermal Advanced Consumer (Micromedex) - Includes Dosage Information Lidocaine Prescribing Information (FDA) Lidocaine Hydrochloride Monograph (AHFS DI) Lidocaine Hydrochloride (Local Anesthetic) Monograph (AHFS DI) Compare UAD Caine with other medications Anesthesia Arrhythmia Ventricular Fibrillation Ventricular Tachycardia Where can I get more information? Your doctor or pharmacist can provide more information about lidocaine injection.

See also: UAD Caine side effects (in more detail)

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MEDIJEL GEL

1. Name Of The Medicinal Product

MEDIJEL GEL

2. Qualitative And Quantitative Composition Lidocaine Hydrochloride BP 0.66% w/w Aminoacridine Hydrochloride BP 1968 0.05% w/w 3. Pharmaceutical Form

Oral Gel

4. Clinical Particulars 4.1 Therapeutic Indications

The quick, effective relief from the pain of common mouth ulcers, soreness of gums and denture rubbing. Medijel Gel is administered directly onto the affected area with a clean finger or small pad of cotton wool.

4.2 Posology And Method Of Administration

The gel should be applied directly to the affected area(s) with a clean finger or small pad of cotton wool. If necessary application may be repeated after 20 minutes.

Each dose is approximately 300mg, i.e. 2mg of Lidocaine Hydrochloride and 0.15mg of Aminoacridine Hydrochloride. Medijel Gel can be used as directed for adults and children.

4.3 Contraindications

Hypersensitivity to the active substances or to any other of the ingredients.

Contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

4.4 Special Warnings And Precautions For Use

If symptoms persist longer than 7 days following the use of the product a doctor or dentist should be consulted.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

None stated.

4.6 Pregnancy And Lactation

The safety of Medijel Gel during pregnancy and lactation has not been established, but is considered not to constitute a hazard.

4.7 Effects On Ability To Drive And Use Machines

None stated.

4.8 Undesirable Effects

Hypersensitivity reactions to Lidocaine have been reported on rare occasions.

4.9 Overdose

Maximum safe dosage for a 70kg adult is 750mg for Lidocaine (Goodman & Gilman, page 313). A tube of Medijel Gel contains 82.5mg of Lidocaine hydrochloride - overdose is not a problem.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Lidocaine Hydrochloride is well documented in Martindale 28th Edition Page 900-904 and Goodman & Gilman, Chapter 15 and pages 767-770.

Lidocaine Hydrochloride was first introduced in 1948 and is one of the most widely used local anaesthetics, producing more prompt, more intense, longer lasting and more extensive anaesthesia than does an equal concentration of procaine (Peak anaesthesia within 2-5 minutes). Local anaesthetics are drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They have good powers of penetration and their action is reversible. Their use is followed by complete recovery in nerve function with no evidence of structural damage to nerve fibres or cells.

Aminoacridine Hydrochloride is a slow acting disinfectant. It exerts germicidal action against bacteria and fungi. It is also used as a surgical and endodontic irrigant and to treat local infections of the ear, mouth and throat. Its exact mode of action is not known but it involves disruption of certain metabolic pathways.

5.2 Pharmacokinetic Properties

Lidocaine is readily absorbed through mucous membranes. They exert their effects in the form of the non-ionised base. Lidocaine undergoes first-pass metabolism in the liver and bioavailability is low after administration by mouth. It is rapidly de-ethylated to the active metabolite monoethylglycinexylidide and then hydrolysed by amidases to various compounds, including glycineexylidide which has reduced activity but a longer elimination half-life. Less than 10% of a dose is excreted unchanged via the kidneys. The metabolic products are excreted in the urine.

Aminoacridine Hydrochloride if administered systematically is rapidly eliminated through the kidney (0.2 grams being eliminated from the blood in 30 minutes). (Medijel Gel dose 0.15mg Aminoacridine hydrochloride).

5.3 Preclinical Safety Data

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Glycerol , Hydroxypolyethoxydodecane HSE, Alcohol 96% v/v, Carbomer, Sucrose, Saccharin Sodium, Peppermint Oil, Ethyl vanillin, Di-isopropanolamine 90% aqueous, Purified Water

6.2 Incompatibilities

None encountered.

6.3 Shelf Life

36 months.

6.4 Special Precautions For Storage

Do not store above 25°C.

6.5 Nature And Contents Of Container

Aluminium tube with membrane seal and spiked polyethylene cap.

6.6 Special Precautions For Disposal And Other Handling

N/A

7. Marketing Authorisation Holder

DDD LIMITED

94, Rickmansworth Road, Watford, Hertfordshire, United Kingdom, WDI8 7JJ.

8. Marketing Authorisation Number(S)

PL 0133/5000R

Legal Status: GSL

9. Date Of First Authorisation/Renewal Of The Authorisation

Date of last renewal: 20/05/03

10. Date Of Revision Of The Text

March 2010

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Anbesol Teething Gel

1. Name Of The Medicinal Product

Anbesol Teething Gel

2. Qualitative And Quantitative Composition

Lidocaine hydrochloride

1.0%w/w

Chlorocresol

0.1%w/w

Cetylpyridinium chloride

0.02%w/w

3. Pharmaceutical Form

Gel for oral administration.

4. Clinical Particulars 4.1 Therapeutic Indications

For the temporary relief of pain caused by recurrent mouth ulcers, denture irritation and teething.

4.2 Posology And Method Of Administration

Adults, children and the elderly: Apply a small amount to the affected area with a clean fingertip. Two applications immediately will normally be sufficient to obtain pain relief. Use up to four times a day.

Babies teething: Apply a small amount to the affected area with a clean fingertip. Use up to four times a day.

4.3 Contraindications

In patients with a known history of hypersensitivity or allergic type reactions to any of the constituents of the product.

4.4 Special Warnings And Precautions For Use

The following statements will appear on the packaging:

If symptoms persist for more than 7 days, consult your doctor or dentist.

Keep all medicines out of the reach of children.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

None known.

4.6 Pregnancy And Lactation

No special precautions required.

4.7 Effects On Ability To Drive And Use Machines

None known.

4.8 Undesirable Effects

There have been reports of non-specific ulceration following oral cetylpyridinium chloride therapy.

4.9 Overdose

Overdose is extremely unlikely considering the small size of the tube used for sale.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Lidocaine is a local anaesthetic of the amide type which acts by reversible inhibition of nerve impulse generation and transmission.

