Xylocaine medicine, in the form of an ointment, acts as a local anesthetic.
How to take Xylocaine
As with any urethral anesthesia, it is recommended to use XYLOCAINE 2%, gel from the first maneuver, in order to avoid too much blood flow of the anesthetic through a mucous membrane scuffed by unsuccessful attempts.
After careful disinfection of the urinary meatus with a mild antiseptic, gently insert the end of the syringe into the meatus until it is sealed after following the instructions for handling the syringe (see section Instructions for use, handling and ‘elimination).
Slowly inject the contents of the syringe, without forcing, by simply pressing the plunger.
Place a rod forceps for 3 minutes at the level of the balano-preputial groove. The anesthesia is complete after 5 to 10 minutes.
Slowly inject a few grams of gel into the urethra by simply pressing the plunger of the syringe.
The amount of gel administered will be adapted to the weight of the child and the growth of the urethral canal. The dosage is 2 to 4 mg / kg of lidocaine hydrochloride, i.e. a gel dose of 0.1 to 0.2 g / kg of weight.
Possible side effects of Xylocaine
- Ventricular extrasystole
- Ventricular fibrillation
- Atrioventricular block
- Cardiovascular depression
- Cardiovascular collapse
- Cardiac arrest
- Arterial hypotension
- Ringing in the ears
- Involuntary muscle contraction
- Anaphylactic shock
- Reactions to amide-linked local anesthetics are rare. The occurrence of an adverse reaction should raise suspicion of an overdose. Toxic neurological or cardiovascular reactions indicating an abnormally high concentration of anesthetic in the blood may appear due to the use of too much anesthetic or in the event of particular susceptibility.
- Cardiac disorders: tachycardia, arrhythmias (ventricular premature beats, ventricular fibrillation), conduction disorder (atrial ventricular block) or depression can lead to cardiovascular collapse or cardiac arrest,
- Vascular disorders: hypertension or hypotension,
Nervous system disorders: yawning, headache, tremors, generalized convulsions (overdose)
· Psychiatric disorders: nervousness, agitation, anxiety, verbal diarrhea,
· Ear and labyrinth disorders: tinnitus,
· Eye disorders: nystagmus
· Musculoskeletal and connective tissue disorders: involuntary muscle contractions,
· Skin and mucous membranes: rash, pruritus,
· Immune system: hives, edema, bronchospasm, anaphylaxis,
· Respiratory, thoracic and mediastinal disorders: dyspnea and tachypnea,
· Gastrointestinal disorders nausea.
- Lidocaine hypersensitivity
- Amide-linked local anesthetics hypersensitivity
- Recurrent porphyria
- Uncontrolled epilepsy
· Known hypersensitivity to lidocaine hydrochloride, local anesthetics of the amide or any of the excipients
– Patients with recurrent porphyrias.
· Epilepsy not controlled by treatment.
Precautions for use of Xylocaine
- Traumatized urethral mucosa
- Inflammatory urethral mucosa
- Porphyria in remission
- Asymptomatic carrier of a mutant gene responsible for porphyria
Do not inject.
Be careful in case of traumatized or inflammatory urethral mucosa where the absorption of lidocaine may be faster and more important.
In this case a reduction in the doses used is recommended.
When combining lidocaine with other medicinal products having anti-arrhythmic properties, monitoring of the patient is necessary (see section Interactions with other medicinal products and other forms of interactions).
Lidocaine should be used with caution in patients with porphyria in remission as well as in patients with asymptomatic carriers of the mutant genes responsible for porphyria.
The attention of athletes will be drawn to the fact that this specialty contains an active principle that can induce a positive reaction to the tests carried out during doping controls.
Drugs interactions with Xylocaine
Many antiarrhythmics are depressants of cardiac automatism, conduction and contractility.
The combination of antiarrhythmic drugs from different classes can provide a beneficial therapeutic effect, but is most often very delicate, requiring close clinical monitoring and control of the ECG. The combination of antiarrhythmics giving torsades de pointes (amiodarone, disopyramide, quinidines, sotalol, etc.) is contraindicated.
The combination of antiarrhythmics of the same class is not recommended, except in exceptional cases, due to the increased risk of cardiac adverse effects.
The association with drugs having negative inotropic bradycardizing properties and / or slowing atrioventricular conduction is delicate and requires clinical monitoring and control of the ECG.
