Lidocaine Formulation Availability
Based on available evidence, lidocaine is not commercially available in a 1g/10ml (100mg/ml) formulation for clinical use. 1
Available Lidocaine Concentrations
Lidocaine is typically available in the following formulations:
Injectable solutions:
- 1% (10mg/ml)
- 2% (20mg/ml)
- 0.5% (5mg/ml)
Topical preparations:
For cardiac emergencies:
- Standard concentration for IV use is typically 10-20mg/ml
- Initial bolus of 1.0-1.5mg/kg (75-100mg) 1
Clinical Implications
The highest concentration of lidocaine documented in the guidelines is 50mg/ml (in co-phenylcaine spray), which is half the concentration of the requested 100mg/ml formulation 1.
Safety Considerations
- A 100mg/ml concentration would present significant safety concerns:
- Maximum safe dose of lidocaine with epinephrine is 7mg/kg for adults and 3.0-4.5mg/kg for children 2
- A 10ml vial at 100mg/ml would contain 1000mg (1g) of lidocaine, which exceeds the maximum safe dose for most adults
- Risk of local anesthetic systemic toxicity (LAST) would be extremely high with such a concentrated formulation
Dosing Calculations
For reference, when using standard concentrations:
Alternative Approaches
If higher concentrations are needed for specific procedures:
- Consider using commercially available preparations in appropriate volumes
- For topical anesthesia, 1-10% lidocaine provides onset within 5 minutes and duration of 30-60 minutes 1
- For cardiac emergencies, standard protocols recommend initial bolus of 1.0-1.5mg/kg followed by 0.5-0.75mg/kg every 5-10 minutes as needed 1
Conclusion
The requested 1g/10ml (100mg/ml) lidocaine formulation is not commercially available. The highest concentration typically available is 50mg/ml in specific combination products. Using standard available formulations with appropriate dosing calculations is the recommended approach for clinical practice.