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Lidocaine and alcohol. Lignocaine Injection: Uses, Side Effects, and Precautions

by alexxlab

What is Lignocaine Injection used for. How does Lignocaine Injection work. Who should not use Lignocaine Injection. What are the potential side effects of Lignocaine Injection. How is Lignocaine Injection administered. What precautions should be taken when using Lignocaine Injection. Can Lignocaine Injection interact with other medications.

Содержание

Understanding Lignocaine Injection: A Comprehensive Guide

Lignocaine Injection, also known as lidocaine, is a versatile medication that serves dual purposes in medical practice. It belongs to two distinct groups of medicines: local anesthetics and antiarrhythmic drugs. This dual classification underscores its importance in various medical procedures and treatments.

Local Anesthetic Properties

As a local anesthetic, Lignocaine Injection works by temporarily blocking pain signals in a specific area of the body. This property makes it invaluable in various medical and dental procedures where localized pain relief is required.

Antiarrhythmic Properties

In its role as an antiarrhythmic drug, Lignocaine Injection helps restore irregular or rapid heart rhythms to normal. This makes it a crucial medication in managing certain cardiac conditions.

Primary Uses of Lignocaine Injection

Lignocaine Injection is primarily used for:

  • Local anesthesia during minor surgical procedures
  • Dental procedures requiring pain management
  • Management of certain types of cardiac arrhythmias
  • Pain relief in specific medical conditions

It’s important to note that Lignocaine Injection may be prescribed for conditions not mentioned here. Your healthcare provider will explain the specific reason for your prescription.

Contraindications: When Lignocaine Injection Should Not Be Used

Are there situations where Lignocaine Injection is not recommended? Indeed, there are several contraindications to be aware of:

  • Allergic reactions to lignocaine or any ingredients in the injection
  • Presence of infection or swelling at the injection site
  • Blood infections or disorders
  • Severe shock
  • Low blood pressure
  • Diseases of the brain and spinal cord
  • Frequent episodes of sudden loss of consciousness
  • Myasthenia gravis (a condition causing severe muscle weakness)
  • Certain heart problems

If you’re unsure whether any of these contraindications apply to you, it’s crucial to consult with your healthcare provider before receiving Lignocaine Injection.

Precautions and Considerations Before Using Lignocaine Injection

Prior to receiving Lignocaine Injection, it’s essential to inform your healthcare provider about certain health conditions and factors. These include:

Allergies

Do you have any known allergies? It’s crucial to disclose any allergies you may have, including:

  • Allergies to medications
  • Allergies to foods
  • Allergies to preservatives or dyes

Pregnancy and Breastfeeding

Are you pregnant, planning to become pregnant, or breastfeeding? Your healthcare provider needs to know this information to assess the risks and benefits of using Lignocaine Injection in your specific situation.

Pre-existing Medical Conditions

Certain medical conditions may affect the use of Lignocaine Injection. It’s important to inform your doctor if you have or have had any of the following:

  • Liver or kidney problems
  • Epilepsy or porphyria
  • Diseases of the brain and spinal cord
  • Heart problems
  • Severe fever
  • Blood pressure or circulation issues
  • Slow heart rate
  • Low potassium levels
  • Breathing difficulties
  • Low oxygen levels in the blood
  • Blood clotting disorders

Potential Drug Interactions with Lignocaine Injection

Can Lignocaine Injection interact with other medications? Yes, there are several medications that may interact with Lignocaine Injection. It’s crucial to inform your healthcare provider about all medications you’re currently taking, including:

  • Other antiarrhythmic drugs (e.g., amiodarone)
  • Heart or blood pressure medications (e.g., propranolol, metoprolol, atenolol)
  • Cimetidine (used for treating reflux and ulcers)
  • Anti-epileptic medications (e.g., phenytoin, carbamazepine, primidone, phenobarbitone, sodium valproate)
  • Warfarin (a blood thinner)
  • Aspirin, salicylates, or other non-steroidal anti-inflammatory drugs (NSAIDs)

This list is not exhaustive, and other medications may also interact with Lignocaine Injection. Always provide a complete list of your medications, including over-the-counter drugs and supplements, to your healthcare provider.

Administration of Lignocaine Injection

How is Lignocaine Injection typically administered? Lignocaine Injection is usually given in a clinical or hospital setting by a trained healthcare professional. The method of administration can vary depending on the specific medical condition being treated and may include:

  • Subcutaneous injection (under the skin)
  • Intramuscular injection (into a muscle)
  • Intravenous injection (into a vein)
  • Epidural injection (into the space around the spinal cord)

The dosage and frequency of administration will be determined by your healthcare provider based on your individual needs and medical condition.

Potential Side Effects of Lignocaine Injection

Like all medications, Lignocaine Injection can cause side effects, although not everyone experiences them. Some potential side effects include:

Common Side Effects

  • Dizziness or lightheadedness
  • Nausea or vomiting
  • Numbness or tingling sensations
  • Temporary changes in heart rate or blood pressure

Rare but Serious Side Effects

While rare, some serious side effects may occur and require immediate medical attention. These can include:

  • Allergic reactions (including difficulty breathing, swelling of the face or throat, severe rash)
  • Seizures
  • Severe heart rhythm disturbances
  • Severe low blood pressure

If you experience any severe or persistent side effects, it’s crucial to inform your healthcare provider immediately.

Monitoring and Follow-up Care

After receiving Lignocaine Injection, what kind of monitoring or follow-up care might be necessary? Your healthcare provider will likely monitor you closely after administration of Lignocaine Injection, especially if it’s given for cardiac purposes. This monitoring may include:

  • Regular checks of your heart rate and rhythm
  • Blood pressure monitoring
  • Assessment of any pain or numbness at the injection site
  • Observation for any signs of allergic reactions or adverse effects

The duration and intensity of monitoring will depend on the reason for using Lignocaine Injection and your individual health status.

Special Considerations for Lignocaine Injection Use

Are there any special considerations to keep in mind when using Lignocaine Injection? Indeed, there are several important points to consider:

Elderly Patients

Older adults may be more sensitive to the effects of Lignocaine Injection. Dosage adjustments may be necessary, and closer monitoring might be required.

Patients with Liver or Kidney Disease

If you have liver or kidney problems, your body may process Lignocaine differently. Your healthcare provider may need to adjust the dosage or monitor you more closely.

Patients with Heart Conditions

If you have pre-existing heart conditions, your healthcare provider will carefully weigh the risks and benefits of using Lignocaine Injection, especially when used for its antiarrhythmic properties.

Driving and Operating Machinery

Lignocaine Injection can cause dizziness or affect your reflexes. It’s advisable to avoid driving or operating machinery until you know how the medication affects you.

Long-term Use and Dependency Concerns

Can long-term use of Lignocaine Injection lead to dependency? Lignocaine Injection is not typically associated with dependency or addiction when used as prescribed. However, it’s important to use this medication only as directed by your healthcare provider. Long-term use should be monitored closely to assess ongoing need and potential side effects.

Tolerance

With repeated use, some patients may develop tolerance to the effects of Lignocaine Injection, requiring higher doses to achieve the same effect. This is why it’s crucial to use this medication under close medical supervision.

