Lacain-A
Generic Name
Lidocaine with Epinephrine Injection (2%)
Manufacturer
Generic Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lacain a 2 00005 injection | ৳ 90.00 | N/A |
Description
Overview of the medicine
Lacain-A Injection is a combination of lidocaine, a local anesthetic, and epinephrine, a vasoconstrictor. It is used to produce local numbness (anesthesia) during minor surgical or dental procedures, helping to reduce pain and bleeding at the injection site.
Uses & Indications
Dosage
Adults
Dosage varies greatly depending on the procedure, area to be anesthetized, vascularity of the tissues, and individual patient response. Maximum recommended single dose for lidocaine with epinephrine is typically 7 mg/kg (not to exceed 500 mg) for healthy adults.
Elderly
Reduced dosages may be required due to decreased hepatic function and/or renal impairment. Careful titration and monitoring are essential.
Renal_impairment
Use with caution. Dosage adjustments may be necessary, especially with repeated doses or in patients with severe impairment.
How to Take
Administered by healthcare professionals via infiltration, nerve block, or other regional anesthetic techniques. Intravenous administration is contraindicated.
Mechanism of Action
Lidocaine blocks the initiation and conduction of nerve impulses by decreasing the permeability of the nerve cell membrane to sodium ions, thereby stabilizing the membrane. Epinephrine acts as a vasoconstrictor, reducing blood flow to the injection site, which prolongs lidocaine's action and reduces systemic absorption.
Pharmacokinetics
Onset
2-5 minutes (for local infiltration).
Excretion
Lidocaine and its metabolites are primarily excreted by the kidneys. Less than 10% of unchanged lidocaine is excreted in urine.
Half life
Lidocaine: Approximately 1.5-2 hours in adults. Epinephrine: Very short (minutes) due to rapid metabolism.
Absorption
Rapidly absorbed from the site of injection, absorption is slowed by co-administered epinephrine. Peak plasma levels usually reached within 5-15 minutes.
Metabolism
Lidocaine is primarily metabolized in the liver by microsomal enzymes (CYP1A2, CYP3A4) into active metabolites. Epinephrine is rapidly metabolized by COMT and MAO enzymes.
Side Effects
Contraindications
- Hypersensitivity to lidocaine, epinephrine, or other amide-type local anesthetics
- Severe heart block or other cardiac conduction disturbances
- Patients with uncorrected hypotension or severe shock
- Intravenous regional anesthesia (Bier block)
- Patients with narrow-angle glaucoma (due to epinephrine)
Drug Interactions
Beta-blockers
May reduce hepatic metabolism of lidocaine, increasing its plasma levels and potential for toxicity. Monitor closely.
Phenothiazines
May diminish or reverse the pressor effects of epinephrine.
Ergot-type oxytocic drugs
May cause severe persistent hypertension and possibly cerebrovascular accidents.
Tricyclic antidepressants, MAO inhibitors
May potentiate the pressor effects of epinephrine, leading to severe hypertension or cardiac arrhythmias.
Antiarrhythmic drugs (e.g., Mexiletine, Class I antiarrhythmics)
Additive cardiac effects may occur, increasing risk of cardiac depression.
Storage
Store at room temperature (20-25°C) and protect from light. Do not freeze. Discard any unused portion after opening if not a multiple-dose vial.
Overdose
Overdose can lead to systemic toxicity, including central nervous system (CNS) effects (e.g., nervousness, dizziness, seizures, respiratory depression) and cardiovascular effects (e.g., hypotension, bradycardia, cardiac arrest). Management involves supportive care, maintaining airway and ventilation, and managing seizures with benzodiazepines. Intravenous lipid emulsion therapy may be considered for severe systemic toxicity.
Pregnancy & Lactation
Pregnancy Category B. Use in pregnant women should be considered only if the clinical benefit outweighs the potential risk to the fetus. Lidocaine is excreted in breast milk in small amounts; use with caution during lactation. Epinephrine's effects are generally localized and short-lived.
Side Effects
Contraindications
- Hypersensitivity to lidocaine, epinephrine, or other amide-type local anesthetics
- Severe heart block or other cardiac conduction disturbances
- Patients with uncorrected hypotension or severe shock
- Intravenous regional anesthesia (Bier block)
- Patients with narrow-angle glaucoma (due to epinephrine)
Drug Interactions
Beta-blockers
May reduce hepatic metabolism of lidocaine, increasing its plasma levels and potential for toxicity. Monitor closely.
Phenothiazines
May diminish or reverse the pressor effects of epinephrine.
Ergot-type oxytocic drugs
May cause severe persistent hypertension and possibly cerebrovascular accidents.
Tricyclic antidepressants, MAO inhibitors
May potentiate the pressor effects of epinephrine, leading to severe hypertension or cardiac arrhythmias.
Antiarrhythmic drugs (e.g., Mexiletine, Class I antiarrhythmics)
Additive cardiac effects may occur, increasing risk of cardiac depression.
Storage
Store at room temperature (20-25°C) and protect from light. Do not freeze. Discard any unused portion after opening if not a multiple-dose vial.
Overdose
Overdose can lead to systemic toxicity, including central nervous system (CNS) effects (e.g., nervousness, dizziness, seizures, respiratory depression) and cardiovascular effects (e.g., hypotension, bradycardia, cardiac arrest). Management involves supportive care, maintaining airway and ventilation, and managing seizures with benzodiazepines. Intravenous lipid emulsion therapy may be considered for severe systemic toxicity.
Pregnancy & Lactation
Pregnancy Category B. Use in pregnant women should be considered only if the clinical benefit outweighs the potential risk to the fetus. Lidocaine is excreted in breast milk in small amounts; use with caution during lactation. Epinephrine's effects are generally localized and short-lived.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months when stored under recommended conditions. Check specific product labeling for exact duration.
Availability
Available in hospitals, clinics, and pharmacies
Approval Status
Approved (DGDA)
Patent Status
Generic
WHO Essential Medicine
YesClinical Trials
Lidocaine with epinephrine has been extensively studied for its efficacy and safety in various local and regional anesthetic applications. Numerous clinical trials support its use in dentistry and minor surgical procedures.
Lab Monitoring
- Monitor vital signs (heart rate, blood pressure, respiratory rate) during and after administration.
- ECG monitoring may be necessary in high-risk patients or if systemic toxicity is suspected.
Doctor Notes
- Always aspirate prior to injection to avoid intravascular administration.
- Monitor for signs of systemic toxicity, especially in highly vascular areas.
- Exercise caution in patients with cardiovascular disease, hyperthyroidism, or severe hepatic impairment.
Patient Guidelines
- Inform your doctor about any allergies, especially to local anesthetics.
- Report any unusual symptoms such as dizziness, lightheadedness, or heart palpitations during or after the procedure.
- Follow post-procedure instructions carefully.
Missed Dose Advice
This medicine is typically administered as a single dose by a healthcare professional for a specific procedure and is not for regular dosing schedules. Therefore, a missed dose is not applicable.
Driving Precautions
This medication may cause dizziness or drowsiness. Patients should be advised to avoid driving or operating hazardous machinery until they are certain that the medication does not adversely affect their ability to perform such activities.
Lifestyle Advice
- Avoid strenuous activities immediately after the procedure if advised by your doctor.
- Ensure adequate rest.
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