LIDOCAINE HYDROCHLORIDE

Adults The volume and rate of infusion will depend upon the requirements of the individual patient and the judgement of the physician. Following a loading dose, lidocaine containing infusions are administered at a rate of 1-4 mg of lidocaine per minute for 12-48 hours.

Children and Elderly Doses should generally be reduced in the elderly and children. Although dosage will be dictated by clinical response as judged by ECG changes. For Solution for Infusion. Fluid balance, serum glucose, serum sodium and other electrolytes may need to be monitored before and during administration, especially in patients with increased non-osmotic vasopressin release (syndrome of inappropriate antidiuretic hormone secretion, SIADH) and in patients co-medicated with vasopressin agonist drugs due to the risk of hyponatraemia.

Monitoring of serum sodium is particularly important for physiologically hypotonic fluids. 8).

Rarely, allergic reactions may occur. Systemic toxicity mainly involves the CNS and cardiovascular system, although early signs include numbness or the tongue and perioral region. Excitation of the CNS may be manifested by yawning, restlessness, excitement, nervousness, dizziness, tinnitus, nystagmus, blurred vision, nausea and vomiting, muscle twitching, tremors and convulsions.

Excitation may be transient and be followed by CNS depression manifested by drowsiness, respiratory failure and coma. Effects on the cardiovascular system include myocardial depression and peripheral vasodilation resulting in hypertension and bradycardia, arrhythmias and cardiac arrest may also occur.

4). 9) Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

The continuous infusion of lidocaine requires careful monitoring by electrocardiograph. Should be given cautiously to patients with epilepsy, impaired cardiac condition or respiratory function, or with liver damage or myasthenia gravis.

Because lidocaine is metabolised in the liver, it should be used with caution in any other conditions which reduce hepatic blood flow such as cardiac and circulatory failure.

The label states:

Do not use unless the solution is clear and free from particles. Contains lidocaine hydrochloride. Glucose Solution for Infusions are usually isotonic solutions. 2). Depending on the tonicity of the solution, the volume and rate of infusion and depending on a patient's underlying clinical condition and capability to metabolize glucose, intravenous administration of glucose can cause electrolyte disturbances most importantly hypo- or hyperosmotic hyponatraemia.

g. 5) are at particular risk of acute hyponatraemia upon infusion of hypotonic fluids. Acute hyponatraemia can lead to acute hyponatraemic encephalopathy (brain oedema) characterized by headache, nausea, seizures, lethargy and vomiting.

Patients with brain oedema are at particular risk of severe, irreversible and life-threatening brain injury. g. meningitis, intracranial bleeding, and cerebral contusion) are at particular risk of the severe and life-threatening brain swelling caused by acute hyponatraemia.

Patients with hypovolaemia, heart block or other conduction disturbances, bradycardia, or cardiac decompensation or hypertension not due to treatable tachyarrhythmias. Hypersensitivity to local anaesthetics.