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Lidocaine (Lidocaine Hydrochloride) - Side Effects and Adverse Reactions



SYSTEMIC: Adverse experiences following the administration of lidocaine are similar in nature to those observed with other amide local anesthetic agents. These adverse experiences are in general, dose-related and may result from high plasma levels caused by excessive dosage, rapid absorption or inadvertent intravascular injection, or may result from a hypersensitivity idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature. The following types are those most commonly reported.

CENTRAL NERVOUS SYSTEM: CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest.

Drowsiness following the administration of lidocaine is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption.

CARDIOVASCULAR SYSTEM: Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest.

ALLERGIC: Allergic reactions are characterized by cutaneous lesions, urticaria, edema or anaphylactoid reactions. Allergic reactions may occur as a result of sensitivity either to local anesthetic agents or to the methylparaben used as a preservative in multiple dose vials. Allergic reactions as a result of sensitivity to lidocaine are extremely rare and, if they occur, should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value.

NEUROLOGIC: The incidences of adverse reactions associated with the use of local anesthetics may be related to the total dose of local anesthetic administered and are also dependent upon the particular drug used, the route of administration, and the physical status of the patient. In a prospective review of 10,440 patients who received lidocaine for spinal anesthesia, the incidences of adverse reactions were reported to be about 3 percent each for positional headaches, hypotension and backache, 2 percent for shivering, and less than 1 percent each for peripheral nerve symptoms, nausea, respiratory inadequacy and double vision. Many of these observations may be related to local anesthetic techniques, with or without a contribution from the local anesthetic.

There have been reported cases of permanent injury to extraocular muscles requiring surgical repair following retrobulbar administration.


Below is a sample of reports where side effects / adverse reactions may be related to Lidocaine. The information is not vetted and should not be considered as verified clinical evidence.

Possible Lidocaine side effects / adverse reactions in 32 year old female

Reported by a health professional (non-physician/pharmacist) from United States on 2011-10-03

Patient: 32 year old female

Reactions: Malaise, Overdose, Post Procedural Complication, Respiratory Arrest

Adverse event resulted in: death

Suspect drug(s):

Possible Lidocaine side effects / adverse reactions in 25 year old female

Reported by a health professional (non-physician/pharmacist) from United Kingdom on 2011-10-06

Patient: 25 year old female

Reactions: Mydriasis, Amaurosis, Vith Nerve Paralysis, Pallor, Iiird Nerve Paralysis, Eyelid Ptosis, Trigeminal Palsy, Eye Disorder, Blindness

Adverse event resulted in: hospitalization

Suspect drug(s):
    Dosage: ;x2;dent
    Indication: Tooth Extraction

    Dosage: 2.2 ml;x2;dent
    Indication: Tooth Extraction

Possible Lidocaine side effects / adverse reactions in 31 year old female

Reported by a physician from Taiwan, Province of China on 2011-10-06

Patient: 31 year old female

Reactions: Back Pain, Pain in Extremity, Staphylococcal Bacteraemia, Injection Site Papule

Adverse event resulted in: hospitalization

Suspect drug(s):
Bupivacaine HCL
    Dosage: 11 mg of 0.5%
    Indication: Spinal Anaesthesia

    Dosage: 2 mg q 12 hours for 3 days

Ropivacaine Hydrochloride
    Dosage: continuous infusion of 1%
    Indication: Epidural Anaesthesia

Sodium Chloride
    Indication: Epidural Anaesthesia

    Dosage: single 2 mg bolus in 10 ml normal saline
    Indication: Postoperative Analgesia

    Dosage: 1%
    Indication: Local Anaesthesia

    Dosage: continuous infusion of 2 ug/ml
    Indication: Epidural Anaesthesia

Other drugs received by patient: Ampicillin Sodium

See index of all Lidocaine side effect reports >>

Drug label data at the top of this Page last updated: 2007-08-04

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