Lidocaine for Mouth

1. Introduction

Lidocaine for mouth and throat is a local anaesthetic used to relieve pain, irritation, or discomfort in the oral cavity and throat. It works by blocking sodium channels, temporarily numbing the area and providing pain relief. It is commonly used for dental procedures, sore throats, and post-operative care.

2. Indications

  • Approved Indications:
    • Relief of pain and irritation in the mouth and throat.
    • Pre-procedure anaesthesia for dental or throat procedures.
    • Post-surgical pain relief (e.g., following tonsillectomy or dental extractions).
  • Off-Label Uses:
    • Pain relief for oral ulcers or stomatitis.
    • Temporary relief of sore throat associated with infections.

3. Dosage

  • Adults:
    • Gel or Viscous Solution: Apply 5–10 mL to the affected area, up to 4 times daily.
    • Spray: 2–3 sprays directed at the area, up to 4 times daily.
  • Children (≥3 years):
    • Gel or Viscous Solution: 1–5 mL applied to the affected area, up to 4 times daily.
    • Spray: 1–2 sprays directed at the area, up to 3 times daily.
  • Elderly:
    • Use the lowest effective dose, as elderly patients may have increased sensitivity to lidocaine.

4. Administration

  • Gel or Viscous Solution:
    • Apply a small amount directly to the affected area using a cotton swab or clean finger. Avoid swallowing large amounts.
  • Spray:
    • Hold the bottle upright and direct the spray at the affected area. Avoid spraying directly into the throat to prevent accidental choking or aspiration.

5. Forms Available

  • Gel: 2%, 5%.
  • Viscous solution: 2%.
  • Spray: 10% (100 mg/mL).

6. Side Effects

6.1. Common Side Effects

  • Temporary numbness in the mouth or throat.
  • Mild irritation or tingling at the application site.
  • Altered taste.

6.2. Less Common Side Effects

  • Dry mouth.
  • Mild nausea (if swallowed).

6.3. Rare but Serious Side Effects

  • Allergic reactions (e.g., rash, swelling).
  • Systemic toxicity (e.g., confusion, drowsiness, seizures) if excessive amounts are used.
  • Numbness in the throat leading to difficulty swallowing or choking.

7. Warnings

  • Swallowing Risks: Excessive use in the throat can impair the gag reflex, increasing the risk of choking or aspiration.
  • Systemic Toxicity: Overuse or ingestion of large amounts can lead to serious side effects, including seizures and cardiac arrest.
  • Allergic Reactions: Rare but possible; discontinue immediately if symptoms occur.

8. Precautions

  • Avoid eating or drinking immediately after application to prevent choking or biting injuries to the tongue or cheeks.
  • Use cautiously in children under 3 years and those with swallowing difficulties.
  • Avoid excessive or repeated use, especially in large areas or for extended durations.

9. Interactions

  • Drug-Drug Interactions:
    • Beta-blockers: May reduce lidocaine clearance, increasing toxicity.
    • CYP3A4 inhibitors (e.g., erythromycin, ketoconazole): May increase lidocaine levels.
  • Drug-Food Interactions:
    • Avoid eating or drinking immediately after application.

10. Monitoring Parameters

  • Relief of pain or irritation.
  • Signs of numbness extending beyond the application area.
  • Symptoms of systemic toxicity (e.g., confusion, drowsiness, seizures).

11. Use in Children

  • Safe for children aged ≥3 years at the recommended dose. Avoid excessive application to minimise the risk of toxicity or swallowing difficulties.

12. Use in Pregnancy

  • Category B: Generally considered safe for use in pregnancy, as systemic absorption is minimal with topical application. Use with caution.

13. Use in Elderly

  • Safe for use at recommended doses. Monitor for signs of systemic toxicity, as elderly patients may be more sensitive to lidocaine.

14. Use in Kidney Disease

  • No dose adjustments required, as systemic absorption is minimal with topical use.

15. Use in Liver Disease

  • Use cautiously in severe liver impairment, as systemic absorption may be affected.

16. Patient Counselling Points

  • Apply lidocaine as directed to the affected area. Do not exceed the recommended dose or frequency.
  • Avoid eating or drinking immediately after application to prevent choking or biting injuries.
  • Report symptoms of numbness that last longer than expected or extend beyond the application site.
  • Do not use for more than 7 days unless directed by a healthcare professional.
  • Keep out of reach of children to prevent accidental ingestion.

17. Table of Brand Names, Manufacturers, and Prices

Brand NameManufacturerPrice (USD)
Xylocaine ViscousAstraZeneca$10–20 (100 mL, 2% solution)
Lidocaine Oral GelVarious manufacturers$5–15 (30 g, 2%)
Lidocaine SprayVarious manufacturers$15–25 (50 mL, 10%)

18. FAQs (15 Questions)

  1. What is lidocaine used for in the mouth and throat?
    It is used to relieve pain, irritation, or discomfort in the oral cavity and throat.
  2. How does lidocaine work?
    It blocks nerve signals, numbing the area to reduce pain and irritation.
  3. How often can I use lidocaine gel or spray?
    It can be used up to 4 times daily or as directed by your doctor.
  4. Can I eat or drink after applying lidocaine?
    Wait at least 30 minutes after application to avoid choking or biting injuries.
  5. Is lidocaine safe for children?
    Yes, but it should be used cautiously in children ≥3 years old, following recommended doses.
  6. Can lidocaine cause side effects?
    Common side effects include temporary numbness, irritation, and altered taste.
  7. Can lidocaine be used for oral ulcers?
    Yes, it can provide temporary relief for pain caused by oral ulcers.
  8. How long does lidocaine last?
    The numbing effect typically lasts 30–60 minutes.
  9. Can lidocaine cause an allergic reaction?
    Rarely, but symptoms such as rash, swelling, or difficulty breathing should be reported immediately.
  10. Can lidocaine be swallowed?
    Swallowing small amounts is unlikely to cause harm, but large amounts may lead to toxicity.
  11. Is lidocaine safe during pregnancy?
    Yes, it is generally safe when used as directed, but consult your doctor.
  12. Can I use lidocaine with other medications?
    Yes, but consult your doctor to ensure there are no significant interactions.
  13. What should I do if I apply too much lidocaine?
    Seek medical attention immediately if symptoms like dizziness, confusion, or irregular heartbeat occur.
  14. Can lidocaine be used for sore throat?
    Yes, it can provide temporary relief for throat pain or irritation.
  15. How should lidocaine products be stored?
    Store at room temperature, away from light and moisture.