Chlorocresol: Chlorocresol has a disinfectant action.

Cetylpyridinium chloride: Cetylpyridinium chloride has a disinfectant action.

5.2 Pharmacokinetic Properties

Lidocaine hydrochloride

Absorption and fate: Lidocaine is readily absorbed from mucous membranes and through damaged skin. Lidocaine undergoes first-pass metabolism in the liver and about 90% is dealkylated to form monoethylglycinexylidide and glycinexylidide. Further metabolism occurs and the metabolites are excreted in the urine with less than 10% as unchanged lidocaine.

Chlorocresol

Absorption: There is no significant absorption of chlorocresol through the skin or mucous membranes.

Cetylpyridinium chloride

Absorption: There is no significant absorption of cetylpyridinium chloride through the skin or mucous membranes.

5.3 Preclinical Safety Data

The active ingredients in Anbesol Teething Gel have a well established safety record.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Alcohol 96%

Glycerin

Clove Oil

Sodium Saccharin

Hydroxypropyl Cellulose

Ponceau 4R (E124)

Purified Water

6.2 Incompatibilities

None known.

6.3 Shelf Life

36 months unopened.

6.4 Special Precautions For Storage

Store at a temperature not exceeding 25°C.

6.5 Nature And Contents Of Container

Membrane sealed lacquered aluminium tubes fitted with plastic caps containing 10g gel.

6.6 Special Precautions For Disposal And Other Handling

None.

7. Marketing Authorisation Holder

Alliance Pharmaceuticals Limited

Avonbridge House

Bath Road

Chippenham

Wiltshire

SN15 2BB

UK

8. Marketing Authorisation Number(S)

PL 16853/0126

9. Date Of First Authorisation/Renewal Of The Authorisation

31/01/06

10. Date Of Revision Of The Text

29th July 2011

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Iodopengha

Iodopengha may be available in the countries listed below.

Ingredient matches for Iodopengha Eugenol

Eugenol is reported as an ingredient of Iodopengha in the following countries:

France Lidocaine

Lidocaine is reported as an ingredient of Iodopengha in the following countries:

France

International Drug Name Search

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Imidapril Hydrochloride

Imidapril Hydrochloride may be available in the countries listed below.

Ingredient matches for Imidapril Hydrochloride Imidapril

Imidapril Hydrochloride (BANM, JAN) is also known as Imidapril (Rec.INN)

International Drug Name Search

Glossary

BANMBritish Approved Name (Modified)JANJapanese Accepted NameRec.INNRecommended International Nonproprietary Name (World Health Organization)
Click for further information on drug naming conventions and International Nonproprietary Names.

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Boots Pharmacy Anaesthetic Throat Spray

Boots Pharmacy Anaesthetic Throat Spray

(Lidocaine Hydrochloride)

Specifically to:

Relieve severe sore throat pain

20 ml e

Read all of this carton for full instructions.

A local anaesthetic spray to provide direct and soothing relief from the pain of severe sore throats.

Before you use this medicine Do not use: If you are allergic to any of the ingredients If you have asthma, or difficulty breathing If you are under 12 years of age Talk to your pharmacist or doctor: If you are receiving any medical treatment If you have a high fever, headache, feel sick or are being sick as well as having a sore throat If you are pregnant or breastfeeding

This spray may cause your tongue to become numb. You must take care when eating or drinking hot foods or drinks.

How to use this medicine

Use at the back of the throat only.

Do not breathe in when you use the spray, or get the spray in your eyes.

To spray: Swing the nozzle through 90° and press.

Before first use or after storing the spray for a long time: Press the spray 3 times away from the face into a sink.

Adults and children of 12 years and over
Three sprays at the back of the throat every 3 hours, if you need to.
Don’t use more than 6 times in any 24 hours.

Do not use for children under 12 years.

Do not use more than the amount recommended above.

If you use too much:

Talk to a doctor straight away. Take your medicine with you.

If symptoms do not go away, talk to your doctor.

Possible side effects

Most people will not have problems, but some may get some.

If you get any of these serious side effects, stop using the spray.

See a doctor at once:

Difficulty in breathing, swelling of the face, neck, tongue or throat (severe allergic reactions)

If you notice any side effect not listed here, please tell your pharmacist or doctor.

Keep all medicines out of the sight and reach of children.

Use by the date on the side of the carton.

Active ingredient

This liquid contains Lidocaine Hydrochloride 2% w/v.

Also contains: purified water, ethanol (30 vol %), sorbitol (E420), sodium citrate, saccharin, quinoline yellow (E104), patent blue V (E131), flavours (peppermint, levomenthol, aniseed).

PL00014/0430

P

Text prepared 10/07

Manufactured for the Marketing Authorisation holder Boots Pharmacy Nottingham NG2 3AA

by

The Boots Company PLC Nottingham NG2 3AA

Contains approximately 150 sprays.

If you need more advice ask your pharmacist.

BTC22021 vE 15/05/08

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Lidocaine Hydrochloride Injection BP Minijet 2% (International Medication Systems)

1. Name Of The Medicinal Product

Lidocaine Hydrochloride Injection BP Minijet 2% w/v.

2. Qualitative And Quantitative Composition

Lidocaine Hydrochloride BP 20 mg per ml

3. Pharmaceutical Form

Sterile aqueous solution for infiltration injection or intravenous administration.

4. Clinical Particulars 4.1 Therapeutic Indications

For local anaesthesia by infiltration, intravenous regional anaesthesia and nerve blocks.

By intravenous injection for the emergency management of ventricular arrhythmias, particularly after myocardial infarction and cardiac surgery.

4.2 Posology And Method Of Administration

For local anaesthesia:

The dosage varies depending upon the area to be anaesthetised, vascularity of the tissues, number of neuronal segments to be blocked, individual tolerance and the anaesthetic technique. The lowest dosage needed to provide anaesthesia should be administered.

Adults: the usual dose should not exceed 200 mg.

Children: the usual dose should not exceed 3 mg/kg.

For epidurals, a test dose should be administered at least 5 minutes before total dose to prevent inadvertent intravascular or subarachnoid injection.

For continuous epidural, caudal or paracervical anaesthesia, the maximal dose should not be repeated at intervals under 90 minutes.

For IV regional anaesthesia (Bier's block), the tourniquet should not be released until at least 20 minutes after administration.

