Side Effects of Lidoderm (lidocaine)

Lidoderm (lidocaine) is an amide-type, local anesthetic medication available in a patch form prescribed for relief of pain associated with postherpetic neuralgia. Lidocaine, like other local anesthetics causes a loss of sensation by reducing the flow of sodium in and out nerves to decrease the initiation and transfer of nerve signals. 

Common side effects of Lidoderm include

• application site reactions (local burning, bruising, blisters, itching, irritation),
• lightheadedness,
• dizziness,
• nausea,
• nervousness,
• blurred vision, and
• low blood pressure.

Serious side effects of Lidoderm include

• severe application site reactions (burning, stinging, irritation, swelling, or redness),
• sudden dizziness or drowsiness after medicine is applied,
• confusion,
• blurred vision,
• ringing in your ears, and
• unusual sensations of temperature.

Drug interactions of Lidoderm include anti-arrhythmia medications like amiodarone, propafenone, sotalol, tocainide, and mexiletine because such combinations can affect heart rate and rhythm and cause other additive side effects. 

There are no adequate studies done on Lidoderm patches to determine safe and effective use in pregnant women.

Lidocaine may enter breast milk in trace amounts; therefore, it is best to be cautious before using it in breastfeeding mothers.

Common side effects of lidocaine patches include:

• local burning,
• bruising,
• blisters,
• itching,
• irritation,
• lightheadedness,
• dizziness,
• nausea,
• nervousness,
• blurred vision, and
• low blood pressure.

Application Site Reactions

• During or immediately after treatment with Lidoderm (lidocaine patch 5%), the skin at the site of application may develop blisters, bruising, burning sensation, depigmentation, dermatitis, discoloration, edema, erythema, exfoliation, irritation, papules, petechia, pruritus, vesicles, or may be the locus of abnormal sensation.
• These reactions are generally mild and transient, resolving spontaneously within a few minutes to hours.

Allergic Reactions

• Allergic and anaphylactoid reactions associated with lidocaine, although rare, can occur.
• They are characterized by angioedema, bronchospasm, dermatitis, dyspnea, hypersensitivity, laryngospasm, pruritus, shock, and urticaria.
• If they occur, they should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value.

Other Adverse Events

• Due to the nature and limitation of spontaneous reports in postmarketing surveillance, causality has not been established for additional reported adverse events including:
• Asthenia, confusion, disorientation, dizziness, headache, hyperesthesia, hypoesthesia, lightheadedness, metallic taste, nausea, nervousness, pain exacerbated, paresthesia, somnolence, taste alteration, vomiting, visual disturbances such as blurred vision, flushing, tinnitus, and tremor.

Systemic (Dose-Related) Reactions

• Systemic adverse reactions following appropriate use of Lidoderm are unlikely, due to the small dose absorbed. Systemic adverse effects of lidocaine are similar in nature to those observed with other amide local anesthetic agents, including CNS excitation and/or depression (light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest).
• Excitatory CNS reactions may be brief or not occur at all, in which case the first manifestation may be drowsiness merging into unconsciousness. Cardiovascular manifestations may include bradycardia, hypotension and cardiovascular collapse leading to arrest.

Antiarrhythmic Drugs

• Lidoderm should be used with caution in patients receiving Class I antiarrhythmic drugs (such as tocainide and mexiletine) since the toxic effects are additive and potentially synergistic.

Local Anesthetics

• When Lidoderm is used concomitantly with other products containing local anesthetic agents, the amount absorbed from all formulations must be considered.