Table of ContentsView AllTable of ContentsHow Lidocaine WorksCausesSymptomsDiagnosisTreatmentComplications
Table of ContentsView All
View All
Table of Contents
How Lidocaine Works
Causes
Symptoms
Diagnosis
Treatment
Complications
Lidocaine is a medicine that blockspain signals.While it has benefit for some conditions and medical procedures that cause pain, it can have toxic effects throughout the body if too much is used.
Though uncommon, a lidocaine overdose can occur if a healthcare provider injects too much or if your skin absorbs more of the drug than is safe while using a pain patch. Symptoms ranging from dizziness and blurred vision to paranoia, seizures, and slowed heart rate can occur.
In some cases, lidocaine overdose can be a life-threatening medical emergency.
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This article talks about how lidocaine overdose happens, the signs and symptoms of lidocaine toxicity, and what to do if you think you’ve received or taken too much lidocaine.
Lidocaine (also called Xylocaine) is a medication that blocks pain signals in the body to help reduce pain. The medication can be injected into tissues or absorbed through the skin with a patch. It can work on one specific part of the body (localized) or throughout the whole body (systemic).
Lidocaine is commonly used to numb the mouth for dental procedures. It can also be used as a pain reliever for certain medical conditions.
Lidocaine can be an option for people who do not want to use other types of pain medications that carry the risk of misuse or have mind-altering effects.That said, lidocaine does have risks.
The higher the dosage used for pain control, the more likely a person is to have side effects or even overdose.
Causes of Lidocaine Overdose
When a lidocaine overdose happens, it’s usually because of accidental injection of too much lidocaine during numbing or pain reduction procedures. The inappropriate use or overuse of lidocaine dermal patches can also lead to an overdose.
Lidocaine is chemically similar to the drug cocaine.Sometimes, lidocaine is used to “cut” cocaine, which can make the drug even more dangerous.If people use both substances at the same time, they are more likely to experience an overdose.
Symptoms of Lidocaine Overdose
Lidocaine overdose symptoms can include:
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How Lidocaine Overdose Is Diagnosed
There is a blood test that can show the level of lidocaine in the blood. However, it usually isn’t helpful because it takes too long for the results to come back and a person who has possibly overdosed on lidocaine needs to be treated as soon as possible.
Usually, just having symptoms after using lidocaine is enough for a provider to diagnose a lidocaine overdose.
However, lidocaine overdose from slower-acting administration of the drug, like dermal patches, is harder to diagnose. That’s why it’s very important that you tell your provider what type of lidocaine you were using (specifically, that you were using a patch).
Treatment for Lidocaine Overdose
Lidocaine overdose treatment depends on the symptoms you’re having.
To help reverse an overdose of lidocaine, emergency medications such as benzodiazepines and injectable lipids may be administered.
Patients with cardiac arrhythmias are at risk forcardiac arrest. If it happens, they will need to be resuscitated using advanced cardiovascular life support (ACLS). In some cases, this process may take longer than usual.
If lidocaine is accidentally injected into the veins during local numbing procedures, it can lead to severe cardiovascular reactions, including low blood pressure (hypotension),heart failure, and life-threatening problems with the heartbeat (arrhythmias) such as:
In severe cases, lidocaine overdose can be fatal.
Summary
If you are using lidocaine to treat pain, it’s important that you follow your healthcare provider’s instructions for taking it.