For intravenous use in cardiac arrhythmias:

Adults: the usual dose is 50 to 100 mg administered intravenously under ECG monitoring. This dose may be injected at a rate of approximately 25 to 50 mg (2.5 to 5.0 ml 1% solution or 1.25 to 2.5 ml 2% solution) per minute. A sufficient period of time should be allowed to enable a slow circulation to carry the drug to the site of action. If the initial dose of 50 to 100 mg does not produce the desired response, a second dose may be given after 5 minutes. No more than 200 to 300 mg of lidocaine should be administered during a one hour period.

Following a single injection in those patients in whom arrhythmia tends to recur and who are incapable of receiving oral antiarrhythmic therapy, intravenous infusions of lidocaine may be administered at the rate of 1 to 4 mg/minute (20 to 50 mcg/kg/minute). IV infusions must be given under ECG monitoring to avoid potential overdosage and toxicity. The infusion should be terminated as soon as the patient's basic cardiac rhythm appears to be stable or at the earliest signs of toxicity. It should rarely be necessary to continue the infusion beyond 24 hours. As soon as possible, patients should be changed to an oral antiarrhythmic agent for maintenance therapy.

Children: experience with lidocaine is limited. A suggested paediatric dose is a loading dose of 0.8 to 1 mg/kg repeated if necessary up to 3-5 mg/kg, followed by continuous infusion of 10 to 50 mcg/kg/minute.

Elderly: doses may need to be reduced depending on age and physical state.

4.3 Contraindications

Lidocaine is contraindicated in patients with known hypersensitivity to local anaesthetics of the amide type and in patients with porphyria.

4.4 Special Warnings And Precautions For Use

Constant ECG monitoring is necessary during IV administration. Resuscitative equipment and drugs should be immediately available for the management of severe adverse cardiovascular, respiratory or central nervous system effects. If severe reactions occur, lidocaine should be discontinued.

Use with caution in patients with epilepsy, liver disease, congestive heart failure, severe renal disease, marked hypoxia, severe respiratory depression, hypovolaemia or shock and in patients with any form of heart block or sinus bradycardia. Hypokalaemia, hypoxia and disorders of acid-base balance should be corrected before treatment with lidocaine begins.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Propranolol and cimetidine may reduce the renal and hepatic clearance of lidocaine, thus increasing toxicity. The cardiac depressant effects of lidocaine are additive to those of other antiarrhythmic agents. Lidocaine prolongs the action of suxamethonium.

4.6 Pregnancy And Lactation

The safe use of lidocaine has not been established with respect to possible adverse effects upon foetal development. Lidocaine is excreted in breast milk and so should be used with caution in nursing women.

4.7 Effects On Ability To Drive And Use Machines

Not applicable; this preparation is intended for use only in emergencies.

4.8 Undesirable Effects

Adverse effects are usually due to inadvertent intravenous administration or overdosage. Allergic reactions (including anaphylaxis) have been reported rarely.

The following systemic reactions have been reported in association with lidocaine:

Central nervous system: light-headedness, drowsiness, dizziness, apprehension, nervousness, euphoria, tinnitus, blurred or double vision, nystagmus, vomiting, sensations of heat, cold or numbness, twitching, tremors, paraesthesia, convulsions, unconsciousness, respiratory depression and arrest.

Cardiovascular system: hypotension, cardiovascular collapse and bradycardia which may lead to cardiac arrest.

4.9 Overdose

Symptoms: reactions due to overdose with lidocaine (high plasma levels) are systemic and involve the central nervous and cardiovascular systems. Effects include medullary depression, tonic and clonic convulsions and cardiovascular collapse.

Treatment: institute emergency resuscitative procedures and administer the drugs necessary to manage the severe reaction. For severe convulsions, small increments of diazepam or an ultra-short acting barbiturate (thiopentone), or if not available, a short-acting barbiturate (pentobarbitone or quinalbarbitone), or if the patient is under anaesthesia, a short-acting muscle relaxant (suxamethonium) may be given intravenously. Patency of the airway and adequacy of ventilation must be assured.

Should circulatory depression occur vasopressors such as metaraminol may be used.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Lidocaine stabilises the neuronal membrane and prevents the initiation and transmission of nerve impulses, thereby effecting local anaesthetic action. The onset of action is rapid and the blockade may last up to 2 hours.

In the heart, lidocaine reduces automaticity by decreasing the rate of diastolic (phase 4) depolarisation. Lidocaine is considered as a class 1b (membrane stabilising) antiarrhythmic agent. The duration of the action potential is decreased due to blockade of the sodium channel and the refractory period is shortened.

5.2 Pharmacokinetic Properties

Lidocaine is rapidly distributed to all body tissues. About 65% is plasma bound. Lidocaine crosses the placenta and the blood brain barrier. The plasma half life is 1.6 hours. About 80% of the dose is metabolised in the liver; less than 10% is found unchanged in the urine.

5.3 Preclinical Safety Data

Not applicable since lidocaine has been used in clinical practice for many years and its effects in man are well known.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Hydrochloric Acid BP

Sodium Chloride BP

Sodium Hydroxide BP

Water for Injection USP

6.2 Incompatibilities

None known.

6.3 Shelf Life

3 years.

6.4 Special Precautions For Storage

Store below 25°C.

6.5 Nature And Contents Of Container

The solution is contained in a USP type I glass vial with an elastomeric closure which meets all the relevant USP specifications. The product is available as a 2% solution in a 5ml vial.

6.6 Special Precautions For Disposal And Other Handling

The container is specially designed for use with the IMS Minijet injector.

7. Marketing Authorisation Holder

International Medication Systems (UK) Ltd

208 Bath Road

Slough

Berkshire

SL1 3WE

UK

8. Marketing Authorisation Number(S)

PL 03265/0006R

9. Date Of First Authorisation/Renewal Of The Authorisation

Date first granted: 28 February 1991

Date renewed: 29 November 1996

10. Date Of Revision Of The Text

June 2004

11. Legal category

POM

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Lidocaine Ointment

Pronunciation: LIE-doe-cane
Generic Name: Lidocaine
Brand Name: Generic only. No brands available.
Lidocaine Ointment is used for:

Relieving pain in the mouth and throat. It is also used to temporarily relieve pain and itching associated with minor cuts and skin scrapes, minor burns (including sunburn), minor skin irritation, and insect bites. It may also be used for certain medical procedures or other conditions as determined by your doctor.

Lidocaine Ointment is an anesthetic. It works by preventing nerves from transmitting painful impulses to the brain.