Withdrawal

Unlike some medications, Lignocaine Injection does not typically cause withdrawal symptoms when discontinued. However, if it’s being used to manage a chronic condition, sudden discontinuation may lead to a return of the original symptoms.

Alternative Treatments and Complementary Therapies

Are there alternatives to Lignocaine Injection for pain management or cardiac arrhythmias? While Lignocaine Injection is effective for many patients, there may be alternative treatments available depending on your specific condition:

Alternative Local Anesthetics

  • Bupivacaine
  • Ropivacaine
  • Mepivacaine

Alternative Antiarrhythmic Medications

  • Amiodarone
  • Propafenone
  • Flecainide

Non-Pharmacological Approaches

For some conditions, non-drug therapies may be considered, such as:

  • Physical therapy for certain types of pain
  • Cognitive-behavioral therapy for chronic pain management
  • Ablation procedures for certain cardiac arrhythmias

Your healthcare provider can discuss these alternatives and determine the most appropriate treatment plan for your specific situation.

Research and Future Developments

What current research is being conducted on Lignocaine Injection? Ongoing research continues to explore new applications and formulations of lignocaine:

Extended-Release Formulations

Researchers are developing extended-release forms of lignocaine to provide longer-lasting pain relief, potentially reducing the need for repeated injections.

Combination Therapies

Studies are investigating the effectiveness of combining lignocaine with other medications to enhance its pain-relieving properties or reduce side effects.

Novel Delivery Methods

New methods of delivering lignocaine, such as transdermal patches or nano-particle formulations, are being explored to improve efficacy and patient comfort.

Expanded Indications

Researchers are studying the potential use of lignocaine in treating conditions beyond its current indications, including certain neurological disorders and chronic pain syndromes.

As research progresses, our understanding of Lignocaine Injection and its potential applications continues to evolve, potentially leading to improved treatments and patient outcomes in the future.

Lignocaine Injection (lidocaine) Drug / Medicine Information

lidocaine (lignocaine)

Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about Lignocaine Injection. It does not
contain all the available information. It does not take the place of talking to your
doctor or pharmacist.

All medicines have benefits and risks. Your doctor has weighed the risks of you taking
Lignocaine Injection against the benefits this medicine is expected to have for you.

This medicine is likely to be used while you are at the clinic or in hospital. If
possible, please read this leaflet carefully before this medicine is given to you.
In some cases this leaflet may be given to you after the medicine has been used.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet

You may need to read it again.

What Lignocaine Injection is used for

Lignocaine Injection belongs to two groups of medicines known as local anaesthetics
and antiarrhythmic drugs. Local anaesthetics stop pain and feeling in the area around
where it is injected; and antiarrhythmic drugs work by restoring irregular and/or
rapid heart beats to normal.

Lignocaine Injection may be used for the management of other conditions that are not
mentioned above. Your doctor will be able to tell you about the specific condition
for which you have been prescribed Lignocaine Injection.

This medicine is available only with a doctor’s prescription.

Before you are given Lignocaine Injection

When you must not be given it

Do not use Lignocaine Injection if:

you have an allergy to lignocaine or any of the ingredients listed at the end of this
leaflet. Symptoms of an allergic reaction may include shortness of breath, wheezing
or difficulty breathing, swelling of the face, lips, tongue or other parts of the
body, rash, itching or hives on the skin.

you have an infection or swelling where the injection will be given

you have blood infections or disorders

you are in severe shock

you have low blood pressure

you have diseases of the brain and spinal cord

you have sudden frequent episodes of loss of consciousness

you have myasthenia gravis, a severe muscle weakness

you have certain heart problems

If you are not sure whether any of these apply to you, check with your doctor.

Before you are given it

Tell your doctor if:

1. you have any allergies to:

any other medicine

any other substances, such as foods, preservatives or dyes

2. you are pregnant or intend to become pregnant

3. you are breast-feeding or plan to breast feed

4. you have or have had any medical conditions, especially the following:

liver and/or kidney problems

epilepsy and porphyria

diseases of the brain and spinal cord

heart problems

severe fever

problems with your blood pressure or circulation

slow heart beat

low potassium level

breathing difficulties

low oxygen in blood

problems with the clotting of your blood

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including any
that you buy without a prescription from your pharmacy, supermarket or health food
shop.

Some medicines and lignocaine may interfere with each other. These include:

antiarrhythmics, medicines to control irregular heart beats, e.g. amiodarone

heart or blood pressure tablets, e.g. propranolol, metoprolol, atenolol

cimetidine, a medicine used to treat reflux and ulcers

medicines to control fits or epilepsy, e.g. phenytoin, carbamazepine, primidone, phenobarbitone,
sodium valproate

warfarin, a medicine used to stop blood clots

aspirin, salicylates or other non-steroidal anti-inflammatory drugs (NSAIDS), medicines
to relieve pain and inflammation

some anaesthetics

some medicines that relax the skeletal muscles, e.g. suxamethonium

nitrates/nitrites e.g. nitric oxide, nitroglycerin, sodium nitroprusside, nitrous
oxide

antineoplastic agents e.g. cyclophosphamide monohydrate, flutamide, hydroxyurea, ifosfamide,
rasburicase

some antibiotics

antimalarials e. g. chloroquine phosphate, primaquine

other drugs such as paracetamol, metoclopromaide, quinine, sulfasalazine

Your doctor will have more information on medicines to be careful with or avoid while
you are being given Lignocaine Injection. Your doctor will advise you about continuing
to take other medicines while you are receiving Lignocaine Injection.

How Lignocaine Injection is given

Lignocaine Injection is given by injection into the skin, directly into the blood
stream or into an organ. It must only be given by a doctor or nurse.

Your doctor will decide what dose and how long you will receive Lignocaine Injection.

If you are given too much (overdose)

This rarely happens as Lignocaine Injection is administered under the care of a highly
trained doctor.

However, if you are given too much lignocaine, you may experience some of the effects
listed under “Side Effects” below.

Your doctor has information on how to recognise and treat an overdose. Ask your doctor
if you have any concerns.

While you are being given Lignocaine Injection

Things to be careful of

Be careful driving or operating machinery after you have been given Lignocaine Injection.
You may be drowsy or your reflexes may be slow.

Do not drink alcohol while you are being given Lignocaine Injection. If you drink
alcohol while you are being given Lignocaine Injection, your blood pressure may drop
making you feel dizzy and faint.

Side effects

Tell your doctor, nurse or pharmacist as soon as possible if you do not feel well
while you are being given lignocaine.

Like other medicines, lignocaine can cause some side effects. If they occur, most
are likely to be minor or temporary. However, some may be serious and need medical
attention.

Ask your doctor or pharmacist to answer any questions you may have.

Do not be alarmed by this list of possible side effects. You may not experience any
of them.

Tell your doctor or nurse if you notice any of the following:

weakness, confusion, nervousness, agitation, drowsiness, disorientation or unconsciousness

nausea, vomiting, difficulty in swallowing

headache, dizziness or light-headedness especially if you get up suddenly from a lying
or sitting position

ringing in the ears

slurred speech, sensations of heat and cold

numbness, tremors, twitching

slow heart beat, low blood pressure

breathing difficulties

blurred or double vision

These are the mild side effects of Lignocaine Injection.