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13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wishart DS, Feunang YD, Guo AC, et al.DrugBank 5.0: a major update to the DrugBank database for 2018.Nucleic Acids Res. 2018;46(D1):D1074-D1082. doi:10.1093/nar/gkx1037Open Anesthesia.Lidocaine toxicity.Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444El-Boghdadly K, Chin KJ.Local anesthetic systemic toxicity: Continuing professional development.Can J Anaesth. 2016;63(3):330-349. doi:10.1007/s12630-015-0564-zLirk P, Picardi S, Hollmann MW.Local anaesthetics: 10 essentials.Eur J Anaesthesiol. 2014;31(11):575-585. doi:10.1097/EJA.0000000000000137Poison Control.Lidocaine can cause harmful effects.Wildsmith JAW, Jansson JR.From cocaine to lidocaine.Eur J Anaesthesiol. 2015;32(3):143-146. doi:10.1097/eja.0000000000000168Government of New South Wales.Cocaine found to contain heroin and large amounts of lidocaine.Kim E, Murray BP, Salehi M, et al.Does lidocaine cause false positive results on cocaine urine drug screen?.J Med Toxicol. 2019;15(4):255-261. doi:10.1007/s13181-019-00720-3Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444Mittal S, Mohan A, Madan K.Ventricular tachycardia and cardiovascular collapse following flexible bronchoscopy: Lidocaine cardiotoxicity.J Bronchol Interv Pulmonol.2018;25(2):e24-e26. doi:10.1097/lbr.0000000000000448Vasques F, Behr AU, Weinberg G, Ori C, Di Gregorio G.A review of local anesthetic systemic toxicity cases since publication of the American Society of Regional Anesthesia Recommendations: To whom it may concern.Reg Anesth Pain Med. 2015;40(6):698-705. doi:10.1097/AAP.0000000000000320Ok SH, Hong JM, Lee SH, Sohn JT.Lipid emulsion for treating local anesthetic systemic toxicity.Int J Med Sci. 2018;15(7):713-722. doi:10.7150/ijms.22643
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wishart DS, Feunang YD, Guo AC, et al.DrugBank 5.0: a major update to the DrugBank database for 2018.Nucleic Acids Res. 2018;46(D1):D1074-D1082. doi:10.1093/nar/gkx1037Open Anesthesia.Lidocaine toxicity.Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444El-Boghdadly K, Chin KJ.Local anesthetic systemic toxicity: Continuing professional development.Can J Anaesth. 2016;63(3):330-349. doi:10.1007/s12630-015-0564-zLirk P, Picardi S, Hollmann MW.Local anaesthetics: 10 essentials.Eur J Anaesthesiol. 2014;31(11):575-585. doi:10.1097/EJA.0000000000000137Poison Control.Lidocaine can cause harmful effects.Wildsmith JAW, Jansson JR.From cocaine to lidocaine.Eur J Anaesthesiol. 2015;32(3):143-146. doi:10.1097/eja.0000000000000168Government of New South Wales.Cocaine found to contain heroin and large amounts of lidocaine.Kim E, Murray BP, Salehi M, et al.Does lidocaine cause false positive results on cocaine urine drug screen?.J Med Toxicol. 2019;15(4):255-261. doi:10.1007/s13181-019-00720-3Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444Mittal S, Mohan A, Madan K.Ventricular tachycardia and cardiovascular collapse following flexible bronchoscopy: Lidocaine cardiotoxicity.J Bronchol Interv Pulmonol.2018;25(2):e24-e26. doi:10.1097/lbr.0000000000000448Vasques F, Behr AU, Weinberg G, Ori C, Di Gregorio G.A review of local anesthetic systemic toxicity cases since publication of the American Society of Regional Anesthesia Recommendations: To whom it may concern.Reg Anesth Pain Med. 2015;40(6):698-705. doi:10.1097/AAP.0000000000000320Ok SH, Hong JM, Lee SH, Sohn JT.Lipid emulsion for treating local anesthetic systemic toxicity.Int J Med Sci. 2018;15(7):713-722. doi:10.7150/ijms.22643
