Lidocaine Dosage

Generic name: lidocaine injection
Brand names: Xylocaine HCl, Xylocaine-MPF, Lidoject 1, Xylocaine Dental Cartridges, Lidoject 2,
Drug classes: Group I antiarrhythmics, Local injectable anesthetics

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  INJ (0.2%): 200 mg per 100 mL; INJ (0.4%): 400 mg per 100 mL; INJ (0.8%): 800 mg per 100 mL; INJ (1%): 10 mg per mL; INJ (1.5%): 15 mg per mL; INJ (2%): 20 mg per mL; INJ (4%): 40 mg per mL; INJ (5% hyperbaric): 50 mg per mL

Ventricular arrhythmias

[1-4 mg/min IV]

Start: 1-1.5 mg/kg/dose IV x1, may repeat dose x1 after 5min; Max: 300 mg/total bolus dose

ACLS, VF/pulseless VT

[0.5-0.75 mg/kg/dose IV/IO q5-10min prn]

Start: 1-1.5 mg/kg/dose IV/IO x1; Max: 3 mg/kg/total dose; Info: see ACLS: VF/Pulseless VT table

Local anesthesia

[infiltration]

Dose: 5-300 mg/total dose (0.5 or 1% conc.) via infiltration; Max: 4.5 mg/kg/dose, 300 mg/total dose

Regional anesthesia

[peripheral nerve block, brachial plexus]

Dose: 225-300 mg/total dose (1.5% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[peripheral nerve block, dental]

Dose: 20-100 mg/total dose (2% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[peripheral nerve block, intercostal]

Dose: 30 mg/total dose (1% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[peripheral nerve block, paravertebral]

Dose: 30-50 mg/total dose (1% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[peripheral nerve block, pudendal]

Dose: 100 mg/total dose (1% conc.) each side perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[peripheral nerve block, paracervical]

Dose: 100 mg/total dose (1% conc.) each side perineurally; Max: 4.5 mg/kg/dose, 200 mg/total dose

[sympathetic nerve block, cervical]

Dose: 50 mg/total dose (1% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[sympathetic nerve block, lumbar]

Dose: 50-100 mg/total dose (1% conc.) perineurally; Max: 4.5 mg/kg/dose, 300 mg/total dose

[caudal block]

Dose: 200-300 mg/total dose (1% or 1.5% conc. MPF) intracaudally; Max: 4.5 mg/kg/dose no more frequently than q90min, 300 mg/total dose

[central neural block]

Dose: 200-300 mg/total dose (1%, 1.5%, or 2% conc. MPF) epidurally; Max: 4.5 mg/kg/dose no more frequently than q90min, 300 mg/total dose; Info: dosing varies w/ number of dermatomes anesthetized

Spinal anesthesia

[obstetrical]

Dose: 50-75 mg (5% hyperbaric) intrathecally x1

[surgical]

Dose: 75-100 mg (5% hyperbaric) intrathecally x1

*Status epilepticus

[1 mg/kg/dose IV x1]

Info: may give 0.5 mg/kg/dose IV x1 2min after 1st dose, then 30 mcg/kg/min IV

Renal dosing

mild-moderate impairment: no adjustment; severe impairment: not defined, caution advised w/ prolonged infusion

HD/PD: not defined

Hepatic dosing

[not defined]

hepatic impairment: caution advised

Recommended Peds Dosing

Dosage forms:  INJ (0.2%): 200 mg per 100 mL; INJ (0.4%): 400 mg per 100 mL; INJ (0.8%): 800 mg per 100 mL; INJ (1%): 10 mg per mL; INJ (1.5%): 15 mg per mL; INJ (2%): 20 mg per mL; INJ (4%): 40 mg per mL; INJ (5% hyperbaric): 50 mg per mL

Ventricular arrhythmias

[20-50 mcg/kg/min IV]

Start: 1 mg/kg/dose IV x1, may repeat dose q10-15min x2 up to 3-5 mg/kg/total dose in 1st hour; Max: 20 mcg/kg/min if in shock or CHF

PALS, VF/pulseless VT

[20-50 mcg/kg/min IV]

Start: 1 mg/kg/dose IV/IO x1; Info: may repeat 1 mg/kg/dose IV/IO x1 if maint. infusion started >15min after initial bolus; see PALS: VF/Pulseless VT table

Local anesthesia

[infiltration]

Dose: dosing varies; Info: max dose varies by age and weight; use lowest effective concentration and dose

Regional anesthesia

[nerve block]

Dose: dosing varies (0.25-0.5% conc.); Max: 3 mg/kg/total dose; Info: use lowest effective concentration and dose

Spinal anesthesia

[obstetrical, 16 yo and older]

Dose: 50-75 mg (5% hyperbaric) intrathecally x1

[surgical, 16 yo and older]

Dose: 75-100 mg (5% hyperbaric) intrathecally x1

Renal dosing

mild-moderate impairment: no adjustment; severe impairment: not defined, caution advised w/ prolonged infusion

HD/PD: not defined

Hepatic dosing

[not defined]

hepatic impairment: caution advised

SRC: NLM .