Serious side effects of Lignocaine Injection include:

fits or convulsions

skin rash, hives or itching

unconsciousness

breathing problems

low blood pressure

slow heart beat

collapse

pale, grey, or blue coloured skin (cyanosis)

rapid heart rate

You may need urgent medical attention if you get these side effects.

Other side effects not listed above may also occur in some patients. If you notice
any other effects, check with your doctor. Some side effects may only be seen by
your doctor.

After using Lignocaine Injection

Storage

Lignocaine Injection will be stored in the pharmacy or on the ward. The injection
is kept in a cool dry place, where the temperature stays below 25°C.

Product description

What it looks like

Lignocaine Injection is a clear, colourless solution in a polyethylene plastic ampoule.

Ingredients

Lignocaine Injection contains 10 mg/mL or 20 mg/mL lidocaine (lignocaine) hydrochloride
monohydrate as the active ingredient and sodium chloride and water for injections
as the excipients. It does not contain a preservative.

Supplier

Pfizer Australia Pty Ltd

Sydney NSW 2000

Toll Free Number: 1800 675 229

www.pfizer.com.au

Lignocaine Injection can be identified by an Australian Registration Number, which
is found on the packaging: AUST R 49296, AUST R 49297, AUST R 49293 and AUST R 49295.

This Leaflet was prepared in December 2020.

Lidocaine (Topical Application Route) Before Using

Before Using

Drug information provided by: IBM Micromedex

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Because of this medicine’s toxicity, it should be used with extreme caution in children younger than 3 years of age, only after other medicines have been considered or found ineffective. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment. Do not give lidocaine viscous topical solution for teething pain.

Appropriate studies have not been performed on the relationship of age to the effects of lidocaine jelly or skin patch in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Ztlido® skin patch in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

No information is available on the relationship of age to the effects of lidocaine topical in geriatric patients. However, because of this medicine’s toxicity, it should be used with caution, after other medicines have been considered or found ineffective. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.


  • Dihydroergotamine


  • Dronedarone


  • Saquinavir


  • Vernakalant

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Amifampridine


  • Amiodarone


  • Amprenavir


  • Arbutamine


  • Atazanavir


  • Bupivacaine Liposome


  • Bupropion


  • Cobicistat


  • Dasabuvir


  • Delavirdine


  • Disopyramide


  • Donepezil


  • Encainide


  • Etravirine


  • Flecainide


  • Fosamprenavir


  • Fosphenytoin


  • Hyaluronidase


  • Lopinavir


  • Metoprolol


  • Mexiletine


  • Moricizine


  • Nadolol


  • Phenytoin


  • Procainamide


  • Propafenone


  • Quinidine


  • Sotalol


  • Succinylcholine


  • Telaprevir


  • Tocainide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:


  • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or


  • Heart problems or


  • Lung or breathing problems or


  • Methemoglobinemia (blood disorder), hereditary or idiopathic (unknown cause)—Use with caution. May increase risk of having methemoglobinemia.


  • Heart block or


  • Shock, severe—Use with caution.


  • Infection at or near the place of application or


  • Large sores, broken skin, or severe injury at the area of application or


  • Liver disease, severe or


  • Sepsis or


  • Traumatized mucosa, severe—Use with caution. The chance of side effects may be increased.

  • Description and Brand Names
  • Proper Use

Portions of this document last updated: Sept. 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.


.

Lidocaine dermal patch

What is this medicine?

LIDOCAINE (LYE doe kane) causes loss of feeling in the skin and surrounding area. The medicine helps treat pain, including nerve pain.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Aspercreme with Lidocaine, GEN7T, Lidocare, Lidoderm, ZTlido

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • heart disease
  • history of irregular heart beat
  • liver disease
  • skin conditions or sensitivity
  • skin infection
  • an unusual or allergic reaction to lidocaine, parabens, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label or package.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

  • certain medicines for irregular heart beat
  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

This medicine may also interact with the following medications:

  • other local anesthetics like pramoxine, tetracaine

Do not use any other skin products on the affected area without asking your doctor or health care professional.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse.

Be careful to avoid injury while the area is numb from the medicine, and you are not aware of pain.

If you are going to need surgery, a MRI, CT scan, or other procedure, tell your doctor that you are using this medicine. You may need to remove this patch before the procedure.

Do not get this medicine in your eyes. If you do, rinse out with plenty of cool tap water.

This medicine can make certain skin conditions worse. Only use it for conditions for which your doctor or health care professional has prescribed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • breathing problems
  • chest pain or chest tightness
  • dizzines

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • tingling, numbness at site where applied

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

See product for storage instructions. Each product may have different instructions.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Enhanced Removal of Phenol With Lidocaine vs Alcohol: An In Vitro Study | Dermatology | JAMA Dermatology

Phenol cauterization is often the treatment of choice for some types of ingrown toenails; however, there are conflicting reports in the literature as to whether neutralization of the phenol is required or merely effective removal of excess phenol is needed. An intraoperative irrigation with isopropyl alcohol after the application of phenol to the skin does not neutralize the phenol, but rather dilutes it. 1,2 Owing to the solubility of phenol in alcohol and water, we hypothesized that the intraoperative irrigation with an aqueous solution, such as 0.9% sterile saline, isopropyl alcohol, or 2% lidocaine3 would eliminate, rather than neutralize any residual phenol. We performed an in vitro study using the nail bed to test our hypothesis.

Approval for this study was provided by the Research Committee of the Universidad Rey Juan Carlos de Madrid. Nine anatomical cadaveric fresh halluces (5 right, 4 left) from 5 cadaveric bodies were used to perform the in vitro experiment.

An automated cell diffusion system (PermeGear) was used as previously described.4 Briefly, phosphate buffered saline was used as the receptor fluid and a 1-cm2 piece of human cadaver nail bed obtained by dissection from the dorsal side of the foot was placed in each diffusion cell, oriented with the stratum corneum facing upward. The mean (SD) thickness of the skin samples were 1.65 (0.16) mm as measured by a digital caliper with a resolution of 0.01 mm and an accuracy of ±0.04 mm. Irrigation solutions of isopropyl alcohol, 0.9% saline, or 2% lidocaine were used after phenol application as previously described,4 each conducted in triplicate. An additional sample was taken from the receptor compartment to determine the amount of phenol that passed through the nail bed for each of the irrigation solutions.

Independent student t tests were performed to determine statistically significant differences in the quantities of phenol recovered after each irrigation as well as quantities of phenol that passed through the skin between the 3 different irrigation solutions.

No measurable amount of phenol was collected in the receptor compartment for each experiment, suggesting that phenol diffusion through the nail bed does not exist or is below detection limits. Rather, phenol remained on the skin surface for the full 3 minutes of the experiment, similar to the clinical setting. The amount of phenol recovered from the 3 donor compartments after 2 irrigations with each solution is shown in the Table. After the first irrigation, the total phenol recovered was significantly higher with lidocaine compared to alcohol; however, there was not a significant difference between the amount recovered with saline or alcohol. In addition, there were no significant differences between the amounts of phenol recovered after the second irrigation with any of the solutions used.

