Lidocaine Jelly is indicated for:

• Surface anesthesia of the male and female urethra
• Topical treatment of painful urethritis
• Lubrication with anesthetic effect during endotracheal intubation
• Providing adequate analgesia during endoscopic procedures

Lidocaine Jelly is a sterile, water-soluble local anesthetic preparation containing Lidocaine Hydrochloride USP. It is intended for topical or surface anesthesia. The onset of action typically occurs within 3 to 5 minutes. When applied to mucous membranes, it can be rapidly and almost completely absorbed, which may lead to systemic effects.

Lidocaine works primarily by blocking sodium influx through sodium-specific ion channels in nerve cell membranes, especially the voltage-gated sodium channels. By preventing sodium entry, action potentials cannot be generated, and nerve signal conduction is inhibited. The receptor site is believed to be on the cytoplasmic (inner) portion of the sodium channel. Lidocaine binds more effectively to sodium channels in their activated state, making neuronal blockade faster in rapidly firing neurons. This is known as state-dependent blockade.

Urethral anaesthesia:

• Surface anaesthesia of the male adult urethra: For adequate analgesia in males 400 mg is required.
• Surface anaesthesia of the female adult urethra: Instil 100–200 mg in small portions to fill the whole urethra. In order to obtain adequate anaesthesia, several minutes should be allowed prior to perform in the urological procedure.

Lubrication for endotracheal intubation: 100 mg applied on the surface of the tube just prior to insertion. Care should be taken to avoid introducing the product into the lumen of the tube.

Endoscopy: Instillation of 200–400 mg is recommended for adequate analgesia and a small amount should be applied on the instrument for lubrication. Debilitated, elderly patients and children should be given doses commensurate with their age and physical condition.

Note: The applicator is sterilized for 5 minutes in boiling water, cooled and attached to the tube. The jelly is instilled slowly as required. The applicator should be detached after each use and keep the tube tightly closed.

Lidocaine should be used with caution in patients taking antiarrhythmic drugs such as tocainide, as their toxic effects may be additive.

Lidocaine is contraindicated in patients with a known hypersensitivity to amide-type local anesthetics.

Possible adverse effects include nervousness, dizziness, blurred vision, tremors, drowsiness, seizures, unconsciousness, respiratory arrest, hypotension, myocardial depression, bradycardia, cardiac arrest, and allergic reactions such as skin rash, urticaria, and edema.

There is limited evidence regarding safety during pregnancy; however, lidocaine has been widely used without known harmful effects. It may be used during pregnancy if no safer alternative is available. Lidocaine is excreted in breast milk in very small amounts, which are unlikely to affect the infant at therapeutic doses.

Absorption from wound surfaces and mucous membranes can be relatively high, particularly in areas such as the bronchial tree. Lidocaine Jelly should therefore be used cautiously in patients with traumatized mucosa and/or infection (sepsis) at the intended site of application.

If the dose or site of administration is expected to produce elevated blood levels, Lidocaine—like other local anaesthetics—should be administered with caution in patients with epilepsy, compromised cardiac function, bradycardia, impaired liver function, and severe shock.

The application of topical anaesthetics in the oropharyngeal region may impair swallowing reflexes and thereby increase the risk of aspiration. This is especially significant in children due to their frequent eating habits. Numbness of the tongue or buccal mucosa may also raise the risk of accidental biting injuries.

Local and surface anesthetic

Store below 25°C in a dry place, protected from light.