Do NOT use Lidocaine Ointment if: you are allergic to any ingredient in Lidocaine Ointment or other similar medicines (eg, amide-type anesthetics)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Lidocaine Ointment:

Some medical conditions may interact with Lidocaine Ointment. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a blood infection or severe injury of the mouth, throat, or other area where you are applying Lidocaine Ointment if you have heart, liver, or kidney problems if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to any anesthetic medicine

Some MEDICINES MAY INTERACT with Lidocaine Ointment. Tell your health care provider if you are taking any other medicines, especially any of the following:

Amiodarone, beta-adrenergic blockers (eg, metoprolol), cimetidine, or mexiletine because side effects, such as confusion, dizziness, lightheadedness, or tiredness, may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lidocaine Ointment may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lidocaine Ointment:

Use Lidocaine Ointment as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Do not get Lidocaine Ointment in your eyes. Apply a small amount of Lidocaine Ointment to the affected area. Gently rub the medicine in until it is evenly distributed. If applying to broken skin, use a sterile gauze pad to apply the medicine. Wash your hands immediately after using Lidocaine Ointment unless your hands are part of the treated area. If you miss a dose of Lidocaine Ointment, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Lidocaine Ointment.

Important safety information: Lidocaine Ointment may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Lidocaine Ointment with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Tell your doctor or dentist that you take Lidocaine Ointment before you receive any medical or dental care, emergency care, or surgery. Lidocaine Ointment may make it difficult for you to swallow. Do not eat anything for at least 1 hour after Lidocaine Ointment has been applied in the mouth or throat area. Numbness of the tongue may cause you to bite the inside of your mouth accidentally. Do not eat any food or chew gum while your mouth or throat area is numb. Lidocaine Ointment may cause a numbing effect at the application site. Do not scratch, rub, or expose the area to extreme hot or cold temperature until the numbness is gone. Use caution when applying Lidocaine Ointment over large areas. Do not use more medicine, apply it more often, or use it for longer than prescribed. Your condition will not improve faster, but the risk of side effects may be increased. PREGNANCY and BREAST-FEEDING: It is not known if Lidocaine Ointment can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lidocaine Ointment while you are pregnant. It is not known if Lidocaine Ointment is found in breast milk after topical use. If you are or will be breast-feeding while you use Lidocaine Ointment, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Lidocaine Ointment:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Redness or swelling at the application site.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); choking; confusion; dizziness or lightheadedness; fast breathing; fast, slow, or irregular heartbeat; fever; mood or mental changes; ringing in the ears or hearing changes; seizures; shortness of breath; swelling of the throat; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include apprehension; blurred vision; confusion; difficulty breathing; nervousness; ringing in the ears; seizures; sensations of heat, cold, or numbness; severe dizziness, drowsiness, or lightheadedness; slow or irregular heartbeat; tremor; twitching; unconsciousness; vomiting.

Proper storage of Lidocaine Ointment:

Store Lidocaine Ointment at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Keep Lidocaine Ointment out of the reach of children and away from pets.

General information: If you have any questions about Lidocaine Ointment, please talk with your doctor, pharmacist, or other health care provider. Lidocaine Ointment is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Lidocaine Ointment. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Lidocaine resources Lidocaine Use in Pregnancy & Breastfeeding Lidocaine Support Group 22 Reviews for Lidocaine - Add your own review/rating Compare Lidocaine with other medications Anal Itching Anesthesia Burns, External Hemorrhoids Pain Persisting Pain, Shingles Pruritus Sunburn

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Anodesyn Ointment

1. Name Of The Medicinal Product

Anodesyn Ointment

Care Haemorrhoid Relief Ointment

Sainsburys Haemorrhoid Relief Ointment

Tesco Haemorrhoid Relief Ointment

2. Qualitative And Quantitative Composition

Allantoin 0.5% w/w.

Lidocaine Hydrochloride 0.5% w/w.

For excipients, see 6.1

3. Pharmaceutical Form

A soft white translucent ointment.

4. Clinical Particulars 4.1 Therapeutic Indications

For the symptomatic relief of pain and irritation associated with external haemorrhoids.

4.2 Posology And Method Of Administration

Route of administration: For external application.

Adults & the elderly.

For external piles, wash the affected area with tepid water, dry and apply the ointment with gauze or lint.

Repeat as required, do not use for more than 7 days unless advised by your doctor.

Children.

Not recommended for children.

4.3 Contraindications

Hypersensitivity to any of the ingredients, especially lidocaine.

4.4 Special Warnings And Precautions For Use

Anodesyn Ointment / Care Haemorrhoid Relief Ointment / Sainsburys Haemorrhoid Relief Ointment/Tesco Haemorrhoid Relief Ointment is intended for use for short periods and should not be used for longer than 7 days without medical advice. Patients should be instructed to seek medical advice if they experience persistent pain or bleeding from the anus, especially where associated with a change in bowel habit, if the stomach is distended or if they are losing weight.

Avoid contact with the eyes.

The label will state:

Keep all medicines out of the reach and sight of children.

If symptoms persist for more than 7 days consult your doctor.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

No clinically significant drug interactions known.

4.6 Pregnancy And Lactation

The safety of Anodesyn Ointment / Care Haemorrhoid Relief Ointment / Sainsburys Haemorrhoid Relief Ointment/Tesco Haemorrhoid Relief Ointment in pregnancy and lactation has not been assessed, but it is thought unlikely to constitute a hazard, though caution should be exercised during the first trimester.

Lidocaine crosses the placenta and is distributed into breast milk.

4.7 Effects On Ability To Drive And Use Machines

No or negligible influence.

4.8 Undesirable Effects

Hypersensitivity to any of the ingredients, especially lidocaine.

4.9 Overdose

Accidental ingestion may result in anaesthesia of the upper respiratory tract, nausea, vomiting and abdominal discomfort. Ingestion of very large quantities could result in CNS and cardiovascular toxicity. Treatment should be symptomatic and supportive.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

C05A X - Other antihaemorrhoidals for topical use

Lidocaine has a local anaesthetic action, relieving pain and discomfort in the affected areas.

Allantoin is claimed to promote healing.

5.2 Pharmacokinetic Properties

No data available.

5.3 Preclinical Safety Data

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars 6.1 List Of Excipients

White Soft Paraffin

Wool Fat

Purified Water

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

Three years.

6.4 Special Precautions For Storage

Store at or below 25°C.

6.5 Nature And Contents Of Container

A collapsible 25g aluminium tube, internally lacquered with a latex welt and HPDE screw cap. Supplied with a nozzle and packed in a carton.

6.6 Special Precautions For Disposal And Other Handling

None stated

7. Marketing Authorisation Holder

Thornton & Ross Limited

Linthwaite

Huddersfield

West Yorkshire

HD7 5QH

United Kingdom

8. Marketing Authorisation Number(S)

PL 00240/0072

9. Date Of First Authorisation/Renewal Of The Authorisation

2 December 2002 / 29 September 2003

10. Date Of Revision Of The Text

23/1/2008

11 DOSIMETRY (IF APPLICABLE)

Not Applicable

12 INSTRUCTIONS FOR PREPARATION OF RADIOPHARMACEUTICALS (IF APPLICABLE)

Not Applicable

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High Potency Multi B Complex

Dosage Form: FOR ANIMAL USE ONLY
HIGH POTENCY VITAMIN B COMPLEX INDICATIONS

For use as a supplement source of B complex vitamins in cattle, swine and sheep.

Precautions

Allergic-type reactions following the injection of products containing thiamine have been reported. Administer with caution and keep treated animals under close observation.

High Potency Multi B Complex Dosage and Administration

Inject intramuscularly. May be administered subcutaneously or intravenously if recommended by your veterinarian. The following are suggested dosages, depending on the condition of the animal and the desired response.

Adult Cattle--1 to 2 mL per 100 pounds body weight.
Calves, Swine and Sheep--5 mL per 100 pounds of body weight.

May be repeated daily, if indicated.

TAKE TIME OBSERVE LABEL DIRECTIONS

COMPOSITION

Each mL of sterile aqueous solution contains:

Thiamine Hydrochloride (B1) . . . . . . . . . . . . . 100 mg
Riboflavin (B2) . . . . . . . . . . . . . . . . . . . . . . . . .5 mg
  (as Riboflavin 5'--Phosphate Sodium)
Niacinamide . . . . . . . . . . . . . . . . . . . . . . . . .100 mg
Pyridoxine Hydrochloride (B6) . . . . . . . . . . . . . 10 mg
d-Panthenol . . . . . . . . . . . . . . . . . . . . . . . . . .10 mg
Cyanocobalamin (B12) . . . . . . . . . . . . . . . . .100 mcg
With Citric Acid and Benzyl Alcohol 1.5% v/v (preservative)

Store at controlled room temperature between 15o and 30oC (59o-86oF)

Protect from light

High Potency Multi B Complex 
cyanocobalamin, niacinamide, dexpanthenol, p yridoxine hydrochloride, riboflavin 5 phosphate sodium, thiamine hydrochloride  injection Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 58005-606 Route of Administration INTRAMUSCULAR, SUBCUTANEOUS, INTRAVENOUS DEA Schedule      Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength CYANOCOBALAMIN (CYANOCOBALAMIN) CYANOCOBALAMIN 100 ug  in 1 mL NIACINAMIDE (NIACINAMIDE) NIACINAMIDE 100 mg  in 1 mL DEXPANTHENOL (DEXPANTHENOL) DEXPANTHENOL 10 mg  in 1 mL PYRIDOXINE HYDROCHLORIDE (PYRIDOXINE) PYRIDOXINE HYDROCHLORIDE 10 mg  in 1 mL RIBOFLAVIN 5'-PHOSPHATE SODIUM (RIBOFLAVIN) RIBOFLAVIN 5'-PHOSPHATE SODIUM 5 mg  in 1 mL THIAMINE HYDROCHLORIDE (THIAMINE) THIAMINE HYDROCHLORIDE 100 mg  in 1 mL Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains          Packaging # NDC Package Description Multilevel Packaging 1 58005-606-04 100 mL In 1 VIAL None 2 58005-606-05 250 mL In 1 VIAL None 3 58005-606-06 500 mL In 1 VIAL None
Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 07/01/1996
Labeler - Sparhawk Laboratories, Inc. (958829558) Revised: 08/2010Sparhawk Laboratories, Inc.

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Emla

Generic Name: lidocaine and prilocaine topical (LY doh kayn and PRIL oh kayn TOP ik al)
Brand Names: Emla

What is lidocaine and prilocaine topical?

Lidocaine and prilocaine topical is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine and prilocaine topical is used to numb the skin, or surfaces of the penis or vagina, in preparation for a medical procedure or to lessen the pain of inserting a medical instrument such as a tube or speculum.

Lidocaine and prilocaine topical may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about lidocaine and prilocaine? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Do not use lidocaine and prilocaine topical if you have had an allergic reaction to a numbing medicine in the past.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have liver disease, a history of allergic reaction to lidocaine or prilocaine, or a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

What should I discuss with my health care provider before using lidocaine and prilocaine topical? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood.

Overdose is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

Do not use lidocaine and prilocaine topical if you have a blood cell disorder called methemoglobinemia.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have:

liver disease;

a history of allergic reaction to lidocaine or prilocaine; or

a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use lidocaine and prilocaine topical.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Lidocaine and prilocaine topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use lidocaine and prilocaine topical?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of medicine needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

This medication comes with instructions for safe and effective application. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

You should be lying down when lidocaine and prilocaine topical cream is applied.

Your medicine may have been supplied with bandages to cover the cream when it is applied to a small area on your skin. If using a bandage dressing, first apply a thick layer of the cream to the skin, taking care not to spread the cream out. Place the bandage over the cream and smooth down the edges until it is completely sealed around the cream.

Lidocaine and prilocaine topical is usually applied 1 to 2 hours before the start of a procedure that requires the treated area to be numb. Follow your doctor's instructions about the length of time the cream should be left on the skin.

Store lidocaine and prilocaine topical at room temperature away from moisture and heat. Do not allow the cream to freeze. What happens if I miss a dose?

Since lidocaine and prilocaine topical is used as needed, it is not likely that you will be on a dosing schedule.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. An overdose of lidocaine and prilocaine topical applied to the skin can cause life-threatening side effects such as uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). What should I avoid while taking lidocaine and prilocaine topical? Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

Lidocaine and prilocaine topical side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using lidocaine and prilocaine topical and call your doctor at once if you have any of these serious side effects:

severe burning, stinging, or sensitivity where the medicine is applied;

swelling or redness;

sudden dizziness or sleepiness after medicine is applied;

bruising or purple appearance of the skin; or

unusual sensations of temperature.

Less serious side effects may include:

mild burning where the medicine is applied;

skin redness; or

changes in skin color where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lidocaine and prilocaine topical?

Before this medication is applied, tell your doctor if you are using any of the following drugs:

heart rhythm medication such as mexiletine (Mexitil);

acetaminophen (Tylenol);

chloroquine (Aralen);

dapsone;

nitrates or nitrites such as Imdur, Isordil, Monoket;

nitrofurantoin (Furadantin, Macrodantin, Macro-Bid);

phenobarbital (Luminal, Solfoton);

primaquine;

quinine; or

a sulfa drug (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others).

This list is not complete and there may be other drugs that can interact with lidocaine and prilocaine topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More Emla resources Emla Side Effects (in more detail) Emla Use in Pregnancy & Breastfeeding Emla Support Group 0 Reviews for Emla - Add your own review/rating Emla Topical Advanced Consumer (Micromedex) - Includes Dosage Information Emla Consumer Overview EMLA Prescribing Information (FDA) EMLA Cream MedFacts Consumer Leaflet (Wolters Kluwer) Compare Emla with other medications Anesthesia Where can I get more information? Your pharmacist can provide more information about lidocaine and prilocaine topical.

See also: Emla side effects (in more detail)

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Apomorphine Hydrochloride

Dosage Form: pellet
APOMORPHINUM MURIATICUM 3X (Apomorphine Hydrochloride) Free from yeast, wheat, corn, and soy.
DIRECTIONS: Dissolve 3 or 4 pellets
in mouth or under tongue 3 times a day or as directed by a physician.
Children 2 years and older take 1/2
adult dose.
INDICATIONS: To be used according
to standard homeopathic indications
for self limiting conditions such as
those indicated on the front panel or as directed by a physician.
Warnings: *Use only if cap and
seal are unbroken. * Keep this and all medications out of reach of children.
* If symptoms persist for more then 3
days, consult your physician.
*As with any drug, if your are pregnant or nursing a baby, seek the advice of a
health professional before using this product.*Store tightly closed in a cool, dark place.
Made according to The Homoeopathic Pharmacopoeia of the United States by: Remedy Makers, Pomona, CA 91768

APOMORPHINUM MURIATICUM 
Apomorphine Hydrochloride  pellet Product Information Product Type HUMAN PRESCRIPTION DRUG NDC Product Code (Source) 10191-1225 Route of Administration SUBLINGUAL DEA Schedule      Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength Apomorphine Hydrochloride (APOMORPHINE ) Apomorphine Hydrochloride 3 [hp_X] Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains          Packaging # NDC Package Description Multilevel Packaging 1 10191-1225-2 153 PELLET In 1 VIAL, GLASS None
Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved homeopathic 03/18/2002
Labeler - Remedy Makers (018543582) Revised: 12/2009Remedy Makers
More Apomorphine Hydrochloride resources Apomorphine Hydrochloride Side Effects (in more detail) Apomorphine Hydrochloride Use in Pregnancy & Breastfeeding Apomorphine Hydrochloride Drug Interactions Apomorphine Hydrochloride Support Group 4 Reviews for Apomorphine Hydrochloride - Add your own review/rating Apomorphine Hydrochloride Monograph (AHFS DI) Apokyn Advanced Consumer (Micromedex) - Includes Dosage Information Apokyn MedFacts Consumer Leaflet (Wolters Kluwer) Apokyn Consumer Overview Compare Apomorphine Hydrochloride with other medications Parkinson's Disease Tardive Dyskinesia

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Lidocaine Hydrochloride Injection BP 1.0% w / v

1. Name Of The Medicinal Product

Lidocaine Hydrochloride Injection BP 1.0% w/v.

2. Qualitative And Quantitative Composition

Each 1ml of solution contains 1.0% w/v of Lidocaine Hydrochloride BP (Lidocaine Hydrochloride).

3. Pharmaceutical Form

Clear, colourless, sterile solution for injection, intended for parenteral administration to human beings.

4. Clinical Particulars 4.1 Therapeutic Indications

Lidocaine is a local anaesthetic of the amide group. The injectable form has a wide range of applications for nerve blockade. It can be used by percutaneous infiltration; to block a major nerve plexus such as the brachial; for epidural anaesthesia; for intravenous regional analgesia.

4.2 Posology And Method Of Administration

The dosage should be adjusted according to the response of the patient and the site of administration. The lowest concentration and smallest dose producing the required effect should be given. The maximum dose for healthy adults should not exceed 200mg.

Children and elderly or debilitated patients require smaller doses, commensurate with age and physical status.

4.3 Contraindications

Known hypersensitivity to anaesthetics of the amide type.

4.4 Special Warnings And Precautions For Use

Lidocaine should be administered by persons with resuscitative skills and equipment. Extreme care should be observed in patients with hypovolaemia, heart block or other conduction disturbances. It should be used with caution in patients with congestive heart failure, bradycardia or respiratory depression, including where agents are known to interact with Lidocaine either to increase its availability or additive effects e.g. phenytoin or prolong its elimination e.g. hepatic or end renal insufficiency where the metabolites of Lidocaine may accumulate.

Intramuscular Lidocaine may increase creatinine phosphokinase concentrations which can interfere with the diagnosis of acute myocardial infarction. The use of Lidocaine for the treatment of ventricular arrhythmias not associated with a myocardial infarction might be hazardous in patients with hypoxia where there is a depression of the cough reflex. Lidocaine has been shown to be porphyrinogenic in animals and should be avoided in persons suffering from porphyria.

The effect of Lidocaine may be reduced if it is injected into inflamed or infected areas. Care should be observed in patients suffering from epilepsy.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Lidocaine toxicity is enhanced by the co-administration of cimetidine and propranolol. Both drugs decrease hepatic blood flow. Also, cimetidine depresses microsomial activity. Ranitidine produces a small reduction in Lidocaine clearance.

Cardiovascular collapse has been reported following the use of bupivacaine in patients on treatment with verapamil and timolol; Lidocaine is closely related to bupivacaine.

Prenylamine and Lidocaine Infusion may precipitate atrioventricular block and ventricular tachycardia.

Dopamine and 5 hydroxytryptamine reduce the convulsant threshold to Lidocaine.

Narcotics are probably proconvulsants and this would support the evidence that Lidocaine reduces the seizure threshold to fentanyl in man.