Phenol ablation is the most widely performed method of matricectomy.5 The caustic nature of the phenol, which allows it to destroy the lateral and subproximal nail fold matrix, may cause significant tissue necrosis, pain, persistent exudative drainage, and periostitis.6 In our study, we recovered active phenol after irrigation with alcohol, saline, or lidocaine, indicating these solutions do not neutralize the phenol but merely dilute it. Alcohol is not an optimal choice for intraoperative irrigation of a surgical wound, and the recovery of more phenol using lidocaine vs alcohol suggests that it could be an optimal choice to eliminate any residual phenol that could cause continued burning of the germinal nail matrix. Our findings may help standardize treatment of ingrown toenails and thereby improve outcomes; however, a full clinical study is warranted to confirm our in vitro results.

Corresponding Author: Marta Elena Losa Iglesias, PhD, Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos Avda. Atenas s/n 28922-Alcorcón- Spain ([email protected]).

Accepted for Publication: November 8, 2016.

Published Online: March 1, 2017. doi:10.1001/jamadermatol.2016.5244

Author Contributions: Drs Marta Elena Losa Iglesias and Ricardo Becerro de Bengoa Vallejo had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: D. Cordoba Diaz, Losa Iglesias, M. Cordoba Diaz.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Administrative, technical, or material support: D. Cordoba Diaz, M. Cordoba Diaz.

Supervision: Losa Iglesias.

Conflict of Interest Disclosures: None reported.

1.

Butterworth
 R. Nail Surgery. In: Banks
 A, ed.  McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001.

2.Goslin
 RW.  A comparison of the dilution and non-dilution of phenol with alcohol following nail avulsions.  Foot. 1992;2(4):225-228.Google ScholarCrossref 4.Cordoba Diaz
 D, Losa Iglesias
 ME, Cordoba Diaz
 M, Becerro de Bengoa Vallejo
 R.  Enhanced removal of phenol with saline solution over alcohol: an in vitro study.  Dermatol Surg. 2012;38(8):1296-1301.PubMedGoogle ScholarCrossref 6.Gilles
 GA, Dennis
 KJ, Harkless
 LB.  Periostitis associated with phenol matricectomies.  J Am Podiatr Med Assoc. 1986;76(8):469-472.PubMedGoogle ScholarCrossref

Lipocaine® 5 – Alcohol-free liposomal 5% lidocaine cream all natural

LIPOCAINE® is a topical anesthetic cream containing lidocaine 5% formulated in liposomes for fast and deep skin numbing. The cream vehicle is composed with 100% naturally derived ingredients with a natural preservative system. Pharmacist formulated; ALCOHOL free. No sting upon application!

  • FAST AND DEEP PENETRATION – Lidocaine is formulated in liposomes to penetrate the skin without the need of alcohol or other harsh chemicals. This means you get maximum penetration quickly, and maximum numbness. Starts numbing in 3-5 minutes and effective numbing for many procedures at 30 minutes. Best results at 45-60 minutes, even up to 90 minutes for tattoos.
  • MAXIMUM STRENGTH – It contains Lidocaine 5%, the maximum strength available without a prescription. This means relief without a expensive visit to the doctor.
  • LONG LASTING – Numbness lasts approximately double the application time. 60 minutes application gives you 2 hours of numbness.
  • CONVENIENT SIZES – Available in a 4 Oz (113 gram) tube and in a 1 Oz (30 gram) tube. Both with CHILD-RESISTANT caps.
  • ALL NATURAL, VEGAN – All natural cream, FREE of propylene glycol, PEGs, parabens, silicones, petroleum derivatives, artificial colors or fragrances. Natural preservative system. Compare LIPOCAINE®’s ingredients with our competitor’s!
  • ALCOHOL FREE – No sting upon application.

Delivers lidocaine quickly and deeply without the use of harsh chemicals or alcohol. No sting upon application! Great to use on the face and sensitive areas. Hypoallergenic and suitable for even the most sensitive skins.

How it works

LIPOCAINE is formulated with 5% lidocaine, the maximum concentration allowed by FDA to be sold without a prescription. Lidocaine is a topical anesthetic molecule that works by temporarily blocking the pathway of pain signals along nerves. It does this by stopping the sodium from entering the nerve ending at the site of the pain. For this to happen, the molecule has to reach the nerve receptors located deep in the skin. By encapsulating lidocaine in liposomes, this process is facilitated. Liposomes are small lipid vesicles that merge with cell membranes and deliver their payload within.

How to use

Apply LIPOCAINE® topical anesthetic cream in a thin layer to the area of interest. Will start numbing within 2-3 minutes and reach numbness sufficient to make most procedures comfortable in 20-30 minutes. The degree of numbness is variable depending on the individual and the area of the body. As a rule of thumb, the longer the application time, the more effective the anesthetic effect. For some individuals and applications, it works best to apply for 45-60 minutes or even 90 minutes. Do not get discouraged, experiment and find the application time that works best for you. Reapply as needed.

How available

LIPOCAINE® is available in 1 Oz (30 g) and 4 Oz (113 g) tubes with child-resistant caps.

Frequently Asked Questions

Q: What are liposomes?
A: Liposomes are lipid vesicles formed by double layers of special phospholipids. They are similar to the natural cell membranes and have the ability to penetrate the stratum corneum of the skin. The vesicles have an interior aqueous compartment and a peripheral lipid compartment within the membrane. Lidocaine is soluble in both compartments and liposomes with a high payload can be prepared. When the liposomes interact with a cell membrane, they deliver the payload into the cell. This delivery mechanism is very helpful in helping medicines cross the skin barrier.

Q: Where is LIPOCAINE® made?
A: It is MADE IN USA as are all of ESBA Lab’s products. All of ESBA Laboratories products are Pharmacist developed and manufactured in the United States.

Q: How does LIPOCAINE® smell?
A: It is virtually odorless. Does not contain solvents like alcohol or propyleneglycol, or any kind of fragrance.

Q: How is LIPOCAINE® preserved?
A: It is preserved with Caprylhydroxamic Acid; an amino acid derived from coconut oil. Not only is it plant-based and non-toxic, when combined with other natural glycols in our formulation, it provides guaranteed, broad-spectrum performance against bacteria and fungi. Plus, it’s Whole Foods Premium Body Care approved, and their standards, developed by a team of scientists over the course of years, are some of the strictest available. In the world of preservatives, this little amino acid is a real winner!

Ingredients

Lidocaine 5 % in a non-oily cream with Allantoin, Aloe Barbadensis Leaf Extract, Beta-Sitosterol, Caprylhydroxamic Acid, Cetyl Alcohol, Cetyl Palmitate, Vegetable Glycerin, Glyceryl Caprylate, Isostearyl Alcohol, Lecithin (Sunflower, non GMO), Purified Water, Sucrose Distearate, Sucrose Stearate , Tocopheryl Acetate, Triethylcitrate, Xanthan Gum.

Does NOT contain: parabens, PEGs, propyleneglycol, petrolatum, mineral oil, artificial color or fragrances, GMO derived ingredients, alcohol, artificial preservatives, color or fragrances.

Amazon.com : Solarcaine Cool Aloe Burn Relief Spray with Lidocaine and Aloe Vera, Doctor Tested, Fragrance Free, Alcohol Free and Non-irritating, #1 Sunburn Relief Brand (6 Ounce Spray) : After Shaving Healing Products : Health & Household

Treating Minor Sunburn

ACT Quickly at the first sign of skin reddening/tingling.

