lidocaine
The lidocaine patch works well to treat nerve pain that's limited to a small area of your body. It can cause skin irritation, but it's typically mild and temporary. The lidocaine patch is available by prescription and as an over-the-counter (OTC) medication.
What is Lidocaine?
What is Lidocaine used for?
Nerve pain caused by shingles - 5% and 1.8% patches (by prescription only)
Temporary relief of minor pain - 4% patches (OTC)
How Lidocaine works
The lidocaine patch 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 directly underneath the patch.
Drug Facts
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What are the side effects of Lidocaine?
Common Side Effects
- Bruising
- Burning sensation
- Dry, itchy skin
- Peeling skin
- Changes in skin color
- Warmth on skin
- Small red or purple spots caused by bleeding underneath the skin
- Small bumps on skin
- Small blisters
Other Side Effects
- Feeling confused
- Dizziness
- Headache
- Feeling faint
- Feeling very tired and having no energy
- Tingling or numbness in hands and feet
- Nausea
- Vomiting
- Changes in taste
- Blurry vision
- Ringing in the ears
- Tremors
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: 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
Pros
The 5% patch is available as a lower-cost generic
The 4% patch is available over the counter
Typically well tolerated with low risk of serious side effects
Can cut patches to fit the area of pain
Cons
Not a good choice if you have pain in many areas of your body
Can cause skin irritation
Patches might fall off during rigorous exercise
Not recommended for people with severe liver problems because of higher risk of side effects
Pharmacist tips for Lidocaine
Always wash your hands after applying the lidocaine patch. This gets rid of medication that might've accidentally stuck to your fingers. Avoid touching your eyes until after you've washed your hands. Lidocaine can cause very bothersome irritation if it gets into your eye.
Avoid applying the lidocaine patch to areas of your skin with open cuts or wounds. This might affect how much medication your skin absorbs and potentially lead to side effects.
If needed, you can cut lidocaine patches to fit smaller areas of the skin. This won't affect how the medication works.
If you're using the ZTlido (lidocaine) patch 1.8% and the edges lift up, firmly press down on the edges to help it stick. If the patch comes off completely, you can stick it back on your skin and continue to use it. If the patch no longer sticks to your skin, remove it, fold it in half, and throw it away out of reach of children and pets. You can put on a new patch, but make sure the combined time you use the old and new patch is not longer than 12 hours.
Avoid using a heating pad or electric blanket over your lidocaine patch because the heat might cause you to absorb more medication, which can put you at higher risk for side effects. You can wear clothing over your lidocaine patch. Clothing won't affect how much medication gets absorbed. If you're using the ZTlido (lidocaine) patch 1.8%, you can still apply the patch after exposure to moderate heat (e.g., using a heating pad for 15 minutes on the medium setting).
Lidocaine patch 4%: Stop using lidocaine patch and talk with your provider if you've been using this medication for more than a week or if symptoms (e.g., skin pain) come back after clearing up. Also let your provider know if you have symptoms of rash, itching, redness, irritation, swelling, or blistering.
It's not recommended to use more than one medication that contains lidocaine at the same time. Doing so can lead to skin irritations or more serious side effects, such as seizure, heart rhythm problems, and coma. Lidocaine can be found in many over-the-counter pain medications that you apply on your skin. These include other patches or creams, such as IcyHot or Salonpas. Talk with your pharmacist or healthcare provider if you're not sure whether you're using multiple lidocaine products.
Skin irritations from using the lidocaine patch are generally mild and temporary. They typically go away on their own in a few minutes to hours. Take off your patch if you experience symptoms, such as dry, itchy skin, or a burning or warm sensation on your skin. Don't put it back on again until after the symptoms go away. Let your provider know if they don't go away or get worse over time.
Throw away lidocaine patches after a single use. The best way to throw away a medication patch is to fold it in half, sticky sides together. This will keep someone from accidentally touching the medication side of the patch and getting it on their skin. Discarded patches can be dangerous if a child or pet chews or eats them because used patches still contain some medication.
Avoid storing lidocaine patches in bathroom cabinets since exposing the patch to too much moisture can cause the adhesive to not work as well. Lidocaine patches should be stored up and away and out of children's reach and sight. This prevents them from accidentally swallowing medication that's left out. Always put medication away every time you use it. If you think that your child might’ve accidentally swallowed a lidocaine patch, call your Poison Control Center at 1-800-222-1222 right away even if you aren't completely sure.
Frequently asked questions about Lidocaine
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What are the risks and warnings for Lidocaine?
Lidocaine 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.
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 patches 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 patches 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 a lidocaine patch. Earliest signs include headache, tiredness, and your skin turning blue. Take off your lidocaine patch and 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).
Absorbing too much medication
Risk factors: Using heating pad or electric blanket on skin | Applying patch to red, irritated, or broken skin | Leaving patch on for more than 12 hours | Using more patches than recommended | Liver problems
Your body can absorb too much lidocaine over time if you use more patches or leave them on longer than recommended. It might also happen if you apply the patches to broken skin or if you use a heating pad over the patches. Absorbing too much lidocaine is dangerous because it can cause life-threatening side effects. If you feel lightheaded or dizzy, or experience twitching or uncontrolled muscle movements in your body, take off your lidocaine patch and get medical help right away.
