Lidoderm (Lidocaine) - Topical

What Is Lidoderm?

Lidoderm (lidocaine) is a topical medication used on different surfaces of the body to relieve pain and itching from certain conditions. It belongs to a class of medication known as local anesthetics.

Lidocaine works by blocking pain signals sent by nerves, causing a temporary loss of feeling in the area applied.

Lidocaine is available in various forms. Lidoderm is a prescription-only transdermal patch (lidocaine patch 5%) often used to treat pain from post-herpetic neuralgia, a chronic complication of shingles. Lidocaine is also available by prescription and over-the-counter (OTC) under several other brand names and as a generic. Other forms include topical gel, ointment, and viscous solution.

Drug Facts

Generic Name: Lidocaine

Brand Name(s): Lidoderm, Glydo, Laryng-O-Jet Kit, Lidocaine Viscous, Ztlido, others

Drug Availability: Prescription, over-the-counter (OTC)

Administration Route: Topical

Therapeutic Classification: Analgesic, local anesthetic

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Lidocaine

Dosage Form(s): Patch, ointment, cream, gel, spray, viscous solution

What Is Lidoderm Used For?

Prescription Lidoterm (lidocaine 5%) patches are used to treat pain from post-herpetic neuralgia (PHN), or lasting pain from shingles. PHN is a complication from shingles that can cause burning, stabbing, or aching pains that can last for months or years after infection.

Other lidocaine products include:

  • Prescription lidocaine viscous, a solution formulation of the drug, is used to treat a sore or irritated mouth and throat associated with cancer chemotherapy or medical procedures. It is also sometimes used to reduce gagging during dental X-rays or impressions.
  • Other prescription lidocaine products (e.g., sprays, creams, jelly) can help prevent and treat pain during certain medical procedures.
  • OTC lidocaine forms such as patches, creams, and ointments can help relieve minor pain and itches from certain conditions, such as scrapes, minor burns, and insect bites. These products may come in patches, creams, ointments, sprays, or jelly formulations.

How to Use Lidoderm

Lidoderm is available as a transdermal patch. The patch should only be applied to normal intact skin. Do not apply to skin that is broken or irritated.

Lidocaine Transdermal Patch

For Lidoderm, apply the prescribed number of patches as directed by your healthcare provider, usually once a day, to the most painful area on your skin. Typically, the patch may be left on the skin for up to eight or 12 hours. If a smaller patch is needed, it may be cut with scissors before the liner is removed. For complete instructions, be sure to read and follow all directions on the product package before using this medication.

The OTC transdermal lidocaine comes as a 4% lidocaine patch. Apply this patch to the skin up to three times a day for eight hours. Make sure to apply the patch to clean, dry, and intact skin in an area that won't be rubbed against by tight clothing. Like the prescription version, you can cut the patches into smaller sizes using scissors if needed.

Lidocaine Viscous Solution

Shake the liquid well before applying. You will usually use this as needed, but don't apply it more frequently than every three hours. Adults should not exceed eight doses in 24 hours, and children under 3 years should not exceed four doses in 12 hours. Doses for infants and children under 3 years should be measured with a proper measuring device. The medication can be applied to the affected area with a cotton-tipped applicator.

The lidocaine solution formulation can be used in the following ways:

  • Sore or irritated mouth: Place the dose in your mouth and swish it until the pain lessens. Spit out.
  • Sore throat: Gargle the correct dose of the liquid and swallow it. Try to use the minimum amount needed to relieve pain.

Lidocaine Ointment or Cream

For minor skin conditions, apply a thin layer of lidocaine ointment or cream to the affected area. You can use a sterile gauze pad to apply to broken skin tissue. Follow the instructions on the packaging for how often you can use the product.

Other lidocaine products may be used differently. Always read the product's label for directions of use. In general, you should always apply lidocaine to the surface of intact skin. Wash your hands before applying any form of medication. Side effects can be directly related to the amount applied, so be careful how much is used.

Storage

Store the carton of patches at 77 F. Do not store the patches outside of the sealed envelope. After use, fold the patches so that the adhesive sticks to itself and discard used patches out of reach of children and pets.

Store other forms (e.g., cream, ointment, jelly) at room temperature (68 F to 77 F).

What Are the Side Effects of Lidoderm?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects with Lidoderm are application site reactions, such as:

  • Skin irritation
  • Redness
  • Blisters 
  • Skin peeling
  • Itchiness

If any of these side effects don’t go away or become more severe, talk to your healthcare provider or pharmacist.