Cool The Painful Sunburn with a cool shower/bath. Apply Solarcaine Cool Aloe Spray or Gel for fast, cooling relief. Use as directed.

Drink Plenty Of Fluids and watch for signs of dehydration.

Soothe The Skin with moisturizer when it begins to peel.

consult a doctor if burn covers a large area, is blistering, or seems severe or if you experience extreme pain, headache, confusion, nausea or chills.

Treating Minor Burns

assess the burn. 1st degree burns turn red and swell. 2nd degree burns can form blisters. 3rd degree burns may be charred. Seek medical help for major burns.

cool the burn under cool water/apply a cool compress for 15 minutes. Apply Solarcaine for fast pain relief. Use as directed.

leave blisters alone. If they break, clean with soap & water, apply antibiotic ointment and cover with bandage.

consult a doctor if large blisters develop, if burn covers a large area or at sign of infection.

Treating Cuts & Scrapes

wash your hands to help prevent infection.

stop the bleeding. Apply pressure with sterile bandage.

rinse the cut with plenty of cool water.

remove remaining debris with sterilized tweezers. Bandages can help keep the cut clean.

relieve the itch and pain with Solarcaine. Use as directed.

consult a doctor at sign of infection, redness, increased pain, drainage, warmth or swelling. Seek medical attention if the wound is deep and may require stitches, or if caused by glass or a rusty nail.

Treating Insect Bites

Wash The Area: Wash the area with soap and water.

Apply A Cool Compress : Apply a cloth dampened with cold water or ice to reduce swelling.

Relieve Pain And Itching: For pain or itch from insect bites, try Solarcaine. Use as directed.

consult a doctor : If you experience signs of an allergic reaction or the symptoms do not disappear within a few days, seek medical attention.

20 Medications You Should Never Mix With Alcohol

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We’ve all seen the cautionary label on pill bottles, telling us in big, bold letters to avoid drinking while taking the medication. But what happens if you ignore that warning? Nothing good.

“Alcohol can either inhibit or amplify the effects of the medication in an uncontrolled and unpredictable way,” says Kristine Arthur, MD, an internist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

That’s true for both over-the-counter and prescription medications—and even mixing alcohol with natural remedies, like St. John’s Wort, can be problematic. The consequences of drinking while taking medications can range from minor (feeling a bit dizzy, for instance) to fatal.

“A cold pill that makes you a little drowsy could make you unconscious mixed with alcohol. And an anxiety or sleep medication which calms you could make you stop breathing,” says David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. “While the effects of alcohol on virtually all classes of medication can be dangerous, what is scarier is the unpredictability,” he notes.

Fortunately, we can anticipate some of the potential side effects that can occur when you imbibe while on medications. From over-the-counter allergy meds to prescription sleeping pills and everything in between, here are some of the scary consequences that can result if you ignore that alcohol warning on a pill bottle.

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1

Allergy & cold medications

Including brand-name drugs like: Claritin, Benadryl, Zyrtec, Triaminic Cold & Allergy, Tylenol Cold & Flu

Springtime sniffles may have you reaching for allergy meds, which are known for interacting poorly with alcohol. According to the National Institute for Alcohol Abuse and Alcoholism (NIAAA), mixing over-the-counter sniffle stoppers with booze can leave you feeling drowsy or dizzy. “Any antihistamines—the class of medication [that combats allergies]—that are associated with drowsiness can have more of an effect of sedating with alcohol,” says Dr. Andrew Weinstein, a board-certified allergist and clinical immunologist, and Associate Clinical Professor of Pediatrics at Thomas Jefferson Medical College.

2

Angina medications

Including brand-name drugs like: Isordil, Nitrostat, Rectiv, Nitrolingual

If you experience chest pains, your doctor may prescribe a drug to prevent attacks. But be warned: Do not drink while taking these drugs. “Mixing alcohol and medication for chest pain like nitroglycerin [the generic name for Nitrostat, Rectiv, and Nitrolingual]…can cause dangerously low blood pressure or abnormal heart rhythms,” Dr. Arthur says. The NIAAA also notes that alcohol can increase side effects of nitroglycerin including dizziness, lightheadedness, and fainting.

There’s a similar warning for an other type of angina medication called isosorbide. The NIAA lists rapid heartbeat and sudden change in blood pressure as potential reactions to mixing the medication with alcohol

3

Anxiety medications

Including brand name drugs like: Ativan, Xanax, Librium, Valium

Mixing alcohol with benzodiazepines—drugs that help relieve anxiety and panic attacks—can result in life-threatening symptoms. You might feel drowsy or dizzy, or, even experience difficulty breathing, impaired motor control, unusual behavior, or memory problems.

4

Arthritis medications

Including brand-name drugs like: Celebrex, Naprosyn, Voltaren

If you’re taking medication to manage arthritis pain, you should know that all of these medications are strong non-steroidal anti-inflammatory drugs (NSAIDs), and as such, can cause ulcers, stomach bleeding, or liver damage. But here’s the kicker: The risk of these potentially severe side effects increases when you drink alcohol, according to the NIH, especially for older adults and those who are already in poor health.

5

ADD and ADHD medications

Including brand-name drugs like: Adderall, Ritalin, Focalin, Dexedrine, Strattera, Concerta

Prescription medications for attention-deficit/hyperactivity disorder are considered central nervous system stimulants. Combining them with alcohol can lead to dizziness and drowsiness. Another side effect worth noting: Drinking while taking Focalin, Concerta, or Ritalin, can actually result in impaired concentration—the exact reverse of the medication’s purpose.

There are additional concerns, too. “Stimulant drugs like those for ADHD…can have wildly activating effects when mixed with alcohol,” says Dr. Cutler. Mixing Adderall, Vyvanse, or Dexedrine with alcohol increases the risk for heart problems, and drinking on Strattera carries a risk for liver damage, the NIAAA notes.

6

Blood clot medications

Including brand-name drugs like: Coumadin, Eliquis, Bevyxxa, Pradaxa

If you’re taking any type of blood clot medication, it’s important to note that even occasional drinking (think: a glass of wine with dinner a few times per week) can lead to internal bleeding. Heavier drinking may also cause internal bleeding, as well as blood clots, stroke, or heart attack, the NIAAA warns. Dr. Arthur echos these warnings, adding that mixing alcohol with blood thinners can also increase or decrease the thickness of the blood and can cause dangerous bleeding or hemorrhage.

7

Cough medications

Including brand-name drugs like: Mucinex, Robitussin Chest Congestion

If you have a nagging cough, you’ll likely reach for an over-the-counter expectorant. While the drug can quell your symptoms, if mixed with alcohol, it can result in extreme drowsiness or dizziness. It also carries an increased risk for overdose. Overdose symptoms might include breathing problems, blurred vision, coma, constipation, seizures, nausea, and vomiting, among other things, according to the NIH.

8

Depression medications

Including brand-name drugs like: Prozac, Wellbutrin, Zoloft, Effexor, Marplan, Lexapro

Most antidepressants out there fall into two classes: selective serotonin reuptake inhibitors (SSRIs) or Monoamine oxidase inhibitors (MAOIs). Both are problematic when mixed with alcohol, and can cause drowsiness, dizziness, or increased feelings of depression or hopelessness.

