II. Indications

  1. Postherpetic Neuralgia (or other localized peripheral neuropathic pain)
  2. Other localized pain (e.g. Musculoskeletal Low Back Pain)

III. Contraindications

  1. Avoid in severe liver disease (higher toxicity risk)

IV. Precautions

  1. Avoid measures that increase systemic absorption, toxicity (e.g. LAST Reaction, Seizures, Arrhythmia)
    1. Do NOT use under Occlusion (e.g. overlying dressing)
    2. Limit application to unbroken skin only
    3. Do not apply with heat (e.g. electric blanket)

V. Medications

  1. Lidocaine 5% Patch (prescription $7/patch, Lidoderm)
  2. Lidocaine 4% Patch (OTC $2/patch, Lidocare, Icy Hot)

VI. Dosing

  1. Apply one patch to affected area for no more than 12 hours
  2. Remove patch, and maintain 12 hours free of Lidocaine before applying the next patch
  3. Apply a new patch for 12 of every 24 hours as needed

VII. Adverse Effects

  1. Application site reactions (e.g. Contact Dermatitis)
  2. Allergic Reaction (rare)
  3. Systemic toxicity if significant absorption (see precautions above)
    1. See Lidocaine
    2. See LAST Reaction

VIII. Safety

  1. Pregnancy category B
  2. Unknown safety in Lactation

X. References

  1. (2017) Presc Lett 24(11):13

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Cost: Medications

lidoderm (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LIDODERM 5% PATCH Generic $1.78 each