6 mins read

Overview: Transdermal lidocaine is commonly used to relieve pain, including certain kinds of nerve pain. It works by temporarily blocking nerve signals that cause you to feel pain. The most common side effect is redness, irritation, or itching where it is applied. Serious side effects are rare, but include a serious blood disorder called methemoglobinemia.

Uses

What is transdermal lidocaine used for?

Transdermal lidocaine is commonly used to relieve pain, including certain kinds of nerve pain. 

Transdermal lidocaine may also be used for other conditions as determined by your healthcare provider.

How does transdermal lidocaine work (mechanism of action)?

Transdermal lidocaine works by temporarily blocking nerve signals that cause you to feel pain.

How is transdermal lidocaine supplied (dosage forms)?

Brands and other names

  • Lidoderm
  • Relevea
  • ZTlido

Dosage forms and strengths

  • 1.8% transdermal patch
  • 4% transdermal patch
  • 5% transdermal patch

Other forms of lidocaine are available. See Lidocaine mucous membranes and Lidocaine topical for more information.

How should I store transdermal lidocaine?

4% Transdermal Patch. Transdermal lidocaine 4% patch should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). Store in a cool, dry place. Protect from light and moisture.

1.8% and 5% Transdermal Patches. Transdermal lidocaine 5% patch should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. 

Side Effects

What are the most common side effects of transdermal lidocaine?

The most common side effects of transdermal lidocaine are application site reactions, such as redness, irritation, or itching (see below).

There may be other side effects of transdermal lidocaine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of transdermal lidocaine?

While less common, the most serious side effects of transdermal lidocaine are described below, along with what to do if they happen.

Application Site Reactions. Transdermal lidocaine may cause blisters, bruising, a burning feeling, redness, itching, swelling, peeling, or unusual sensations on the skin it is applied to. These reactions are usually mild and go away on their own in a few minutes or hours. If you notice any skin reaction while using transdermal lidocaine, take it off and wait until your skin feels normal before putting on a new patch.

Methemoglobinemia. Transdermal lidocaine can cause a serious blood disorder called methemoglobinemia. Hemoglobin is a protein that normally carries oxygen in your blood. Methemoglobinemia is when you have too much of a form of hemoglobin called methemoglobin. If you have methemoglobinemia, it is harder for your body to get oxygen to your tissues. Certain people, such as young children and those taking certain medicines, may be at higher risk of methemoglobinemia. Get help right away if you have any of the following symptoms.

  • Changes in the color of your skin, including pale, gray, or blue colored skin
  • Headache
  • Fast heartbeat
  • Shortness of breath
  • Feeling lightheaded
  • Tiredness or weakness

Severe Allergic Reactions. Transdermal lidocaine may cause allergic reactions, which can be serious. Stop using transdermal lidocaine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use transdermal lidocaine?

Allergies to Ingredients. People who are allergic to any of the following should not use transdermal lidocaine.

  • Lidoderm
  • ZTlido
  • Lidocaine
  • Any other medicine known as an amide anesthetic 
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific transdermal lidocaine products they stock.

What should I know about transdermal lidocaine before using it?

If transdermal lidocaine was prescribed to you by a healthcare provider, use it as prescribed. If you are using over-the-counter transdermal lidocaine, follow the instructions that come with the product.

Do not share transdermal lidocaine that was prescribed for you by a healthcare provider with other people, even if they have the same condition as you. It may harm them.

Transdermal lidocaine patches should only be used on unbroken skin. Do not apply a patch to skin that is irritated, scraped, cut, or burned. 

Do not wrap a patch tightly. Do not apply heat to a patch, such as with a heating pad or electric blanket. Heat may increase lidocaine levels in your body and increase your risk of side effects. 

Wash your hands well after applying or removing a patch. 

Do not allow the patch to come in contact with your eyes. If the medicine comes into contact with your eye, wash your eye with water or saline right away and protect the eye until the numbing effect has worn off.

Read the instructions that come with the patch you are using to see whether it can be worn while exercising or bathing. If you are not sure how to use the patch, talk with your pharmacist or other healthcare provider.

Do not wear a patch for longer than instructed or wear more patches than instructed. This can increase your risk for serious side effects. 

Keep transdermal lidocaine out of the reach of children. A used patch still has medicine in it, so make sure to fold it in half and throw it away properly, in a place where children and pets will not reach it. 

What should I tell my healthcare provider before using transdermal lidocaine?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if transdermal lidocaine is right for you.

In particular, make sure that you discuss any of the following.

Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems, such as an abnormal heart rate or rhythm
  • History of a blood disorder, such as methemoglobinemia 
  • A genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Lung problems 
  • Kidney problems
  • Liver problems
  • An allergy or sensitivity to any medicine known as a para-aminobenzoic acid (PABA)

Other Medicines and Supplements. Transdermal lidocaine may interact with other medicines and supplements. Before using transdermal lidocaine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how transdermal lidocaine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. Transdermal lidocaine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use transdermal lidocaine while breastfeeding.

Interactions

Does transdermal lidocaine interact with foods or drinks?

There are no known interactions between transdermal lidocaine and foods or drinks.

It is unknown if drinking alcohol will affect transdermal lidocaine.

Does transdermal lidocaine interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using transdermal lidocaine.

  • A nitrate, such as Isordil, Nitro-Dur, NitroMist, or Nitrostat, which is a medicine used to prevent chest pain caused by a type of heart disease
  • Any other local anesthetic, such as lidocaine, benzocaine, or prilocaine
  • A medicine used to treat cancer
  • A medicine used for bacterial infection
  • A medicine used to treat or prevent malaria 
  • A medicine used to manage seizures
  • Acetaminophen (Tylenol), which is a medicine used for pain or fever
  • Metoclopramide (Reglan and others), which is a medicine for certain stomach problems
  • Sulfasalazine (Azulfidine), which is a medicine used for certain inflammatory conditions, such as ulcerative colitis or rheumatoid arthritis
  • A medicine used for an irregular heart rhythm

This may not be a complete list of medicines that can interact with transdermal lidocaine. Always check with your healthcare provider.

 

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much transdermal lidocaine?

If you or someone else has used too much transdermal lidocaine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of transdermal lidocaine?

If you forgot to apply a patch, apply it as soon as you remember. If it is almost time to apply the next patch, skip the missed patch and only apply the next patch. Do not apply double or extra patches.

Look up another drug