But that’s not all. Both classes of drugs share some additional risks when combined with alcohol. “Mixing antidepressants such as selective serotonin reuptake inhibitors with alcohol can impair motor function and suppress breathing as well as cause unusual behavior,” says Dr. Arthur. And the NIAAA notes that combining MAOIs (like Marplan or Nardil) with alcohol “may result in serious heart-related side effects.”

If you’re on MAOIs, it’s especially important that you avoid red wine and beer. These beverages contain a byproduct that when consumed with MAOIs can increase the risk of high blood pressure. Not sure what class of drug you’re taking? Play it safe and simply avoid drinking altogether.

9

Diabetes medications

Including brand-name drugs like: Diabinese, Glucophage, Orinase

Mixing diabetes medication with alcohol is never a good idea. Doing so can result in abnormally low blood sugar levels, nausea, vomiting, headaches, a rapid heartbeat, or a sudden change in blood pressure, according to the NIAAA. If you drink while taking Glucophage (generic: metformin), you may also experience feelings of weakness.

10

Enlarged prostate medications

Including brand-name drugs like: Flomax, Uroxatral, Cardura, Minipress, Rapaflo

Drinking while taking Flomax (generic: tamsulosin) or other drugs prescribed for an enlarged prostate, could lead to feeling dizzy or lightheaded, or even fainting.

11

Tummy treatments

Including brand-name drugs like: Reglan, Zantac, Tagamet, Maalox, Rolaids, Nexium, Prilosec

Alcohol is a common cause of heartburn, sour stomach,and indigestion, so you probably don’t want to head to happy hour if you’re experiencing any of these issues. Plus, doing so can be dangerous. Over-the-counter medications to prevent or treat these tummy troubles can increase the inebriating effects of alcohol and can also result in a rapid heart rate or a sudden change in your blood pressure—two things that can cause dizziness and fainting spells, the NIAAA cautions.

12

High blood pressure medications

Including brand-name drugs like: Accupril, Lopressor, Norvasc, Hytrin

If you manage your high blood pressure with prescription medication, saying no to alcohol is extremely important. Why? Drinking can cause arrhythmia or a change in your heartbeat. It could also leave you feeling dizzy, faint, or drowsy.

13

High cholesterol medications

Including brand-name drugs like: Lipitor, Crestor, Pravigard, Zocor, Niaspan

If you’re one of many Americans with high cholesterol, you might be managing it with the help of a medication like Lipitor (generic: atorvastatin). If that’s the case for you, be sure to avoid alcohol. When mixed with booze, cholesterol medications can cause liver damage. And patients taking Niaspan (generic: niacin) or Advicor (generic: niacin extended-release and lovastatin) could also experience uncomfortable itching and flushing.

14

Infection medications

Including brand-name drugs like: Flagyl, Grisactin, Nydrazid, Seromycin, Tindamax, Zithromax

Treating an infection with prescription medication? Not only will you want to avoid drinking while using the drug, but you should also avoid alcohol for several days afterward, too. Drinking alcoholic beverages or consuming anything that contains propylene glycol (an additive found in select packaged foods including, ice creams, frosting cake mixes, and salad dressing) while taking a drug for an infection may cause stomach pain, nausea, vomiting, headache, or flushing, according to the Mayo Clinic.

15

Mood stabilizers

Including brand-name drugs like: Depakene, Depakote, Eskalith, Lithate, Lithobid, Valproic

Lithate and Lithobid (generic: lithium) are antimanic agents prescribed to both treat and prevent manic episodes in people with bipolar disorder. Valproic (generic: valproic acid), which treats seizures as well as mania, is another. One of the side effects of valproic acid is sleepiness, and alcohol can increase that effect, the NIH says. Drinking while on valproic acid can also lead to liver damage, the NIAAA points out.

Consuming alcohol while taking lithium or valproic acid can also cause drowsiness, dizziness, and tremors. It also increases your risk of experiencing these medications’ side effects including restlessness, loss of appetite, depression, and impaired motor control.

16

Muscle spasm medications

If you strain a muscle at the gym or get a particularly bad charley horse, your doctor may prescribe Flexeril (generic name: cyclobenzaprine) or Soma (generic name: carisoprodol). Accompany these medications with rest and physical therapy—not cocktails. “Cyclobenzaprine can make the effects of alcohol worse,” the NIH says, and can also leave patients feeling drowsy. The NIAA notes that drinking while taking muscle relaxants can also lead to an increased risk of seizures, impaired motor control, unusual behavior, and memory problems.

17

Nausea & motion sickness medications

Including brand-name drugs like: Antivert, Dramamine, Phenergan

If you suffer from motion sickness, you might take a preventative dose of Antivert or Dramamine to ward off nausea and dizziness. Or, you might try Phenergan, which can also be used to manage nausea and vomiting that may occur post-surgery, according to the NIH. You probably don’t feel like drinking much if you’re nauseated—and that’s a good thing, since taking these drugs while boozing can leave you feeling drowsy or dizzy, and also increases your risk for overdose.

18

Painkillers—both prescription and OTC

Including brand-name drugs like: Advil, Motrin, Tylenol, Aleve

Popping a couple of Advil to rid yourself of a headache, lower a fever, or ease muscle aches may not seem like a big deal. But over-the-counter pain medications should be taken with care. “Mixing alcohol with common over the counter anti-inflammatory pain medications like ibuprofen and Naprosyn can cause GI upset, ulcers, and even stomach bleeding,” says Dr. Arthur. “Mixing alcohol with Tylenol/acetaminophen can cause severe liver damage and even failure. Never take Tylenol after a night of drinking to prevent a hangover,” Dr. Arthur adds.

And, of course, prescription painkillers—such as Vicodin, Percocet, or Demerol—are serious business. Drinking while you are taking prescription-strength painkillers and opioids can result in a laundry list of unpleasant side effects, including an increased risk of overdose, impaired motor control, memory problems, and unusual behavior. “Even a single large dose of an opioid can cause severe respiratory depression (slowing or stopping of breathing), which can be fatal; taking opioids with alcohol or sedatives increases this risk,” the NIH cautions.

19

Seizure medications

Including brand-name drugs like: Keppra, Dilantin, Topamax

Drinking while taking a seizure medication like Keppra or Dilantin can leave you feeling drowsy or dizzy, and can actually increase the risk of a seizure. Mixing alcohol with Topamax may cause thoughts of suicide.

20

Sleep medications

Including brand-name drugs like: Lunesta, Ambien, Sominex, Prosom, Unisom

Trouble catching Zzz’s? If you turn to herbal remedies, like a soothing cup of chamomile or lavender tea, and accompany it with alcohol, you may feel extra drowsy. Combine alcohol with prescription treatments like Lunesta or Ambien, and you may feel unusually drowsy, sleepy, and dizzy. Those side effects may not seem so serious when you’re aiming to head to dreamland anyway. But the NIAAA also cautions that combining these prescription-strength sleep aids with alcohol could also lead to impaired motor control, unusual behavior, memory problems, and slowed or difficult breathing. All in all, that’s one nightcap to avoid.

Madeleine Burry
Madeleine Burry is the former associate managing editor for Parents.com, and is currently a freelance writer, editor, and content strategist, with work appearing in Women’s Health, Health.com, and other online publications.