Combinations subject to precautions for use
Risk of increased plasma concentrations of lidocaine, with the possibility of neurological and cardiac adverse effects, by decrease in its hepatic metabolism by amiodarone. Clinical monitoring, ECG and possibly monitoring of plasma concentrations of lidocaine. If necessary, adjustment of the dose of lidocaine during treatment with amiodarone and after its discontinuation.
With cimetidine used at doses greater than or equal to 800 mg / day: increase in plasma concentrations of lidocaine with the risk of neurological and cardiac adverse effects (inhibition of hepatic metabolism of lidocaine). Clinical monitoring, ECG and possibly plasma concentrations of lidocaine; If necessary, dose adjustment of lidocaine during treatment with cimetidine and after its discontinuation.
The treatment of a patient showing signs of systemic toxicity consists of treating the seizures and ensuring adequate ventilation with oxygen, if necessary by assisted or controlled ventilation (breathing). In adults, when seizures occur, they should be treated promptly by intravenous injection of thiopental (2 to 4 mg / kg) or short-acting benzodiazepines (diazepam 0.1 mg / kg or midazolam 0.05 mg / kg) . Intravenous succinylcholine (50-100 mg) can be used to provide muscle relaxation provided the clinician is able to perform endotracheal intubation and manage a completely paralyzed patient.
After the seizure has stopped and adequate pulmonary ventilation is provided, no further treatment is usually necessary. However, in the event of hypotension or bradycardia, 5 to 10 mg of ephedrine will be injected intravenously and repeated if necessary after 2 to 3 minutes.
Pregnancy and breast feeding
Lidocaine can be used during pregnancy regardless of the term. Indeed, the clinical data are reassuring and the experimental data have not revealed any malformative or foetotoxic effect.
Feeding with milk
Breastfeeding is possible after local anesthesia.
Appearance and shape of Xylocaine
The gel is uncolored.
10 g in a pre-filled syringe (polypropylene / bromobutyl stopper) in a sterile container; box of 10.
|Active ingredient||Urethral gel|
|Lidocaine||2 g *|
* per unit doseActive ingredients: Lidocaine Excipients: Hypromellose , Sodium hydroxide and / or , Acid hydrochloric acid qs pH 6.2 to 6.8 , Water for injections
No excipient with known effect ? is not present in the composition of this drug
Action mechanism of Xylocaine
LOCAL ANESTHESICS, ATC Code: N01BB02.
(N: Central Nervous System)
Lidocaine belongs to the group of amide bonded anesthetics.
The pKa of lidocaine is 7.7. It is a weak base. It is bound to proteins (mainly alpha 1-glycoproteins) at about 65%.
Lidocaine is an amide-functional anesthetic that locally interrupts the spread of nerve impulses along the nerve fiber instead of application. It works by blocking voltage dependent sodium channels by attaching to receptors located near the intracellullary pole of the channel. It therefore has properties on cardiac conduction.
Other information about Xylocaine
- Pharmaceutical form: Urethral gel
- Route of administration: Urethral
- ATC code: N01BB02
- Pharmacotherapeutic group: Lidocaine
- Prescribing and dispensing conditions: Medicinal product subject to medical prescription (List II). Medicines on list II (green frame on the box) can be dispensed several times from the same prescription for 12 months, unless otherwise specified by the prescriber.
- Specialty Identifier Code (CIS): 66652284
- Actual benefit (SMR): Important
- Holder laboratory AMM: Aspen France (06/17/1994)
- Operating laboratory: Aspen france
This drug does not belong to any generic group.
- Summary of Product Characteristics (SPC) of French and European marketing authorizations (AMM)
- Drug interactions booklet from the National Agency for the Safety of Medicines and Health Products (ANSM)
- ANSM generic directory
- Reference documents from the Haute Autorité de Santé (HAS): transparency sheets, good use sheets, SAM documents (Decision Support System for Medicines)
- Prices and reimbursements from the Economic Committee for Health Products (CEPS)
- Information from laboratories holding Marketing Authorization (see above in the “Other information” tab of this page)
- Information wholesalers distributors
- Health insurance (CNAMTS): guide to long-term assignments (ALD)
- Technical Agency for Information on Hospitalization (ATIH): CIM10 classification
- World Health Organization (WHO): ATC classification
- European Pharmacopoeia: Standard Terms and EPhMRA Classification
- Ministry of Health: doping substances