What is the proper dosing for lidocaine (local anesthetic) cream in managing shingles pain?

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From the FDA Drug Label

◆ Apply to affected area not more than 3 to 4 times daily The proper dosing for lidocaine cream in managing shingles pain is to apply to the affected area no more than 3 to 4 times daily.

  • Key points:
    • Apply to affected area
    • No more than 3 to 4 times daily
    • Wash hands with soap and water after applying 1

From the Research

For managing shingles pain, lidocaine 5% cream or patch can be applied to the affected area up to three times daily. Apply a thin layer of cream to cover the painful area, or place the patch directly over the affected skin. Each application should remain in place for up to 12 hours, followed by a 12-hour patch-free period if using patches. Do not exceed the maximum daily dose of 3 patches or three applications of cream. Avoid applying to broken skin, mucous membranes, or near the eyes. Lidocaine works by temporarily blocking sodium channels in nerve endings, which prevents pain signals from being transmitted to the brain. This provides localized pain relief without systemic effects. Patients should wash hands thoroughly after application and monitor for signs of skin irritation. While lidocaine can provide temporary relief, it should be used as part of a comprehensive treatment plan for shingles that may include antiviral medications and other pain management strategies.

Key Considerations

  • The use of lidocaine for shingles pain management is supported by studies such as 2 and 3, which demonstrate its efficacy in relieving pain.
  • It's essential to follow the recommended dosing and application guidelines to minimize the risk of adverse effects.
  • Lidocaine should be used in conjunction with other treatments, such as antiviral medications, to provide comprehensive pain management.
  • Patients should be monitored for signs of skin irritation and other potential side effects.

Additional Treatment Options

  • Antiviral medications, such as aciclovir, valaciclovir, and famciclovir, can help reduce the severity and duration of shingles symptoms 4.
  • Other pain management strategies, such as nerve blocks, tricyclic antidepressants, and gabapentin, may be necessary for some patients 5.
  • Topical capsaicin cream and transcutaneous electrical nerve stimulation (TENS) may also be beneficial for some patients 5.

References

Research

WITHDRAWN: Topical lidocaine for the treatment of postherpetic neuralgia.

The Cochrane database of systematic reviews, 2013

Research

Topical lidocaine for the treatment of postherpetic neuralgia.

The Cochrane database of systematic reviews, 2007

Research

[Update in the treatment of herpes zoster].

Actas dermo-sifiliograficas, 2006

Research

Management of herpes zoster (shingles) and postherpetic neuralgia.

Expert opinion on pharmacotherapy, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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