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wishart DS, Feunang YD, Guo AC, et al.DrugBank 5.0: a major update to the DrugBank database for 2018.Nucleic Acids Res. 2018;46(D1):D1074-D1082. doi:10.1093/nar/gkx1037Open Anesthesia.Lidocaine toxicity.Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444El-Boghdadly K, Chin KJ.Local anesthetic systemic toxicity: Continuing professional development.Can J Anaesth. 2016;63(3):330-349. doi:10.1007/s12630-015-0564-zLirk P, Picardi S, Hollmann MW.Local anaesthetics: 10 essentials.Eur J Anaesthesiol. 2014;31(11):575-585. doi:10.1097/EJA.0000000000000137Poison Control.Lidocaine can cause harmful effects.Wildsmith JAW, Jansson JR.From cocaine to lidocaine.Eur J Anaesthesiol. 2015;32(3):143-146. doi:10.1097/eja.0000000000000168Government of New South Wales.Cocaine found to contain heroin and large amounts of lidocaine.Kim E, Murray BP, Salehi M, et al.Does lidocaine cause false positive results on cocaine urine drug screen?.J Med Toxicol. 2019;15(4):255-261. doi:10.1007/s13181-019-00720-3Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444Mittal S, Mohan A, Madan K.Ventricular tachycardia and cardiovascular collapse following flexible bronchoscopy: Lidocaine cardiotoxicity.J Bronchol Interv Pulmonol.2018;25(2):e24-e26. doi:10.1097/lbr.0000000000000448Vasques F, Behr AU, Weinberg G, Ori C, Di Gregorio G.A review of local anesthetic systemic toxicity cases since publication of the American Society of Regional Anesthesia Recommendations: To whom it may concern.Reg Anesth Pain Med. 2015;40(6):698-705. doi:10.1097/AAP.0000000000000320Ok SH, Hong JM, Lee SH, Sohn JT.Lipid emulsion for treating local anesthetic systemic toxicity.Int J Med Sci. 2018;15(7):713-722. doi:10.7150/ijms.22643
Wishart DS, Feunang YD, Guo AC, et al.DrugBank 5.0: a major update to the DrugBank database for 2018.Nucleic Acids Res. 2018;46(D1):D1074-D1082. doi:10.1093/nar/gkx1037
Open Anesthesia.Lidocaine toxicity.
Golzari SE, Soleimanpour H, Mahmoodpoor A, Safari S, Ala A.Lidocaine and pain management in the emergency department: a review article.Anesth Pain Med. 2014;4(1):e15444. doi:10.5812/aapm.15444
El-Boghdadly K, Chin KJ.Local anesthetic systemic toxicity: Continuing professional development.Can J Anaesth. 2016;63(3):330-349. doi:10.1007/s12630-015-0564-z
Lirk P, Picardi S, Hollmann MW.Local anaesthetics: 10 essentials.Eur J Anaesthesiol. 2014;31(11):575-585. doi:10.1097/EJA.0000000000000137
Poison Control.Lidocaine can cause harmful effects.
Wildsmith JAW, Jansson JR.From cocaine to lidocaine.Eur J Anaesthesiol. 2015;32(3):143-146. doi:10.1097/eja.0000000000000168
Government of New South Wales.Cocaine found to contain heroin and large amounts of lidocaine.
Kim E, Murray BP, Salehi M, et al.Does lidocaine cause false positive results on cocaine urine drug screen?.J Med Toxicol. 2019;15(4):255-261. doi:10.1007/s13181-019-00720-3
Mittal S, Mohan A, Madan K.Ventricular tachycardia and cardiovascular collapse following flexible bronchoscopy: Lidocaine cardiotoxicity.J Bronchol Interv Pulmonol.2018;25(2):e24-e26. doi:10.1097/lbr.0000000000000448
Vasques F, Behr AU, Weinberg G, Ori C, Di Gregorio G.A review of local anesthetic systemic toxicity cases since publication of the American Society of Regional Anesthesia Recommendations: To whom it may concern.Reg Anesth Pain Med. 2015;40(6):698-705. doi:10.1097/AAP.0000000000000320
Ok SH, Hong JM, Lee SH, Sohn JT.Lipid emulsion for treating local anesthetic systemic toxicity.Int J Med Sci. 2018;15(7):713-722. doi:10.7150/ijms.22643
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