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90,000 Lidocaine and alcohol – compatibility, how much you can drink, what are the consequences

Lidocaine is very actively used in medicine, and therefore many people have at least once experienced the effect of this drug on themselves. Sometimes circumstances arise in life that patients ask themselves: is it possible to use lidocaine with alcohol? How do these two substances interact, and what are the consequences of such experiments?

  Contents: 
1.The use of lidocaine
2. Compatibility of lidocaine with alcohol
- Effects on the nervous system
- Effect on breathing
- The appearance of allergic reactions
3. How long can you drink alcohol after an injection of Lidocaine?

Use of Lidocaine

Lidocaine is a drug from the group of local anesthetic drugs. It is used for all types of local anesthesia: terminal, infiltration, conduction and spinal anesthesia. In particular, the drug is administered for pain relief during surgical interventions, in dental practice, for blockade of peripheral nerves with severe pain syndrome.Often powder antibiotics are diluted with lidocaine – so injections become less painful. Lidocaine also has an antiarrhythmic effect, due to which it is used in cardiological practice.

Lidocaine is available in various dosage forms:

  1. Solution,
  2. Aerosol,
  3. Gel,
  4. Eye drops.

The most commonly used solution is Lidocaine hydrochloride. It is used for intramuscular, subcutaneous injection, conduction anesthesia, local treatment of mucous membranes.

Lidocaine compatibility with alcohol

Let’s say a doctor has prescribed a course of treatment with Ceftriaxone. This antibiotic must be diluted with lidocaine. If a person will take lidocaine, is it permissible to consume alcoholic beverages? The instructions for Lidocaine say that the drug should not be taken with alcohol, as this can lead to serious consequences.

Effect on the nervous system

Lidocaine, like other anesthetic drugs, has a depressing effect on the nervous system.Of course, in small dosages, this effect is practically not felt. However, in some situations, the effects of the drug may be more pronounced. In particular, ethanol significantly enhances the inhibitory effect of Lidocaine on the nervous system.

What are the consequences of the use of lidocaine with alcohol? Symptoms from the nervous system may well occur such as:

Important

In difficult situations, the depression of the nervous system can be so pronounced that a person loses consciousness.

Effect on respiration

Many anesthetics have such a serious disadvantage as respiratory depression. The use of adequate doses of lidocaine does not manifest such a side effect. However, in the instructions for the Lidocaine solution, it is indicated that ethanol enhances the inhibitory effect of the drug on respiration . How can this be dangerous?

Let’s say a person got heavily drunk during treatment with lidocaine. He was so overwhelmed with alcohol that, exhausted, he decided to lie down and take a nap.At this moment, a side reaction of the interaction of lidocaine with alcohol is manifested – breathing is inhibited. A person breathes less and less, and even complete cessation of breathing is possible – apnea . This situation requires the provision of resuscitation measures, since it can lead to death. Therefore, given the risk of developing such a complication during the use of Lidocaine, it is necessary to stop drinking alcohol.

Occurrence of allergic reactions

From time to time there is news in the media that the use of lidocaine leads to allergic reactions.So, in 2017 in the Russian Federation, two severe cases were registered in the form of anaphylactic shock to Lidocaine, which led to death. For this reason, before the introduction of the entire dose of lidocaine, a skin allergy test is performed to assess whether a person has a hypersensitivity to the drug.

It is also known that alcoholic beverages can aggravate allergy symptoms. Therefore, when using lidocaine with alcohol, people with hypersensitivity may develop an allergic reaction. The most severe form of allergy is anaphylactic shock. The symptoms of anaphylaxis are:

  • Appearance of malaise, dizziness, fear;
  • The appearance of skin rashes, itching;
  • Nausea, vomiting;
  • Sensation of a lump in the throat, tightness in the chest, inability to inhale;
  • Drop in blood pressure;
  • Increased heart rate;
  • Loss of consciousness.

Important

Anaphylactic shock develops rapidly and, if medical assistance is not provided, can lead to suffocation and death.

How long can you drink alcohol after an injection of lidocaine?

Given the risk of side effects, lidocaine should not be taken with alcohol. You can drink alcohol only after the end of the drug’s effect, and this is no earlier than six to eight hours. . It is during this period of time that the drug is excreted from the body. If the doctor prescribed injections of an antibiotic, which must be diluted with Lidocaine, then you should start tasting alcoholic beverages only after the end of the entire course of treatment.

Grigorova Valeria, doctor, medical observer


    Neo-Penotran ® Forte L

    📜 Instructions for use Neo-Penotran ® Forte L

    💊 Composition of the preparation Neo-Penotran ® Forte L

    ✅ Application of the drug Neo-Penotran ® Forte L

    📅 Storage conditions Neo-Penotran ® Forte L

    ⏳ Expiry date Neo-Penotran ® Forte L

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    Description of the medicinal product

    Neo-Penotran ® Forte L
    (Neo-Penotran ® Forte L)

    Based on the officially approved instructions for use of the drug and prepared for the electronic edition of the Vidal Handbook 2011, update date: 2019.11.26

    Marketing Authorization Holder:

    ATX code:

    G01AF20

    (Combinations of imidazole derivatives)

    Active substances

    Dosage form

    Neo-Penotran ® Forte L

    Supp.vaginal 100 mg + 750 mg + 200 mg: 7 pcs.

    reg. No .: LP-000486
    from 01.03.11
    – Perpetually

    Re-registration date: 10.04.17

    Release form, packaging and composition
    drug Neo-Penotran

    ® Forte L

    Vaginal suppositories in the form of a flat body with a rounded end, from white to slightly yellowish.

    1 supp.
    micronized metronidazole 750 mg
    micronized micronazole nitrate 200 mg
    lidocaine 100 mg

    7 pcs. – plastic blisters (1) complete with finger cots – cardboard packs.

    Pharmacological action

    Suppositories Neo-Penotran Forte-L contain miconazole, which has an antifungal effect, metronidazole, which has an antibacterial and antichomonas effect, and lidocaine, which has a local anesthetic effect.

    Miconazole , a synthetic imidazole derivative, has antifungal activity and a wide spectrum of action. It is especially effective against pathogenic fungi, including Candidaalbicans. In addition, miconazole is effective against gram-positive bacteria. Miconazole works by synthesizing ergosterol in the cytoplasmic membrane. Miconazole alters the permeability of mycotic Candidaspecies cells and inhibits in vitro glucose uptake.

    Metronidazole , which is a derivative of 5-nitroimidazole, is an antiprotozoal and antibacterial agent effective against several infections caused by anaerobic bacteria and protozoa such as Trichomonasvaginalis, Gardnerellavaginalis and anaerobic bacteria. anaerobic streptococci.

    Miconazole and metronidazole do not have a synergistic or antagonistic effect when taken simultaneously.

    Lidocaine stabilizes the neural membrane by inhibiting the ionic flows necessary for the generation and conduction of impulses, thereby providing a local anesthetic effect.

    Pharmacokinetics

    Miconazole nitrate: absorption of miconazole nitrate with intravaginal administration is very low (approximately 1.4% of the dose). Miconazole nitrate can be determined in plasma within three days after intravaginal administration of Neo-Penotran Forte-L suppositories.