Accidental poisoning in children or pets
Risk factors: Not storing or throwing away lidocaine patches correctly
Make sure to fold used patches in half before you throw them away. This prevents the medication from getting on children or animals if they grab or accidentally come in contact with the patches. Used patches still contain enough lidocaine to cause serious or life-threatening problems if they're applied to the skin, chewed, or swallowed. Be sure to throw away used patches and any cut pieces of the patch so that they're out of reach of others, especially children or pets. Call 911 or the Poison Control Center at 1-800-222-1222 right away if you believe a child or pet has accidentally chewed or eaten a lidocaine patch.
Lidocaine dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5% | 30 patches | $830.93 | $27.70 |
Typical dosing for Lidocaine
Lidocaine patches are available in three different strengths: 5%, 4%, and 1.8%. These patches made by different manufacturers might have different directions and age-cutoffs. To make sure you're taking this medication correctly, follow the specific product instructions on the package or talk with your provider or pharmacist about how to use it.
Nerve pain caused by shingles (postherpetic neuralgia)
Lidocaine (Lidoderm) patch 5%
Adults: The typical dose is to apply up to 3 patches to the most painful area of skin once a day. Leave the patch(es) on for up to 12 hours a day, then remove for 12 hours.
Adults: The typical dose is to apply up to 3 patches to the most painful area of skin once a day. Leave the patch(es) on for up to 12 hours a day, then remove for 12 hours.
Temporary relief of minor pain
Adults and children ages 12 years and older: The typical dose is to apply 1 patch to the affected area of skin one to four times a day for up to 8 to 12 hours each time. Check the directions on the box for specific instructions.
Children under 12 years old: Ask your child's provider.
Lidocaine Reviews
GoodRx has partnered with PatientsLikeMe to provide reviews on the different aspects of Lidocaine.
Effectiveness
Learn more about the effectiveness of Lidocaine based on real life experiences.
Overall Rating
Based on 12 people taking this medication
3.4
Effectiveness by condition:
fibromyalgia6 reviews
3.1
chronic pain syndrome2 reviews
1.9
myofascial pain syndrome2 reviews
3.1
Parkinson's disease1 reviews
3.8
Sjogren's syndrome1 reviews
5.0
Severity of side effects
Based on 132 people taking this medication
0%
50%
100%
Top side effects
Rash or skin problems
4%
Application site itching
2%
Burning sensation in skin
2%
Bruising
1%
Elevated blood pressure
1%
Reasons people stopped taking Lidocaine
Based on 108 people who have taken this medication
Did not seem to work
41%
Expense
17%
Course of treatment ended
16%
Other
11%
Change in health plan coverage
7%
Doctor's advice
4%
Side effects too severe
4%
Personal research
3%
How long people take Lidocaine
Based on 388 people taking this medication
0%
50%
100%
Interactions between Lidocaine 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.
How much does Lidocaine cost?
What are alternatives to Lidocaine?
Nerve pain caused by shingles - 5% and 1.8% patches (by prescription only)
Temporary relief of minor pain - 4% patches (OTC)
Nerve pain from shingles in adults
Add on treatment for partial (focal) seizures in people age 3 years and older
Arthritis
Backache
Strains
Sprains
Bruises
Cramps
Bursitis (inflamed bursa)
Tendonitis (inflamed tendon)
What is the latest news about Lidocaine?
Lidocaine images
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References
Best studies we foundAmneal Pharmaceuticals LLC. (2022). LIDOCAINE- lidocaine patch [package insert]. DailyMed.
Carcas, H. C. P. M., et al. (2009). The use of lidocaine as an anti-inflammatory substance: A systematic review. Journal of Dentistry.
Centers for Disease Control and Prevention. (2023). Put your medicines up and away out of sight.
Frank, J. E. (2005). Diagnosis and management of G6PD deficiency. American Family Physician.
MedlinePlus. (2016). Bursitis.
MedlinePlus. (2022). Peripheral neuropathy.
MedlinePlus. (2022). Methemoglobinemia.
National Capital Poison Center. (n.d.). Lidocaine can cause harmful effects.
Patel, P. R., et al. (2023). Partial epilepsy. StatPearls.
Scilex Pharmaceuticals Inc. (2021). ZTLIDO- lidocaine patch [package insert]. DailyMed.
Scilex Pharmaceuticals Inc. (2023). ZTLIDO.
SOLA Pharmaceuticals. (2022). LIDOCAINE 4% PATCH- lidocaine 4% patch [package insert]. DailyMed.
TPU Pharma, Inc. (2022). LIDODERM- lidocaine patch 5% patch [package insert]. DailyMed.
U.S. Food and Drug Administration. (2015). Safe medicine disposal options.
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