Ztlido
Ztlido (lidocaine 1.8%) is a prescription patch used to relieve nerve pain caused by a shingles infection, also known as postherpetic neuralgia (PHN). It's a local anesthetic so it works by numbing the nerves in the area where it's applied. Ztlido (lidocaine 1.8%) is similar to Lidoderm (lidocaine 5%), but uses a newer patch design that delivers the same full dose of medication with less lidocaine. You apply the patch to your skin once a day for up to 12 hours in a 24-hour period. Common side effects include redness, itching, and mild skin irritation where the patch is placed.
What is Ztlido (lidocaine 1.8%)?
What is Ztlido (lidocaine 1.8%) used for?
Nerve pain caused by shingles (postherpetic neuralgia)
How Ztlido (lidocaine 1.8%) works
Ztlido (lidocaine 1.8%) is a local anesthetic, which means it works by numbing the area where it’s applied. It blocks pain signals from the nerves in your skin so they don’t reach your brain. This helps relieve pain in a specific spot without affecting the rest of your body.
Drug Facts
More on Ztlido (lidocaine 1.8%) essentials
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What are the side effects of Ztlido (lidocaine 1.8%)?
Common Side Effects
- Blisters
- Bruising
- Burning sensation
- Changes in skin color
- Rash or redness
- Swelling
- Peeling or flaking skin
- Itching
- Small bumps or spots
- Tiny red or purple dots under the skin
- Tingling or numbness in the area
Other Side Effects
- Confusion
- Dizziness
- Headache
- Feeling faint
- Weakness or low energy
- Tingling or numbness in the skin
- Nausea
- Vomiting
- Changes in taste
- Blurred vision
- Ringing in the ears
- Tremors
Serious Side Effects
- Blood problems (methemoglobinemia): pale, gray, or blue-colored skin, headache, fast heartbeat, shortness of breath, lightheadedness, tiredness, seizures, coma
- Too much lidocaine: numbness around the mouth, tingling in the tongue, dizziness, ringing in the ears, blurred vision
- 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
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Headache, unusual weakness or fatigue, shortness of breath, nausea, vomiting, rapid heartbeat, blue skin or lips, which may be signs of methemoglobinemia
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Change in skin color
- Irritation at application site
Pros and cons of Ztlido (lidocaine 1.8%)
Pros
Generally well-tolerated with few side effects
Able cut patches to fit the area of pain
Can wear patches in the water for a short period of time
Cons
Commonly causes skin irritation
Might interact with many medications
Not recommended for people with severe liver problems
Pharmacist tips for Ztlido (lidocaine 1.8%)
Wash your hands after applying Ztlido (lidocaine 1.8%). This removes any leftover medication from your fingers. Don’t touch your eyes before washing. If medication gets in your eyes, rinse it right away with water or saline.
Apply Ztlido (lidocaine 1.8%) only to clean, dry, healthy skin. Don’t use it on cuts, scrapes, or broken skin.
Don't apply more than 3 Ztlido (lidocaine 1.8%) patches at once or leave them on longer than 12 hours in a 24-hour period. Doing so can cause skin irritation or rare but serious side effects like numbness, tingling, dizziness, or ringing in the ears.
You can cut Ztlido (lidocaine 1.8%) to fit smaller painful areas. Cutting the patch doesn’t change how well it works.
If the edges of Ztlido (lidocaine 1.8%) lift, press them down gently. If the patch comes off completely, you can stick it back on, or throw it away and use a new one. Just make sure your total wear time doesn’t go over 12 hours.
Don’t put heat directly on Ztlido (lidocaine 1.8%), like a heating pad or electric blanket. Heat can make your body absorb too much medication. But you can apply the patch after medium heat, like 15 minutes with a heating pad.
You can wear clothes over Ztlido (lidocaine 1.8%). Clothes won’t change how the patch works or how much medication your skin absorbs.
You can use Ztlido (lidocaine 1.8%) during light activity, like walking or biking for 30 minutes.
Ztlido (lidocaine 1.8%) can stay on during short water exposure, like a 10-minute shower or a 15-minute swim. Afterward, gently pat the patch dry —don’t rub.
Mild skin irritation is common with Ztlido (lidocaine 1.8%) and usually goes away in a few minutes to hours. If you notice itching, burning, or dryness, remove the patch and wait for the symptoms to go away. Tell your prescriber if the irritation gets worse or doesn’t go away.