Opioid-antiemetic combination sometimes used for sedation in children could reduce the convulsant threshold to Lidocaine and increase the CNS depressant effect.

While adrenaline when used in conjunction with Lidocaine might decrease vascular absorption, it greatly increases the danger of ventricular tachycardia and fibrillation if accidentally injected intravenously.

Hypoxia and acidosis will enhance the cardiovascular and central nervous system toxicity of Lidocaine in animals. In man, such changes commonly accompany convulsions and can be expected to exacerbate cardiac sequelae.

4.6 Pregnancy And Lactation

Lidocaine readily crosses the placental barrier after epidural or intravenous administration to the mother. The ratio of umbilical to maternal venous concentration is 0.5 to 0.6. The foetus appears to be capable of metabolising Lidocaine at term. The elimination half life in the newborn of the drug received in utero is about three hours, compared with 100 minutes in the adult.

Moderate doses of Lidocaine over short periods have been used in mothers receiving antiarrhythmic drugs in late pregnancy. Foetal blood concentrations are about half of the maternal values and by term the foetus is capable of metabolising Lidocaine.

Local anaesthetics are not noted for producing congenital malformations. Foetal bradycardia may occur during extradural analgesia using Lidocaine. This may result from placental drug transfer or it may be secondary to maternal circulatory changes.

Symptoms of overdose will occur in the same order as in the adult. In clinical practice, neonatal effects are generally slight and are largely limited to hypotonia and neonatal depression. Excessive doses can occur following paracervical block probably resulting from direct entry of drug to the placental circulation, or because solution is injected to the head in mistake for the caudal canal or the paracervical region.

Lidocaine is secreted into the breast milk. Although mothers on infusions of Lidocaine could probably continue to breast feed with safety, caution should be exercised. There is a remote possibility of an idiosyncratic or allergic reaction.

4.7 Effects On Ability To Drive And Use Machines

Where major motor nerve block occurs e.g. Brachial plexus, epidural, spinal block. Where there is a loss of sensation resulting from nerve block to areas of muscle co-ordination or balance. Advice is that for general anaesthesia as sedative/hypnotic drugs are often used during nerve blockade.

4.8 Undesirable Effects

Localised nerve damage at the site of injection (very rare).

Prolonged neural blockade following epidural may be due to delayed spread. Permanent neural blockade may be more likely associated with hypotension and cord ischaemia.

Following regional blockade as when Lidocaine is injected intrathecally or extradurally, hypotension, hypoventilation, Horners Syndrome and hypoglycaemia may be seen. The degree of these effects will depend on the dose and the height of the block. Urinary retention may occur following sacral or lumbar epidural block. It should not outlast the duration of the block. Apnoea and coma followed by aphasia and hemiparesis following stellate ganglion block. The probable cause is a direct injection of Lidocaine into the vertebral or carotid arteries.

Profound lethargy and death have been reported following the injection of only 10 - 32mg of Lidocaine for dental blocks.

Diplopia and temporary blindness has been reported following Lidocaine for maxillary block, also respiratory arrest following retrobulbar block.

The major adverse effects on the CNS and CVS are primarily due to the absorption of Lidocaine into the systemic circulation. Lidocaine may also produce methaemoglobinaemia.

The initial CNS toxic effects are demonstrated by a gradual onset of drowsiness or inebriation similar to alcoholic intoxication. Balance is disturbed, circumoral pins and needles, numb tongue, roaring in the ears, visual disturbances, restlessness and twitching may occur. Severe intoxication of rapid onset may immediately lead to convulsions followed by circulatory depression. Major overdosage may depress all systems simultaneously. Psychotic reactions have been reported following infusion for the control of arrhythmia.

Profound hypotension may be associated with B blockade, widespread sympathetic block from spinal or epidural block, intercostal nerve block administration or supine hypotension in pregnancy.

Ventricular fibrillation occurs less frequently than that seen with bupivacaine.

Respiratory Depression

Medullary depression associated with systemic effects, following retrobulbar nerve blockade, high spinal or extradural blocks causing motor block, possible subarachnoid spread following on excessive dose by interscalene brachial plexus block. An increase in extradural pressure may cause transient respiratory depression. Respiratory distress as an allergic response can occur.

Allergic reactions (including anaphylaxis) have been reported rarely.

4.9 Overdose

Systemic toxicity affecting principally the CNS and secondarily the CVS may arise because of acute or cumulative overdosage. Acute toxicity can occur due to excessive doses above that recommended minimum by rapid entry of Lidocaine into the circulation from accidental or deliberate intravenous injection, rapid absorption from a vascular site or transplacental passage. Cumulative toxicity may slow elimination or drug interaction.

Symptoms relating to the central nervous and cardiovascular systems are: gradual onset of drowsiness or inebriation, disturbance in balance, later circumoral pins and needles, numb tongue, roaring in the ears, visual disturbances, restlessness and twitching, progressing to convulsions and coma in severe states. If the overdose is of rapid onset, convulsions may occur closely followed by cardiovascular depression. Major overdosage may depress all symptoms simultaneously.

Psychotic reactions have been reported following I.V. infusions of Lidocaine. Bradycardia and hypotension, the latter being due to sympathetic blockade and vasomotor and cardiac centres depression. In the medulla, cardiac depression, allergic reaction.

Heavy pre-anaesthetic medication should be avoided, which will mask early signs of CNS toxicity, while an anticonvulsant may even suppress seizure activity until circulatory collapse supervenes.

Initially, oxygen should be administered. It may be necessary to give an anticonvulsant. Thiopentone has a more rapid onset of action than diazepam. Both drugs especially thiopentone may seriously exacerbate circulatory and respiratory depression.

Persistent convulsion may require the use of suxamethonium to stop muscle activity and allow for intubation, control of the airway and artificial ventilation. Agents to support the cardiovascular system may also be required. The correction of acidosis is very important.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Lidocaine is used to provide anaesthesia by nerve blockade at various sites in the body and in the control of dysrhythmias. It has a rapid onset of action (about one minute following intravenous injection and fifteen minutes following intramuscular injection) and rapidly spreads through the surrounding tissues. The effect lasts about ten to twenty minutes and about sixty to ninety minutes following intravenous and intramuscular injection respectively.

5.2 Pharmacokinetic Properties

The concentration of Lidocaine in the blood will be determined by its rate of absorption from the site of injection, the rate of tissue distribution and the rate of metabolism and excretion.