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Severe allergic reactions: Symptoms may include trouble breathing, hives, or swelling of the tongue, lips, mouth, or throat.
  • Methemoglobinemia: Although rare, symptoms of this condition may include pale, gray, or blue-colored skin, headache, lightheadedness, tiredness, shortness of breath, and rapid heart rate.

Report Side Effects

Lidoderm may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much of Lidoderm Should I Use?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (ointment):
    • For pain and itching caused by minor skin conditions:
      • Adults—Apply to the affected area 3 or 4 times a day. The largest amount of ointment that should be used in a single application is 5 grams. If you use the 5% ointment, this is about 6 inches of ointment from the tube.
      • Children—Dose is based on body weight and must be determined by your doctor.
  • For topical dosage form (skin patch):
    • For pain caused by shingles:
      • Adults—Apply 1 to 3 patches to the painful area for up to 12 hours each day.
      • Children—Use and dose must be determined by your doctor.
  • For topical dosage form (solution):
    • For treatment of irritated or sore mouth or throat:
      • Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 15 milliliters (mL) tablespoonful every 3 hours. Your doctor may adjust your dose as needed. Do not use more than 8 doses in a 24-hour period.
      • Children 3 years of age and older—Dose is based on body weight and must be determined by your doctor.
      • Children younger than 3 years of age—Dose is based on body weight and must be determined by your doctor. The dose should be no more than 1.2 mL applied to the immediate area with a cotton-tipped swab. Wait at least 3 hours between doses, and do not use more than 4 doses in a 12-hour period.

Missed Dose

Since lidocaine is usually used as needed, apply your missed patch or topical form as soon as you remember. If it is almost time for the next dose, skip the missed one and continue with your regular schedule. Do not apply more than one patch to make up for a missed dose. Doing so can increase your risk for side effects.

Overdose: What Happens If I Take Too Much Lidoderm?

Lidoderm overdose through skin absorption is rare, but it still can occur. Contact your healthcare provider if a lidocaine overdose or toxicity is suspected. Call the Poison Control Center or 911 is lidocaine if accidentally orally ingested.

What Happens If I Overdose on Lidoderm?

If you think you or someone else may have overdosed on Lidoderm, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after using Lidoderm, call 911 immediately.

Precautions

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It is very important that your doctor check you or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Make sure you store this medicine out of reach of children. Call your doctor right away if you or your child has pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Check with your doctor right away if you have a rash, burning, stinging, swelling, or irritation of your skin after using this medicine.

After applying this medicine to the skin of your child, watch the child carefully to make sure that he or she does not get any of the medicine into their eyes or mouth. Lidocaine can cause serious side effects, especially in children, if it gets into the mouth and is swallowed.

If you are using the viscous topical solution medicine in the mouth or throat, be aware of signs of toxicity. If you or your child experiences unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness, shallow breathing, or seizures after use of this medication, seek immediate medical attention and do not give any more doses.

If you are using this medicine in the mouth or throat, do not eat or drink anything for at least 1 hour after using it. When this medicine is applied to these areas, it may cause swallowing and choking problems. Do not chew gum or food while your mouth or throat feels numb after you use this medicine. You may accidentally bite your tongue or the inside of your cheeks.

Heat can cause the lidocaine in the patch to be absorbed into your body faster. This may increase the chance of serious side effects or an overdose. While you are using this medicine, do not use a heating pad, electric blanket, heat or tanning lamps, sauna, a sunlamp, or a heated water bed. Do not sunbathe. However, you may apply Ztlido® patch on the skin after exposure to moderate heat (eg, after 15 minutes of heating pad use on a medium setting).

Do not use cosmetics or other skin care products on the treated skin areas.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Lidoderm?

There are a few reasons lidocaine may not be the right medication for you.

Allergy

A person should not take lidocaine if they are allergic to the ingredients.

Non-Intact Skin

Application of Lidoderm on broken or inflamed areas of skin may cause increased levels of lidocaine in your body. Lidoderm is only recommended for use on intact skin. For certain lidocaine dosage forms (e.g., cream, ointment), you may use a sterile gauze pad to apply the medication to broken skin.

Heat Sources

Using of heating pads or electric blankets over Lidoderm patches is not recommended, as it may cause increased levels of lidocaine in your body. You can, however, apply lidocaine 15 minutes after moderate heat exposure.

Eye Exposure

Avoid Lidoderm contact with your eyes, as this may cause severe irritation. If eye contact does occur, immediately wash out eye(s) with water.

Pregnancy

Lidoderm should only be used during pregnancy if the benefits outweigh the risks. It is best to talk to your healthcare provider if you are pregnant or plan to become pregnant, so they can decide the best option for you.

