lidocaine
Lidocaine viscous 2% (also known as viscous lidocaine) is commonly used to numb red, swollen, and painful sores in the mouth and throat. It's available by prescription only. The typical dose for adults is to swish and spit (or swallow) 15 mL of lidocaine viscous 2% every 3 hours, as needed. While lidocaine viscous 2% works well, using this medication more often or at higher doses than recommended can cause serious side effects, such as heart rhythm problems, trouble breathing, and coma.
What is Lidocaine viscous 2%?
What is Lidocaine viscous 2% used for?
Numb the red, swollen, and irritated areas in the mouth and throat
Prevention of gagging during dental procedures
How Lidocaine viscous 2% works
Lidocaine viscous 2% eases pain by numbing the nerves and making them less sensitive to pain. It's a local anesthetic, meaning it only lowers pain in the area of skin closely around or directly in contact with the medication.
Drug Facts
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What are the side effects of Lidocaine viscous 2%?
Common Side Effects
- Lightheadedness
- Dizziness
- Feeling sleepy and tired
- Ringing in the ears
- Blurry or double vision
- Vomiting
- Feeling hot, cold, or numb
- Twitching, shaking
- Seizures
- Coma
- Trouble breathing
- Slow heart rate
- Low blood pressure
Other Side Effects
- Nervousness
- Overwhelming feeling of happiness and joy
- Feeling confused
Serious Side Effects
- Blood problems (methemoglobinemia): Seizures, loss of consciousness, fast heart beat, trouble breathing, feeling dizzy or faint, feeling tired, skin color turning blue
- Too much lidocaine in your body: Drowsiness, confusion, slow heart beat, trouble breathing, difficulty controlling muscle movements
- Serious allergic reactions: Swelling of the face, difficulty breathing, trouble speaking, throat tightening up, red and itchy rash, lightheadedness, clammy skin
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Blurred vision or other changes in vision
burning feeling at site of application
redness of the white part of eyes or inside of eyelids
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Lidocaine viscous 2%
Pros
Can be used as needed
Available as a lower-cost generic
Cons
Not recommended for teething pain in young children
Need to wait 1 hour after rinsing or gargling with the medication before you eat
Need a measuring spoon, medicine cup, or oral syringe to measure out exact dose, so might be inconvenient to use
Pharmacist tips for Lidocaine viscous 2%
Shake the bottle before you pour and measure out the medication. This makes sure the lidocaine is evenly mixed into the thick liquid.
Use a measuring spoon, medicine cup, or an oral syringe to measure out your dose of lidocaine viscous 2%. These can be found at your local pharmacy or retail store. Don't measure your medication with a kitchen or plastic spoon because the dose might not be accurate.
If you're hungry, it's best to eat before using lidocaine viscous 2%. Otherwise, it's recommended that you wait at least 1 hour to eat food after using this medication. This medication can affect your ability to swallow food and eating too soon after using it might cause you to choke.
It's recommended that you wait to eat food or chew gum while your mouth is still numb from lidocaine viscous 2%. If you don't wait, you might accidentally bite your tongue or mouth and injure yourself.
Store lidocaine viscous 2% out of reach of children to prevent them from accidentally exposing themselves to this medication. Make sure the lid is closed tightly. Throw away leftover or unused medication in a safe location. This medication can cause life-threatening side effects in young children, such as seizures or your heart suddenly stopping. If you think your child might've swallowed lidocaine viscous 2%, call the Poison Control Center at 1-800-222-1222.
Frequently asked questions about Lidocaine viscous 2%
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What are the risks and warnings for Lidocaine viscous 2%?
Lidocaine viscous 2% can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Seizures, heart and lungs problems, and death in babies and young children
Risk factors: Age under 3 years old | Using more lidocaine viscous 2% than recommended | Using lidocaine viscous 2% more often than recommended
Lidocaine viscous 2% can cause very serious and sometimes deadly side effects, such as seizures and cardiopulmonary arrest (a condition where the heart and lungs suddenly stop working), in children under 3 years old. This is more likely to happen if a child takes the medication more often or at a higher dose than prescribed. This medication isn't recommended for children under 3 years old, unless safer medications aren't available or haven't worked. It's also not recommended for teething pain. Talk to a healthcare provider to see if this medication is appropriate for your child or loved one. Store lidocaine viscous 2% out of reach of children to prevent them from accidentally using this medication. Make sure the lid is closed tightly. Throw away leftover or unused medication in a safe location. Call 911 and get medical help right away if your child or loved one has a seizure, becomes unconscious, stops breathing, or no longer has a heartbeat or pulse.
Using too much medication
Risk factors: Using lidocaine viscous 2% more often or at a higher dose than recommended
Use lidocaine viscous 2% only as directed by your healthcare provider. Using it more often or at a higher dose than recommended can cause this medication to build up in your body. Too much lidocaine can lead to serious side effects, such as seizures, trouble breathing, low blood pressure, slow heart rate, and your heart suddenly stopping. Get medical help right away if you experience these symptoms.
Blood problem (methemoglobinemia)
Risk factors: History of methemoglobinemia | History of low glucose-6-phosphate dehydrogenase (G6PD) | Heart or lung problems | Age 6 months or younger | Exposure to other oxidizing agents, such as chlorine and hydrogen peroxide
Lidocaine viscous 2% can cause methemoglobinemia, a serious blood problem where your red blood cells cannot bring enough oxygen to your body. Your risk is higher if you have low G6PD, a condition passed down from parent to child, where your red blood cells tend to burst or break apart. Be careful using lidocaine viscous 2% if you're around oxidizing chemicals, such as chlorine and hydrogen peroxide. These chemicals might be present in common household products like cleaning supplies and hair dye. Methemoglobinemia can occur immediately or within hours of using lidocaine viscous 2%. Earliest signs include headache, tiredness, and your skin turning blue. Get medical help right away to avoid more serious and life-threatening side effects like seizures, loss of consciousness, and heart rhythm problems (fast heart beat, dizziness, shortness of breath).
Lidocaine viscous 2% dosage forms
Typical dosing for Lidocaine viscous 2%
Redness, swelling, and skin irritation inside the mouth and throat
Adults: For the mouth, the typical dose is 15 mL swished around the mouth and then spit out no more than every 3 hours. For the throat, the typical dose is 15 mL gargled and then swallowed or spit out no more than every 3 hours. Don't use more than 8 doses in 24 hours.
Children over 3 years old: Dosing for children will depend on the child’s weight or age. Please check with your child's provider for the recommended dose.
Children 3 years old and under: Dosing for children will depend on the child’s weight or age. Please check with your child's provider for the recommended dose. Apply the recommended dose to the affected area with a cotton swab. Wait at least 3 hours before giving the next dose. Don't give more than 4 doses in 12 hours.
Prevention of gagging during dental procedures
The specific dosing and directions will be provided by your dentist.
Children, older adults, and people who are very sick and weak might need to use a lower dose.
Interactions between Lidocaine viscous 2% and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Dihydroergotamine
- Dronedarone
- Saquinavir
- Vernakalant
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amifampridine
- Amiodarone
- Amprenavir
- Arbutamine
- Atazanavir
- Bupivacaine Liposome
- Bupropion
- Cobicistat
- Dasabuvir
- Delavirdine
- Disopyramide
- Donepezil
- Encainide
- Etravirine
- Flecainide
- Fosamprenavir
- Fosphenytoin
- Hyaluronidase
- Lopinavir
- Metoprolol
- Mexiletine
- Moricizine
- Nadolol
- Phenytoin
- Procainamide
- Propafenone
- Quinidine
- Sotalol
- Succinylcholine
- Telaprevir
- Tocainide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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References
Best studies we foundCardinal Health 107, LLC. (2022). LIDOCAINE VISCOUS- lidocaine hydrochloride solution [package insert]. DailyMed.
Pharmascience Inc. (2016). pms-lidocaine viscous 2% - lidocaine hydrochloride oral topical solution, USP [package insert].
U.S. Food and Drug Administration. (2016). FDA drug safety communication: FDA recommends not using lidocaine to treat teething pain and requires new Boxed Warning.
U.S. Food and Drug Administration. (2018). Safely soothing teething pain and sensory needs in babies and older children.
U.S. Food and Drug Administration. (2021). Where and how to dispose of unused medicines.
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