lidocaine rectal

Lidocaine rectal is a local anesthetic applied on the anal area to relieve pain, itching, and burning from hemorrhoids and other anorectal conditions.

Lidocaine rectal is available over-the-counter in the form of creams and gels. Lidocaine rectal relieves pain by blocking the nerve ends from sending pain signals to the brain.

Lidocaine stabilizes the membrane of nerve cells (neurons) and inhibits the flux of sodium ions, preventing the conduction of nerve impulses to the brain. Lidocaine rectal typically takes effect one hour after application and the effect persists until one hour after the medication is removed.

• Do not use lidocaine rectal in patients with known hypersensitivity to amide type of local anesthetics, or to any of the components in lidocaine rectal
• Patients with severe liver disease are at greater risk for increased blood concentration of lidocaine from rectal application because the drug is metabolized by the liver; use with caution
• Increased absorption may occur with:
  • Application to broken or inflamed skin
  • Application to 2,000 cm² or greater of skin of an adult
  • Application to 600 cm² or greater in children 10-20 kg body weight or 100 cm² or greater in children up to 10 kg
• Extensive systemic absorption can cause high blood concentrations of lidocaine that can result in systemic side effects

Common side effects of lidocaine rectal include:

• Application site reactions such as:
  • Rash
  • Itching
  • Swelling (edema)
  • Abnormal sensation
  • Alterations in temperature sensations
  • Pallor or blanching when application for a prolonged time (longer than 2 hours)
• Systemic side effects that may occur with repeated doses or application to large surface area include:
  • Central nervous system excitation and/or depression
  • Dizziness
  • Drowsiness
  • Light-headedness
  • Nervousness
  • Anxiety
  • Euphoria
  • Confusion
  • Twitching
  • Tremors
  • Convulsions
  • Ringing in the ears (tinnitus)
  • Blurred or double vision
  • Vomiting
  • Sensations of heat, cold or numbness
  • Unconsciousness
  • Respiratory depression
  • Cardiovascular reactions including:
    • Slow heartbeat (bradycardia)
    • Low blood pressure (hypotension)
    • Cardiovascular collapse
    • Cardiac arrest

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Anorectal Cream

• 4% (H-Releve Hemorrhoidal)
• 5% (RectiCare, LMX5, Dr. Numb)

Anorectal Gel

• 5% (Topicaine 5)

Hemorrhoids or anorectal pain

Adults and children 12 years of age and above

• Apply to perianal region up to 6 times/day
• Not to be used inside the rectum

Below 12 years of age

• Safety and efficacy not established

Administration

• Not to be used inside the rectum
• When practical, clean area with soap and water, and gently pat dry before use

• Overdose from systemic absorption from lidocaine rectal is unlikely, however, it may occur with repeated doses or application to a large surface area.
• If there is a suspicion of overdose, blood concentration of lidocaine should be checked, and treated with supportive and symptomatic therapy. Seek medical help immediately.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Lidocaine rectal has no listed severe interactions with other drugs.
• Lidocaine rectal has no listed serious interactions with other drugs.
• Lidocaine rectal has no listed moderate interactions with other drugs.
• Lidocaine rectal has no listed mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information.

Check with your doctor or health care provider if you have any questions about the medication.

• Lidocaine rectal may be acceptable for use in pregnancy.
• Lidocaine rectal is excreted in breast milk with extensive systemic absorption.
• Seek advice from a health professional before using OTC drugs including lidocaine rectal, if you are pregnant or breastfeeding.

• Do not apply lidocaine rectal to eyes, ears, or mucous membranes
• In case of contact with eyes, immediately wash with water or saline and protect it until sensation returns
• Do not apply inside the rectum
• Apply on clean, dry, intact skin; applying on broken or inflamed skin can increase absorption and blood concentration of lidocaine
• Follow package directions exactly; do not apply larger or more frequent doses than recommended
• Discontinue lidocaine rectal if:
  • Allergic reaction occurs
  • Rectal bleeding occurs
  • Condition does not improve within 7 days or worsens
  • Symptoms do not subside, or clear up and return within a few days
  • Redness, irritation, swelling, pain or other symptoms develop or increase