Xylocaine-Mpf (lidocaine HCl)
Antiarrhythmic - Class IB (Systemic) Injection Ampul (ML); Injection Vial (ML)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Generic name: lidocaine HCl
Drug class: Antiarrhythmic - Class IB (Systemic)
Therapeutic class: Anesthetics
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Xylocaine-Mpf
Indications
The following indications are listed for Xylocaine-Mpf:
- Administration Of Local Anesthesia
Dosing
No dosing information is available for this tab.
No dosing information is available for this tab.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
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There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Local Anesthetics/Long-Acting Bupivacaine
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1)
CLINICAL EFFECTS: Concurrent or use of local anesthetics with 96 hours of use of long-acting bupivacaine may result in neurologic and cardiovascular toxicity. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also result in methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1)
PREDISPOSING FACTORS: Use of additional agents that are associated with methemoglobinemia may further increase the risk of methemoglobinemia.(1) Patients who are at increased risk of developing methemoglobinemia include those with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended.(1)
PATIENT MANAGEMENT: Avoid the use of other local anesthetics within 96 hours following the administration of long-acting bupivacaine. In patients for whom use is required, monitor for neurologic and cardiovascular effects. Also monitor for methemoglobinemia with use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine.(1,2) Non-liposomal bupivacaine may be administered in the same syringe as bupivacaine liposomal or injected immediately before bupivacaine liposomal as long as the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1)
DISCUSSION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposome bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally. Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1)
There are no moderate interactions for this drug.
Contraindications
There is no enhanced messaging for this drug.
- Adams-stokes syndrome
- Methemoglobinemia
- Severe heart block
- Systemic lidocaine toxicity
- Wolff-parkinson-white pattern
- Chronic heart failure
- Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
- Glucose-6-phosphate dehydrogenase (g6Pd) deficiency
- Hemolytic anemia from pyruvate kinase and g6PD deficiencies
- Hypokalemia
- Hypomagnesemia
- Hypovolemia
- Hypoxia
- Incomplete AV heart block
- Myasthenia gravis
- Respiratory depression
- Shock
- Sinus bradycardia
- Atrial fibrillation
- Disease of liver
Adverse reactions
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Less Frequent
- Hypotension
Rare or Very Rare
- Anaphylaxis
- Bradycardia
- Cardiac arrhythmia
- Chondrolysis of articular cartilage
- CNS toxicity
- Hemiparesis
- Hypertension
- Methemoglobinemia
- Myocardial dysfunction
- Respiratory depression
- Seizure disorder
- Status asthmaticus
- Tachycardia
- Unconsciousness
- Urticaria
- Vasodilation of blood vessels
- Ventricular arrhythmias
Less Frequent
- Chills
- Headache disorder
Rare or Very Rare
- Acute cognitive impairment
- Apprehension
- Blurred vision
- Diplopia
- Dizziness
- Drowsy
- Dysgeusia
- Edema
- Euphoria
- Hypoesthesia
- Injection site sequelae
- Miosis
- Muscle fasciculation
- Nausea
- Nervousness
- Oral hypoesthesia
- Sensation of cold
- Sensation of warmth
- Skin rash
- Symptoms of anxiety
- Tinnitus
- Tremor
- Visual changes
- Vomiting
Precautions
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Administration of local anesthesia | ||
| 3E00XBZ | ICD10PCS | Introduction of anesthetic agent into skin and mucous membranes, external approach |
| 3E013BZ | ICD10PCS | Introduction of anesthetic agent into subcutaneous tissue, percutaneous approach |
| 3E023BZ | ICD10PCS | Introduction of anesthetic agent into muscle, percutaneous approach |
| 3E093BZ | ICD10PCS | Introduction of anesthetic agent into nose, percutaneous approach |
| 3E097BZ | ICD10PCS | Introduction of anesthetic agent into nose, via natural or artificial opening |
| 3E09XBZ | ICD10PCS | Introduction of anesthetic agent into nose, external approach |
| 3E0B3BZ | ICD10PCS | Introduction of anesthetic agent into ear, percutaneous approach |
| 3E0B7BZ | ICD10PCS | Introduction of anesthetic agent into ear, via natural or artificial opening |
| 3E0BXBZ | ICD10PCS | Introduction of anesthetic agent into ear, external approach |
| 3E0C3BZ | ICD10PCS | Introduction of anesthetic agent into eye, percutaneous approach |
