Recommended Frequency of Application for Lidocaine Cream
Lidocaine cream should be applied to the affected area no more than 3 to 4 times daily for adults and children over 12 years of age. 1
Dosing Guidelines
- For topical application, lidocaine cream should be applied to the affected area no more than 3-4 times daily for adults and children over 12 years 1
- For children under 12 years, consult a doctor before using lidocaine cream 1
- After applying lidocaine cream, hands should be washed thoroughly with soap and water 1
Safety Considerations
- The maximum safe dose of lidocaine without epinephrine is 4.5 mg/kg in adults and 1.5-2.0 mg/kg in children 2
- When lidocaine is combined with epinephrine, the maximum safe dose increases to 7.0 mg/kg in adults and 3.0-4.5 mg/kg in children 2
- The total dose of all local anesthetics administered, regardless of route (e.g., regional anesthesia or surgical infiltration), must be considered when calculating maximum safe dosage 3
- Significant interindividual variability exists in lidocaine metabolism, which can affect serum levels and potential toxicity 4
Application Techniques and Timing
- For optimal anesthetic effect, lidocaine cream typically requires:
- When applied with occlusion, absorption increases significantly (up to three times higher serum levels), which may increase effectiveness but also increases risk of toxicity 4
- For specific areas like genitals, lips, and oral mucosa, application time can be reduced due to enhanced absorption 6
Special Considerations
- Lidocaine should not be used within 4 hours of other local anesthetic interventions to prevent cumulative toxicity 7
- For patients with cardiac disease, electrolyte disorders, seizure disorders, renal or hepatic impairment, pregnancy/breastfeeding, or neurological disorders, use lidocaine with caution 3
- When using lidocaine on very vascular areas, lower doses should be used due to increased systemic absorption 8
- Topical 5% lidocaine medicated plasters should be removed before starting any intravenous lidocaine infusion 3
Signs of Toxicity to Monitor
- Early signs of lidocaine toxicity include circumoral numbness, facial tingling, slurred speech, tinnitus, and light-headedness 3
- More severe toxicity can progress to muscle twitching, loss of consciousness, respiratory arrest, cardiac arrhythmias, and potentially ventricular arrest 3
- If any signs of toxicity appear, discontinue use immediately and seek medical attention 3