Ztlido (lidocaine 1.8%) can interact with certain medications and raise your risk of methemoglobinemia, a rare condition that affects oxygen in your blood. Let your prescriber know if you notice symptoms like pale or gray skin, shortness of breath, fast heartbeat, or dizziness. Always share a full list of your medications before starting the patch.
Avoid using other lidocaine products while using Ztlido (lidocaine 1.8%) at the same time. This includes OTC patches or creams, ointments, and gels. Doing so can raise the risk of side effects.
Throw away each Ztlido (lidocaine 1.8%) after one use. Fold it in half with the sticky sides together before throwing it away. This helps prevent kids or pets from touching leftover medication.
Store Ztlido (lidocaine 1.8%) out of children’s reach and sight. Always put the patch away after each use to keep it safe. Apply the patch right after opening the package.
Frequently asked questions about Ztlido (lidocaine 1.8%)
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What are the risks and warnings for Ztlido (lidocaine 1.8%)?
Ztlido (lidocaine 1.8%) 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 | Taking other medications that raise the risk for methemoglobinemia *
While rare, local anesthetics like Ztlido (lidocaine 1.8%) can cause methemoglobinemia, a serious blood problem where your red blood cells can't carry enough oxygen throughout your body. The risk is higher in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency, a history of methemoglobinemia, heart or lung problems, and in infants under 6 months. Be careful using Ztlido (lidocaine 1.8%) patches if you're around oxidizing chemicals like chlorine or hydrogen peroxide, which might be present in cleaning supplies or hair dye.
Symptoms can show up right away or a few hours later, and can include gray, blue, or pale-colored skin. If not treated quickly, methemoglobinemia can lead to seizures, irregular heartbeat, coma, or even death. If you notice any of these symptoms, stop using Ztlido (lidocaine 1.8%) and get emergency medical help right away.
Absorbing too much medication
Risk factors: Using heating pad or electric blanket on skin | Applying the patch to red, irritated, or broken skin | Leaving the patch on for more than 12 hours | Using more patches than recommended | Liver problems | Kidney problems
Your body can absorb too much lidocaine from Ztlido (lidocaine 1.8%) if you use more patches than recommended or leave them on too long. This can also happen if you put the patches on broken skin or use a heating pad over them. Absorbing too much lidocaine is dangerous and can cause serious side effects. If you notice numbness around your mouth, tingling in your tongue, dizziness, ringing in your ears, or blurred vision, remove the patch and get medical help immediately.
Accidental poisoning in children or pets
Risk factors: Not storing or throwing away Ztlido (lidocaine 1.8%) patches correctly
When you’re done using a Ztlido (lidocaine 1.8%), fold it in half with the sticky sides together before throwing it away. This helps keep the medication from getting on a child or pet if they find it. Even a used patch can still contain a lot of lidocaine, and if a child or pet chews or swallows it, it could cause serious harm. Always store and throw the patches away safely and out of reach. If you think a child or pet has chewed or eaten a patch, call 911 or Poison Control at 1-800-222-1222 right away.
Ztlido (lidocaine 1.8%) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1.8% | 30 patches | $379.15 | $12.64 |
Typical dosing for Ztlido (lidocaine 1.8%)
The typical dose is to apply up to 3 patches to the painful area of skin once a day for 12 hours during a 24-hour period. After 12 hours, remove the patch(es) off and leave them off for the next 12 hours.
How much does Ztlido (lidocaine 1.8%) cost?
What are alternatives to Ztlido (lidocaine 1.8%)?
Nerve pain caused by shingles (postherpetic neuralgia)
Nerve pain caused by shingles (postherpetic neuralgia)
Treatment of shingles-related nerve pain (postherpetic neuralgia)
Treatment of diabetes-related nerve pain in the feet (diabetic peripheral neuropathy)
What is the latest news about Ztlido (lidocaine 1.8%)?
Ztlido (lidocaine 1.8%) images
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References
Best studies we foundMedlinePlus. (2023). Glucose-6-phosphate dehydrogenase deficiency.
MedlinePlus. (2024). Methemoglobinemia.
Rowbotham, M. C., et al. (1996). Lidocaine patch: Double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain.
Scilex Pharmaceuticals Inc. (2024). ZTlido- lidocaine patch [package insert]. DailyMed.
Scilex Pharmaceuticals Inc. (2025). ZTech–advanced adhesion and delivery technology.
Torp, K. D., et al. (2022). Lidocaine toxicity. StatPearls.
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