| 3E0C7BZ | ICD10PCS | Introduction of anesthetic agent into eye, via natural or artificial opening |
| 3E0CXBZ | ICD10PCS | Introduction of anesthetic agent into eye, external approach |
| 3E0D3BZ | ICD10PCS | Introduction of anesthetic agent into mouth and pharynx, percutaneous approach |
| 3E0D7BZ | ICD10PCS | Introduction of anesthetic agent into mouth and pharynx, via natural or artificial opening |
| 3E0DXBZ | ICD10PCS | Introduction of anesthetic agent into mouth and pharynx, external approach |
| 3E0E3BZ | ICD10PCS | Introduction of anesthetic agent into products of conception, percutaneous approach |
| 3E0E7BZ | ICD10PCS | Introduction of anesthetic agent into products of conception, via natural or artificial opening |
| 3E0E8BZ | ICD10PCS | Introduction of anesthetic agent into products of conception, via natural or artificial opening endoscopic |
| 3E0F3BZ | ICD10PCS | Introduction of anesthetic agent into respiratory tract, percutaneous approach |
| 3E0F7BZ | ICD10PCS | Introduction of anesthetic agent into respiratory tract, via natural or artificial opening |
| 3E0F8BZ | ICD10PCS | Introduction of anesthetic agent into respiratory tract, via natural or artificial opening endoscopic |
| 3E0G3BZ | ICD10PCS | Introduction of anesthetic agent into upper Gi, percutaneous approach |
| 3E0G7BZ | ICD10PCS | Introduction of anesthetic agent into upper Gi, via natural or artificial opening |
| 3E0G8BZ | ICD10PCS | Introduction of anesthetic agent into upper Gi, via natural or artificial opening endoscopic |
| 3E0H3BZ | ICD10PCS | Introduction of anesthetic agent into lower Gi, percutaneous approach |
| 3E0H7BZ | ICD10PCS | Introduction of anesthetic agent into lower Gi, via natural or artificial opening |
| 3E0H8BZ | ICD10PCS | Introduction of anesthetic agent into lower Gi, via natural or artificial opening endoscopic |
| 3E0J3BZ | ICD10PCS | Introduction of anesthetic agent into biliary and pancreatic tract, percutaneous approach |
| 3E0J7BZ | ICD10PCS | Introduction of anesthetic agent into biliary and pancreatic tract, via natural or artificial opening |
| 3E0J8BZ | ICD10PCS | Introduction of anesthetic agent into biliary and pancreatic tract, via natural or artificial opening endoscopic |
| 3E0K3BZ | ICD10PCS | Introduction of anesthetic agent into genitourinary tract, percutaneous approach |
| 3E0K7BZ | ICD10PCS | Introduction of anesthetic agent into genitourinary tract, via natural or artificial opening |
| 3E0K8BZ | ICD10PCS | Introduction of anesthetic agent into genitourinary tract, via natural or artificial opening endoscopic |
| 3E0L3BZ | ICD10PCS | Introduction of anesthetic agent into pleural cavity, percutaneous approach |
| 3E0M3BZ | ICD10PCS | Introduction of anesthetic agent into peritoneal cavity, percutaneous approach |
| 3E0N3BZ | ICD10PCS | Introduction of anesthetic agent into male reproductive, percutaneous approach |
| 3E0N7BZ | ICD10PCS | Introduction of anesthetic agent into male reproductive, via natural or artificial opening |
| 3E0N8BZ | ICD10PCS | Introduction of anesthetic agent into male reproductive, via natural or artificial opening endoscopic |
| 3E0P3BZ | ICD10PCS | Introduction of anesthetic agent into female reproductive, percutaneous approach |
| 3E0P7BZ | ICD10PCS | Introduction of anesthetic agent into female reproductive, via natural or artificial opening |
| 3E0P8BZ | ICD10PCS | Introduction of anesthetic agent into female reproductive, via natural or artificial opening endoscopic |
| 3E0Q0BZ | ICD10PCS | Introduction of anesthetic agent into cranial cavity and brain, open approach |
| 3E0Q3BZ | ICD10PCS | Introduction of anesthetic agent into cranial cavity and brain, percutaneous approach |
| 3E0R3BZ | ICD10PCS | Introduction of anesthetic agent into spinal canal, percutaneous approach |
| 3E0S3BZ | ICD10PCS | Introduction of anesthetic agent into epidural space, percutaneous approach |
| 3E0T3BZ | ICD10PCS | Introduction of anesthetic agent into peripheral nerves and plexi, percutaneous approach |
| 3E0U3BZ | ICD10PCS | Introduction of anesthetic agent into joints, percutaneous approach |
| 3E0V3BZ | ICD10PCS | Introduction of anesthetic agent into bones, percutaneous approach |
| 3E0W3BZ | ICD10PCS | Introduction of anesthetic agent into lymphatics, percutaneous approach |
| 3E0X3BZ | ICD10PCS | Introduction of anesthetic agent into cranial nerves, percutaneous approach |
| 3E0Y3BZ | ICD10PCS | Introduction of anesthetic agent into pericardial cavity, percutaneous approach |
ICD code information from First Databank (FDB).
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Last reviewed · Source: First Databank (FDB) drug data
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