From the Guidelines
Lidocaine patches should be applied directly to the affected area for up to 12 to 24 hours to manage shingles pain.
Key Considerations
- Lidocaine patches work by blocking sodium ion channels, resulting in local anesthesia after topical application 1.
- The patches can be worn for up to 12 to 24 hours and are particularly practical for use on areas such as the dorsal or plantar surface of the feet.
- For areas like the feet, up to 3 patches may be worn at a time 1.
- Lidocaine patches were initially used to manage postherpetic neuralgia, a condition often associated with shingles, and have been found to be effective in suppressing pain 1.
- The patches can be applied to other affected areas, such as the hands or other parts of the body, as needed.
From the FDA Drug Label
Directions Adults and children 2 years and older: apply externally to the affected area up to 3-4 times daily. To use lidocaine patches for shingles, apply the patch externally to the affected area up to 3-4 times daily for adults and children 2 years and older 2.
- For children under 2 years of age, consult a physician before use 2.
From the Research
Application of Lidocaine Patches for Shingles
- Lidocaine patches can be applied to the intact portion of the painful skin area without blisters at 12-hour intervals, twice a day for 2 consecutive days 3.
- The patches can provide significant pain relief during rest and movement, with a greater percentage change in a patient's global impression than a vehicle patch 3.
- Lidocaine patch 5% can be used to relieve moderate to severe pain associated with acute herpes zoster, presumably through its pharmacological action and physical barrier effect on sensitized skin 3.
Efficacy and Safety of Lidocaine Patches
- Topical lidocaine has been shown to relieve pain better than placebo in patients with postherpetic neuralgia, with a significant difference in mean improvement in pain relief according to a pain relief scale 4.
- The incidence and severity of adverse events are low with lidocaine patch treatment, with no significant difference in adverse skin reactions between treatment and placebo groups 3, 4.
- Lidocaine patch 5% has been found to be well tolerated and effective in providing rapid pain relief in acute neuralgia, and may prevent postherpetic neuralgia if used early 5.
Dosage and Administration
- A 5% lidocaine patch can be applied to the affected skin, with a dosage regimen of 12-hour intervals, twice a day for 2 consecutive days 3.
- A 9% lidocaine (base) in petrolatum/paraffin ointment can be applied to the affected skin, with repeated measurements of pain, tenderness, and cutaneous sensation scores 6.
- A 10% lidocaine-gel can be applied locally to the diseased skin with or without an occlusive dressing, with a remarkable reduction of pain obtained after 9.9 +/- 5.6 (SD) times of lidocaine-gel treatments 7.