Lidocaine (Systemic)

Class: Class Ib Antiarrhythmics
Molecular Formula: C₂₅H₂₈N₆O₃S•½C₄H₄ O₄
CAS Number: 6108-05-0

Medically reviewed by Drugs.com on Oct 20, 2021. Written by ASHP.

Introduction

Antiarrhythmic agent; an amide-type local anesthetic, class Ib agent.

Uses for Lidocaine (Systemic)

Ventricular Arrhythmias

Alternative to other antiarrhythmic drugs (e.g., amiodarone, procainamide, sotalol) for the acute treatment of life-threatening ventricular arrhythmias such as those that occur following MI or during cardiac manipulative procedures such as cardiac surgery.

Used during cardiac arrest for treatment of refractory (i.e., resistant to CPR, defibrillation, and a vasopressor [epinephrine]) VF or pulseless VT. Considered an alternative to amiodarone for this use in current ACLS guidelines in adults; in pediatric patients, current evidence supports use of either amiodarone or lidocaine.

Alternative to other antiarrhythmic agents or synchronized electrical cardioversion in the treatment of hemodynamically stable monomorphic VT; however, other agents (e.g., procainamide, sotalol, amiodarone) preferred.

Status Epilepticus

Treatment of status epilepticus†, as a last resort.

Lidocaine (Systemic) Dosage and Administration

General

Ventricular Arrhythmias

• Solutions containing epinephrine must not be used to treat arrhythmias.

• Adjust dosage carefully according to individual requirements and response; constant ECG monitoring is recommended.

• Terminate infusion as soon as the basic cardiac rhythm appears to be stable or at the earliest sign of toxicity. Immediately stop infusion if signs of excessive cardiac depression occur (e.g., prolongation of PR interval and QRS complex, appearance or aggravation of arrhythmias).

• Infusions continued for >24 hours should be rarely necessary.

Administration

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