Breastfeeding

Lidocaine concentrations in breast milk are low and it is not expected to cause any adverse effects in breastfed infants.

Other Health Conditions

In certain individuals, the body may handle lidocaine differently. A person should inform their healthcare provider if they have or have ever had:

  • Heart, lung, or liver disease
  • An inherited blood disorder called glucose-6-phosphate dehydrogenase (G-6PD) deficiency
  • Methemoglobinemia

What Other Medications Interact With Lidoderm?

Class I antiarrhythmic medications, mexiletine, can cause an increased risk of side effects when taken with Lidoderm. This is because lidocaine is a class 1B antiarrhythmic, and so it is chemically and pharmacologically similar to other medications in this class.

Additionally, the following medications may increase the risk of developing methemoglobinemia when used with Lidoderm:

  • Nitrates, such as nitroglycerin 
  • Local anesthetics, such as benzocaine
  • Antineoplastics, such as hydroxyurea
  • Antibiotics, such as nitrofurantoin
  • Anticonvulsants, such as Dilantin (phenytoin)
  • Acetaminophen
  • Reglan, Gimoti (metoclopramide)
  • Qualaquin (quinine)
  • Azulfidine (sulfasalazine)

This list does not include all drugs that can interact with Lidoderm. Before taking Lidoderm, be sure to tell your healthcare provider about all of the prescription and OTC medications, vitamins, supplements, or herbs you are taking. This will help you avoid potential interactions.

What Medications Are Similar?

Lidoderm is the only prescription lidocaine patch available for pain associated with PHN and shingles.

Additionally, several prescription and OTC topical products also contain lidocaine, including OTC patches, creams, ointments, and sprays. While these come in various dosage forms and have different uses, they are all local anesthetics.

Examples of other topical local anesthetics for various uses include but are not limited to:

  • Lidocaine and tetracaine, which is a combination product used topically to induce local analgesia on the skin for dermatological procedures
  • Benzocaine, used for pain and itching relief associated with minor burns, sunburn, scrapes, insect bites, and other minor skin irritations
  • Procaine, used locally for anesthesia, peripheral nerve block, and spinal nerve block
  • Lidocaine and prilocaine, a combination analgesic used to prevent and treat pain for superficial minor medical procedures

This is not a list of drugs to take with Lidoderm. Moreover, the above-listed medications all belong to the same drug class as Lidoderm, but have different uses and dosage forms. Consult your healthcare provider on which analgesic product is best for you and your needs.

Frequently Asked Questions

  • What is Lidoderm used for?

    Lidoderm is part of a class of medications known as local anesthetics. It helps with pain relief by causing a temporary loss of feeling in the area it is applied. It is often used to treat pain from post-herpetic neuralgia or lasting pain in areas of your skin where you had shingles.

  • What are the side effects of Lidoderm?

    The most common side effects are application site reactions such as redness, irritation, or blistering. However, Lidoderm also has the potential for serious side effects such as an allergic reaction or, more rarely, methemoglobinemia. Call your healthcare provider immediately if you are experiencing any serious side effects. Call 911 if you are experiencing a medical emergency.

  • Can you cut Lidoderm patches?

    Yes, you can cut Lidoderm patches into smaller sizes if needed. Lidoderm comes as a transdermal patch. If necessary, it may be cut with scissors before the liner is removed. For complete instructions, be sure to read and follow all directions on the product package before using this medication.

How Can I Stay Healthy While Taking Lidoderm?

Lidoderm is a safe and effective medication when used correctly. This drug is often used to treat PHN or lasting pain in areas of your skin where you had shingles.

While Lidoderm does have the potential for more severe side effects, more common adverse reactions are milder. Those tend to include skin irritation, redness, or peeling at the application sites. Make sure to use this medication exactly as instructed to prevent side effects.

If you are prescribed Lidoderm, you are likely dealing with the frustrating complications of shingles. Call your healthcare provider if your pain lasts longer than seven days or worsens. In addition to prescribed medication, try pain-relieving strategies like ice packs, massages, warm baths, and avoiding triggers that may exacerbate symptoms.

If you are looking for a topical pain reliever, lidocaine comes in various dosage forms and availability for different uses. It's best to speak with your healthcare provider about which product might be appropriate for you.

Share your current medication use (both prescription and OTC) with your healthcare provider, as Lidoderm has the potential to interact with certain medications.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kaylea Swearingen, PharmD
Kaylea Swearingen is a registered pharmacist and health and wellness writer.