The systemic absorption of Lidocaine is determined by the site of injection, the dosage and its pharmacological profile. The maximum blood concentration occurs following intercostal nerve blockade followed in order of decreasing concentration, the lumbar epidural space, brachial plexus site and subcutaneous tissue. The total dose injected regardless of the site is the primary determinant of the absorption rate and blood levels achieved. There is a linear relationship between the amount of Lidocaine injected and the resultant peak anaesthetic blood levels.

The lipid solubility and vasodilator activity will also influence its rate of absorption. This is seen in the epidural space where Lidocaine is absorbed more rapidly than prilocaine.

Lidocaine is distributed throughout the total body water. Its rate of disappearance from the blood can be described by a two or three compartment model. There is a rapid disappearance (alpha) phase which is believed to be related to uptake by rapidly equilibrating tissues (i.e. tissues with a high vascular perfusion). The slower phase is related to distribution, to slowly equilibrating tissues (Betaphase) and to its metabolism and excretion (Gamma phase).

Lidocaine is distributed less rapidly than prilocaine (an amide drug of similar potency and duration of action) but equally as with mepivacaine. Its distribution is throughout all body tissues. In general, the more highly perfused organs will show higher concentrations of Lidocaine. The highest percentage of this drug will be found in skeletal muscle. This is because of the mass of muscle rather than an affinity.

Lidocaine undergoes enzymatic degradation primarily in the liver. Some degradation may take in tissues other than liver. The main pathway involves oxidative de-ethylation to monoethylglycinexylidide followed by a subsequent hydrolysis to xylidine.

The excretion occurs via the kidney with less than 5% in the unchanged form appearing in the urine. The renal clearance is inversely related to its protein binding affinity and the pH of the urine. This suggests by the latter that excretion of Lidocaine occurs by non-ionic diffusion.

5.3 Preclinical Safety Data

No further relevant information other than that which is included in other sections of the Summary of Product Characteristics.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Sodium Chloride

Sodium Hydroxide 10% w/v

Dilute Hydrochloric Acid

Water for Injections

6.2 Incompatibilities

Lidocaine has been found to be incompatible when mixed with amphotericin, methohexitone and glyceryl trinitrate. It is not advisable to mix Lidocaine with other agents.

6.3 Shelf Life

4 years (48 months).

If only part of an ampoule is used, the remainder should be discarded.

6.4 Special Precautions For Storage

Do not store above 25°C.

Keep in outer carton.

6.5 Nature And Contents Of Container

2ml, 5ml, 10ml & 20ml clear glass ampoules, glass type 1 Ph.Eur. presented in cardboard cartons to contain 10 x 2ml ampoules; 10 x 5ml ampoules; 10 x 10ml ampoules and 10 x 20ml ampoules.

6.6 Special Precautions For Disposal And Other Handling

For S.C., I.M. or I.V. injection.

Use as directed by the physician.

Keep out of reach of children.

If only part used, discard the remaining solution.

7. Marketing Authorisation Holder

Antigen International Ltd.

Roscrea

Co. Tipperary

Ireland

8. Marketing Authorisation Number(S)

PL 02848/0002R

9. Date Of First Authorisation/Renewal Of The Authorisation

25 November 1986 / 24 June 1992

10. Date Of Revision Of The Text

April 2008

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Atrial Fibrillation Medications

Definition of Atrial Fibrillation:

A condition where there is disorganised electrical conduction in the atria, resulting in ineffective pumping of blood into the ventricle.

Acronym: AF

Drugs associated with Atrial Fibrillation

The following drugs and medications are in some way related to, or used in the treatment of Atrial Fibrillation. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

See sub-topics

Topics under Atrial FibrillationPrevention of Thromboembolism in Atrial Fibrillation (24 drugs) Learn more about Atrial Fibrillation

Medical Encyclopedia:

Atrial fibrillation/flutter

Harvard Health Guide:

Symptoms and treatment for Atrial Fibrillation
Drug List:Betapace-AfBreviblocCardizemCardizem-Cd-24-Hour-Sustained-Release-Beads-CapsulesCardizem-La-24-Hour-Extended-Release-Beads-TabletsCartia-Xt-24-Hour-Sustained-Release-Beads-CapsulesCatapresCoregCoreg-Cr-Extended-Release-CapsulesCorvertDigitekDilacor-Xr-24-Hour-Sustained-Release-CapsulesDilt-Xr-24-Hour-Sustained-Release-CapsulesDiltia-Xt-24-Hour-Sustained-Release-CapsulesDiltiazem-Hydrochloride-CdDiltiazem-Hydrochloride-SrDiltiazem-Hydrochloride-XrDiltiazem-Hydrochloride-XtDiltzacLanoxicapsLanoxinLopressorMatzim-LaMetoprolol-Succinate-ErMultaqRythmolRythmol-Sr-Sustained-Release-CapsulesSotalol-Hydrochloride-AfTambocorTiazacToprolXarelto

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Group IV antiarrhythmics

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

See also

Medical conditions associated with group IV antiarrhythmics:

Angina Angina Pectoris Prophylaxis Arrhythmia Atrial Fibrillation Atrial Flutter Bipolar Disorder Cluster Headaches Heart Failure High Blood Pressure Idiopathic Hypertrophic Subaortic Stenosis Migraine Prevention Nocturnal Leg Cramps Raynaud's Syndrome Supraventricular Tachycardia Drug List: Diltia-Xt-24-Hour-Sustained-Release-Capsules Diltiazem-Hydrochloride-Sr Cartia-Xt-24-Hour-Sustained-Release-Beads-Capsules Calan-Sr-Controlled-Release-Tablets Cardizem Isoptin-Sr-Controlled-Release-Tablets Tiazac Verelan-Pm-Sustained-Release-Capsules-Controlled-Onset Diltiazem-Hydrochloride-Cd Calan Cardizem-La-24-Hour-Extended-Release-Beads-Tablets Isoptin Cardizem-Cd-24-Hour-Sustained-Release-Beads-Capsules Verelan-Sustained-Release-Pellet-Filled-Capsules Taztia-Xt-24-Hour-Extended-Release-Beads-Capsules Covera-Hs-Sustained-Release-Tablets-Controlled-Onset Dilacor-Xr-24-Hour-Sustained-Release-Capsules Dilt-Xr-24-Hour-Sustained-Release-Capsules Diltiazem-Hydrochloride-Xr Diltiazem-Hydrochloride-Xt Diltzac Matzim-La

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Group IV antiarrhythmics

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