Lidocaine transdermal patches are primarily available in three strengths: 5% (700mg per patch), 1.8% (36mg per patch), and 4%. The 5% and 1.8% formulations are prescription-based, while the 4% variant may be available in certain markets. These patches are designed for once-daily application, with a maximum of three patches applied simultaneously, and should not be worn for more than 12 hours per day. The 1.8% patch provides equivalent systemic exposure to the 5% patch, making them interchangeable in clinical practice.
Key Points Explained:
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Available Strengths and Dosage Forms
- 5% Lidocaine Patch (700mg/patch): A high-strength prescription option for localized pain relief.
- 1.8% Lidocaine Topical System (36mg/patch): A lower-strength prescription alternative with equivalent systemic exposure to the 5% patch.
- 4% Lidocaine Patch: Less commonly referenced but available in some formulations.
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Dosing Guidelines
- Frequency: Applied once daily, as needed for pain.
- Maximum Use: No more than 3 patches at a time, with a 12-hour wear time followed by a 12-hour break.
- Interchangeability: The 1.8% patch delivers the same systemic exposure as the 5% patch, allowing for flexibility in prescribing.
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Pharmacokinetics
- Absorption: Peak plasma concentration occurs at ~11 hours, with a maximum of 0.13 mcg/mL when using 3 patches.
- Metabolism: Rapidly processed by the liver into active metabolites (MEGX and GX), which have milder effects.
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Safety Considerations
- Protein Binding: 70% of lidocaine binds to plasma proteins, influencing its distribution and duration.
- Drug Interactions: Total lidocaine exposure must be monitored if combined with other local anesthetics to avoid toxicity.
These patches are widely used for localized pain management, offering controlled drug delivery with minimal systemic side effects when used as directed.
Summary Table:
| Aspect | Details |
|---|---|
| Available Strengths | 5% (700mg/patch), 1.8% (36mg/patch), 4% (market-dependent) |
| Prescription Status | 5% & 1.8%: Prescription-based; 4%: Varies by region |
| Dosing Frequency | Once daily, max 3 patches simultaneously; ≤12 hours/day |
| Interchangeability | 1.8% provides equivalent systemic exposure to 5% |
| Peak Absorption | ~11 hours; max plasma concentration: 0.13 mcg/mL (3 patches) |
| Safety Notes | 70% protein binding; monitor interactions with other local anesthetics |
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