Xylocaine with Adrenaline

Description

Xylocaine injections contain lidocaine hydrochloride as a local anesthetic, available plain or combined with adrenaline (epinephrine) to extend effects. In Pakistan, it’s used for numbing areas during medical procedures, dental work, or minor surgeries to block pain signals, with the adrenaline variant narrowing blood vessels for longer action and less bleeding. DRAP approves it for various strengths like 1% or 2%, commonly stocked in urban pharmacies in Lahore, Karachi, or rural areas, often in 10ml or 20ml vials for Rs. 50-150 depending on brand and pack.

Product Specifications

• Name: Xylocaine Injection / Xylocaine with Adrenaline.
• Generic: Lidocaine Hydrochloride; Adrenaline (Epinephrine) Acid Tartrate (in combo variant).
• Requires Prescription: Yes.
• Packaging: Ampoules or vials of 2ml, 5ml, 10ml, 20ml, or 50ml (e.g., 50 x 10ml packs for bulk).
• Price: Approximately Rs. 50-150 per 10ml vial (varies by pharmacy and brand like Xyloaid; DRAP sets max retail prices).
• Storage: Keep in a cool, dry place below 25-30°C, away from light; discard if solution is discolored or expired.

How It Functions

Lidocaine hydrochloride blocks sodium channels in nerve membranes, stopping electrical signals that carry pain to the brain, leading to temporary numbness at the injection site or nearby areas. When mixed with adrenaline, it constricts local blood vessels, slowing absorption for prolonged numbness—up to twice as long—and reducing blood flow. Chemically, lidocaine is 2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide hydrochloride; adrenaline is (R)-4-[1-hydroxy-2-(methylamino)ethyl]benzene-1,2-diol bitartrate. Effects start within minutes and last 1-3 hours plain, or 2-6 hours with adrenaline.

Dosage Information

Injected into skin, near nerves, or epidural space; dose varies by procedure, body weight, and age—typically 1-5ml of 1-2% solution for adults, max 4.5mg/kg (300mg) plain or 7mg/kg (500mg) with adrenaline in 24 hours. For children, halved or weight-based (e.g., 2-3mg/kg plain). Adrenaline variants use lower volumes for same effect. Not for IV; always administered by trained personnel in clinics or hospitals.

Side Effects

• Very Common (>1 in 10): Trembling, headache, nervousness, dizziness, blurred vision, ringing in ears.
• Common (up to 1 in 10): Nausea, vomiting, numbness, drowsiness, low blood pressure, slow heartbeat.
• Rare: Fits, unconsciousness, breathing issues, collapse, skin rash, wheezing (especially with adrenaline’s metabisulfite in some packs).

Drug Interactions

Lidocaine may interact with:

• Heart rhythm meds (e.g., amiodarone): Increases toxicity risk.
• Anti-hypertensives (e.g., beta-blockers like atenolol): Drops blood pressure further.
• Epilepsy drugs (e.g., phenytoin): Alters seizure control.
• Antidepressants (e.g., MAOIs): Heightens side effects.
• Cimetidine: Slows lidocaine breakdown.
• Diuretics or caffeine: Worsens heart effects with adrenaline.

Indications

Approved for local anesthesia in procedures like dental extractions, minor surgeries, epidurals for labor, or numbing during stitches, easing pain by blocking nerve signals in targeted areas.

When Not to Use

Avoid if allergic to lidocaine, adrenaline, or ingredients like sodium metabisulfite. Not for patients with severe heart block, uncontrolled epilepsy, or blood poisoning. Adrenaline variant skips in uncontrolled hypertension or hyperthyroidism.

Precautions

• Check for allergies; test dose if history of reactions.
• Monitor if pregnant/breastfeeding—passes in small amounts but generally low risk; consult for labor use.
• Adjust dose for liver/kidney issues, diabetes, thyroid problems, or blood clotting disorders.
• Avoid in infected skin areas; watch for overdose signs like twitching.
• In hot climates or fasting, stay hydrated to prevent low BP.
• Buy DRAP-registered packs; check for holograms against fakes common in markets.

Warnings

• Heart/circulation problems: May cause irregular beats or pressure drops.
• Nerve issues (e.g., epilepsy): Risk of fits if dose high.
• Overdose: Sight/hearing changes, stiffness—equipment needed for reversal.
• Adrenaline: Can trigger asthma episodes or severe reactions in sulfite-sensitive.
• Driving: Delays reflexes post-injection.

Additional Notes

• Pregnancy Category: Consult physician; used widely in childbirth with minimal baby effects.
• Availability: Common in pharmacies nationwide, with shortages during high demand; generics like Xyloaid available.
• Reporting: Log batch for side effects; report to DRAP via app or hotline for monitoring.

Doctor Review

Dentists and surgeons in Pakistan highlight Xylocaine’s reliability for quick numbing in dental work or ortho procedures, with the adrenaline mix cutting bleed in pollution-aggravated cases in cities like Karachi. DRAP studies note its safety in hypertensives when monitored, but flag heart risks if doses aren’t tailored.

Disclaimer

This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance.