From the FDA Drug Label
◆ Apply to affected area not more than 3 to 4 times daily The recommended frequency of lidocaine jelly application is not more than 3 to 4 times daily for adults and children over 12 years 1.
- For children under 12 years, it is recommended to ask a doctor before applying lidocaine jelly 1.
From the Research
Lidocaine jelly should be applied with caution, considering the potential for toxicity, and its use should be limited to a maximum of 4-5 applications in a 24-hour period, with a minimum of 2-4 hours between applications, as supported by the study 2. The recommended frequency of lidocaine jelly application depends on various factors, including the procedure, patient's medical history, and the area of application.
- For most procedures, lidocaine jelly can be reapplied every 2-4 hours as needed for pain relief.
- The standard concentration of lidocaine jelly is 2%, with dosing that should not exceed 4.5 mg/kg of body weight per application.
- Patients should be monitored for signs of systemic absorption, such as dizziness, numbness around the mouth, or cardiac effects, especially when using on large areas or damaged skin, as excessive absorption can lead to toxicity, as noted in the study 2.
- The onset of action of lidocaine jelly occurs within 5-15 minutes, with effects lasting approximately 20-30 minutes, as reported in the study 3.
- Lidocaine works by blocking sodium channels in nerve cell membranes, preventing the initiation and conduction of pain signals. Some studies have investigated the efficacy and safety of lidocaine jelly in various procedures, including:
- Cataract surgery, where lidocaine 2% jelly was found to be an effective topical anesthetic agent 4.
- Nasogastric intubation, where 10% lidocaine spray plus 2% lidocaine jelly lubrication was more effective in relieving patients' pain and discomfort compared to 2% lidocaine jelly lubrication alone 5.
- Irritable bowel syndrome, where intrarectal lidocaine jelly was found to be an effective treatment for abdominal pain associated with diarrhea-predominant irritable bowel syndrome 6. However, the study 2 highlights the importance of caution when using topical lidocaine preparations, especially when applied in conjunction with occlusive dressings, due to the potential for toxicity.
- The study found significant interindividual variability in serum lidocaine and monoethylglycinexylidide (MEGX) levels, with applications of 5 g of 4% lidocaine resulting in higher serum concentrations of both lidocaine and MEGX.
- The addition of an occlusive dressing resulted in a tripling of the serum lidocaine levels and a doubling of the serum MEGX levels, both of which were statistically significant. Therefore, it is essential to exercise caution when using lidocaine jelly, considering the potential for toxicity, and to follow the recommended dosing and application guidelines to minimize the risk of adverse effects, as supported by the study 2.