    Metronidazole: The bioavailability of metronidazole with intravaginal administration is 20% compared to oral administration.The equilibrium plasma concentration of metronidazole is 1.1-5.0 μg / ml after daily intravaginal administration of Neo-Penotran Forte-L suppositories for 3 days. Metronidazole is metabolized in the liver by oxidation. The main metabolites of metronidazole are hydroxy derivatives and acetic acid compounds are excreted by the kidneys. The biological activity of hydroxy metabolites is 30% of the biological activity of metronidazole. T 1/2 metronidazole is 6-11 hours. After oral or intravenous administration of metronidazole 60-80% of the dose is excreted by the kidneys (about 20% – unchanged and in the form of metabolites).

    Lidocaine: the action begins in 3-5 minutes. Lidocaine is absorbed when applied superficially to damaged skin and mucous membranes and is rapidly metabolized in the liver. The metabolites and the drug in unchanged form (10% of the administered dose) are excreted through the kidneys. After daily intravaginal administration of suppositories Neo-Penotran Forte-L for 3 days, lidocaine is absorbed in a minimal amount, and its plasma levels are 0.04-1 μg / ml.

    Indications of the drug

    Neo-Penotran

    ® Forte L

    • vaginal candidiasis due to Candida albicans;
    • Bacterial vaginitis due to anaerobic bacteria and Gardnerella vaginalis, Trichomonas vaginitis due to Trichomonas vaginalis;
    • mixed vaginal infections.

    Dosing regimen

    Unless otherwise recommended by a doctor, 1 suppository is inserted deep into the vagina at night for 7 days.

    In case of relapsing disease or vaginitis resistant to other treatments it is recommended to extend the course of treatment to 14 days.

    Suppositories should be inserted in the supine position deep into the vagina using the supplied disposable fingertips.

    Side effects

    In rare cases are observed hypersensitivity reactions (skin rashes) and side effects such as abdominal pain, headache, vaginal itching, burning and irritation of the vagina.

    The incidence of systemic side effects is very low, since with the vaginal use of metronidazole contained in Neo-Penotran Forte-L vaginal suppositories, the concentration of metronidazole in plasma is very low (2-12% compared to oral administration).

    Miconazole nitrate , like all other antifungal agents based on imidazole derivatives that are injected into the vagina, can cause vaginal irritation (burning, itching) (2-6%). Such symptoms can be eliminated by the local anesthetic action of lidocaine. In case of severe irritation, treatment should be discontinued.

    Side effects due to systemic use of metronidazole include hypersensitivity reactions (rarely), leukopenia, ataxia, psychoemotional disorders, peripheral neuropathy in case of overdose and prolonged use, convulsions; diarrhea (rare), constipation, dizziness, headache, loss of appetite, nausea, vomiting, abdominal pain or cramps, change in taste (rare), dry mouth, metallic or unpleasant taste, fatigue.These side effects occur in extremely rare cases, since the blood levels of metronidazole with intravaginal use are very low.

    Contraindications to use

    • I trimester of pregnancy;
    • porphyria;
    • epilepsy;
    • severe liver dysfunction;
    • Hypersensitivity to drug components.

    Use during pregnancy and lactation

    Metronidazole and lidocaine are Category B, miconazole is Category C.After the first trimester of pregnancy, Neo-Penotran Forte-L can be used under medical supervision in cases where the intended benefit outweighs the potential risk to the fetus.

    Breastfeeding should be discontinued because metronidazole passes into breast milk. Feeding can be resumed 24-48 hours after the end of treatment. It is not known whether lidocaine passes into breast milk. Lidocaine should be used with caution in a nursing woman.

    Application for violations of liver function

    Contraindicated in severe hepatic impairment.

    In case of serious violations of liver function, the clearance of metronidazole may be impaired.

    Metronidazole may cause symptoms of encephalopathy due to elevated plasma levels and should therefore be used with caution in patients with hepatic encephalopathy.

    In patients with hepatic encephalopathy, the daily dose of metronidazole should be reduced to 1/3.

    In patients with reduced liver function, the half-life of lidocaine may be doubled or more

    Application for impaired renal function

    In renal failure, the dose of metronidazole should be reduced.

    Decreased renal function does not affect the pharmacokinetics of lidocaine, but may cause accumulation of metabolites.

    Use in children

    Not recommended for use in children

    Special instructions

    Not recommended for use in children and virgins.

    It is necessary to avoid drinking alcohol during treatment and at least for 24-48 hours after the end of the course due to possible disulfiram-like reactions.Large doses and long-term systematic use of the drug can cause peripheral neuropathy and seizures. Caution should be exercised when using suppositories simultaneously with contraceptive diaphragms and condoms due to the possible interaction of rubber with the suppository base.

    Patients diagnosed with Trichomonas vaginitis require simultaneous treatment of their sexual partner.

    In renal failure, the dose of metronidazole should be reduced.

    In case of serious violations of liver function, the clearance of metronidazole may be impaired.

    Metronidazole may cause symptoms of encephalopathy due to elevated plasma levels and should therefore be used with caution in patients with hepatic encephalopathy.

    In patients with hepatic encephalopathy, the daily dose of metronidazole should be reduced to 1/3.

    In patients with reduced liver function, the half-life of lidocaine may be doubled or more.

    Decreased renal function does not affect the pharmacokinetics of lidocaine, but may cause accumulation of metabolites.

    Influence on the ability to drive vehicles and mechanisms

    Neo-Penotran Forte-L suppositories do not affect the ability to drive and operate mechanisms.

    Preclinical safety data

    Preclinical studies of safety, pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, reproductive toxicity did not reveal a potential risk to humans.

    Overdose

    Symptoms: nausea, vomiting, abdominal pain, diarrhea, itching, metallic taste in the mouth, ataxia, paresthesia, convulsions, leukopenia, dark urine. Symptoms of miconazole nitrate overdose are nausea, vomiting, dryness in the larynx and mouth, anorexia, headache, diarrhea.

    Treatment: in case of accidental ingestion of a large dose of the drug, if necessary, gastric lavage can be performed.There is no specific antidote; symptomatic treatment is applied. Treatment should be given to individuals who have taken a dose of 12 g of metronidazole.

    Drug Interactions

    As a result of the absorption of metronidazole, the following interactions may occur:

    Alcohol: disulfiram-like reactions.

    Oral anticoagulants: enhancement of the anticoagulant effect.

    Phenytoin: increase in phenytoin levels and decrease in blood levels of metronidazole.

    Phenobarbital: decrease in the level of metronidazole in the blood.

    Disulfiram: changes from the central nervous system are possible (for example, mental reactions).

    Cimetidine: may increase the level of metronidazole in the blood and, therefore, increase the risk of neurological side effects. Lithium: Potentially increased toxicity of lithium.

    Astemizole and terfenadine: metronidazole and miconazole inhibit the metabolism of these compounds and increase their plasma concentration.

    There is an effect on the level in the blood of liver enzymes, glucose (when determined by the hexokinase method), theophylline and procainamide.

    Storage conditions of the drug Neo-Penotran

    ® Forte L

    Store the drug at a temperature not exceeding 25 ° C. Do not refrigerate. Store in original packaging.

    Keep out of reach of children.

    Shelf life of the drug Neo-Penotran

    ® Forte L

    Shelf life is 2 years. Do not use after the expiration date

    Terms of Sale

    The drug is available with a prescription.

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