Lidocaine Patches: How Long They Take to Work and Answers to 6 Other FAQs

Lidocaine patches are applied topically (to the skin) to relieve pain. They’re available in both prescription and over-the-counter (OTC) forms, but in different strengths. Lidoderm (lidocaine 5%) and ZTlido (lidocaine 1.8%) are prescription-only. Aspercreme and Salonpas (lidocaine 4%) are two common OTC brands of lidocaine patches.

There are some differences in how these patches are used. Below, we’ll go over commonly asked questions about lidocaine patches to make sure you get the most out of using them.

1. How long does it take lidocaine patches to work?

It may take up to 4 hours after applying a lidocaine patch before you notice pain relief. But they may start to work in as little as 30 minutes for some people. Try to make sure the patch fully covers the painful area — that will help it work best.

For the first couple of days, you may notice your pain returns or feels more severe when you remove the patch. Don’t try to avoid this by leaving the patch on longer than directed. It’s a normal side effect, and should go away after you’ve been using the patches for a couple of days in a row. Leaving a patch on for too long could prevent it from working properly.

2. What time of day should you use lidocaine patches?

You can use lidocaine patches at any time. But there are some differences in how long you can leave them on once you apply them.

Prescription lidocaine patches can be worn for up to 12 hours in a 24-hour period. And you should wait at least 12 hours after removing a patch before applying another one. OTC lidocaine patches can be worn for up to 8 to 12 hours at a time, depending on the patch.

With this in mind, it may help to apply lidocaine patches during the time of day when you’re having the most pain. If you have pain mostly in the daytime, you may want to apply lidocaine patches in the morning and wear them throughout the day. If pain is keeping you from sleeping, you may want to apply patches right before going to bed.

3. What’s the best way to apply lidocaine patches?

Here are some general tips for applying lidocaine patches:

• Use the patch right after removing it from the envelope. Peel off the backing before applying.

• Apply the patch to the area where you feel pain or discomfort. 

• Only apply lidocaine patches to intact skin. Don’t apply them over cuts, scrapes, or raw areas.

• Water may keep lidocaine patches from sticking. So try to avoid swimming or bathing while using lidocaine 5% patches. But you can shower for up to 10 minutes or bathe for up to 15 minutes with the ZTlido patches.

• Don’t apply heat to the painful area while you’re wearing a lidocaine patch. It could affect the way your patches work. And you may not be able to tell if the area gets too hot while you’re wearing the patch, which could make burns more likely.

• If the patch falls off, don’t try to reapply it. Instead, apply a new patch or wait until your next regular dose. But the clock doesn’t restart with the new patch — you’ll need to remove it once you reach the recommended time based on when the first patch was applied.

After you remove the old patch, fold it in half on the adhesive side so it sticks together. Then throw it in the garbage. Be sure to dispose of the patch in an area where children or pets cannot get to it. You can also dispose of lidocaine patches through a medication disposal program.

Can you cut lidocaine patches?

Yes, it’s OK to cut lidocaine patches. This can be useful if the area you’re treating is small, and it can help you get more uses out of each patch. It’s easier to cut a patch before peeling off the backing.

Keep in mind that this is specific to lidocaine patches. Most other medicated patches should not be cut before you use them.

4. How long do lidocaine patches last?

Most lidocaine patches typically last 8 to 12 hours. And as mentioned, after a few days of regular use you may have less pain even during the times the patch isn’t applied to the skin.

Pay attention to the directions for the specific lidocaine patch you’re using, since they don’t all last the same amount of time. And don’t leave a lidocaine patch on longer than recommended.

5. Can you take other medications while using lidocaine patches?

Yes, but talk to your healthcare provider first. Even though it’s a patch, the lidocaine can be absorbed into your bloodstream through your skin. So it’s possible that it could interact with other medications you’re taking. Keep an up-to-date medication list and have your provider review it to make sure it’s safe for you to use lidocaine patches.

You shouldn’t use other topical lidocaine products, such as gels or creams, while using lidocaine patches. It’s also best to avoid lidocaine patches if you’re taking medication for a heart arrhythmia.

Certain medications can increase the risk of methemoglobinemia if you take them while using lidocaine patches. Methemoglobinemia is a serious condition that affects how well your body delivers oxygen to your organs. These medications include:

• Nitroglycerin (Nitrostat, Nitro-Bid)

• Some antibiotics, like nitrofurantoin (Macrobid) and sulfamethoxazole/trimethoprim (Bactrim, Septra)

• Anticonvulsants, such as phenytoin or valproic acid

• Acetaminophen (Tylenol)

Symptoms of methemoglobinemia include a pale or bluish skin color, fatigue, and weakness. If you develop these symptoms while using lidocaine patches, contact your healthcare provider or call 911 immediately.

6. What happens if you forget to apply or remove a lidocaine patch?

If you forget to apply a new lidocaine patch, apply it as soon as you remember. Just pay attention to the time, so you know when to remove it. If you don’t want to change the times you apply and remove your lidocaine patches, it’s fine to wait until the time when you would usually apply your next patch. Just be aware that pain may return in the meantime.

If you forget to remove a lidocaine patch, take it off as soon as you remember. Lidocaine patches rarely cause an overdose when used as instructed. But leaving your patch on for too long, or using more patches than instructed, could cause you to absorb too much lidocaine. It could also cause itching or skin irritation.

Symptoms of a lidocaine overdose include numbness around the mouth or tongue, dizziness, and lightheadedness. It can also cause tinnitus (ringing in your ears) or blurred vision. If you experience these at any time while using lidocaine patches, contact your healthcare provider right away.

7. What can you do if you experience side effects from lidocaine patches?

Side effects from lidocaine patches are rare, but can happen. Skin irritation is the most common. Symptoms include burning or discomfort where the patch is applied. The patches can also cause redness or swelling. Wearing a patch longer than instructed increases the risk of skin irritation.

Other possible side effects of lidocaine patches are less common and include: 

• Lightheadedness

• Nervousness

• Headache

• A metallic taste

• Nausea or vomiting

Contact your healthcare provider if you experience any bothersome side effects while using lidocaine patches.

Tips on how to save money with your lidocaine patches prescription

There are many ways to save on lidocaine patches, which are available as both brand-name and generic medications. GoodRx can help you save over 70% off the average retail price of the generic version of prescription lidocaine patches. The price of generic lidocaine patches at certain pharmacies is as low as $ with a free GoodRx discount.

The price of over-the-counter lidocaine patches at certain pharmacies is as low as $20.01 with a free GoodRx discount. Keep in mind that you’ll need a prescription from your provider to use the discount in this case.

And if you have commercial insurance, you may be eligible to pay as little as $0 for ZTlido using a savings card from the manufacturer. 

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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