Patient Medication Information: uses, side effects, how to take - Lidocaine Hydrochloride and Epinephrine Injection USP (Pfizer Canada)
What LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP is used for:
Lidocaine Hydrochloride and Epinephrine Injection USP is used to anesthetize part of the body for surgical operations and also for pain relief and can be used:
- To numb the area of the body where surgery is to be performed;
- To provide pain relief in labour and after surgery.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP should be used with caution in children younger than 2 years of age.
How LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP works:
Lidocaine Hydrochloride and Epinephrine Injection USP acts by preventing the nerves in the injected area from transmitting sensations of pain, heat or cold. However, you may still experience sensations such as pressure and touch. In this way, the nerve(s) is numbed in the part of the body, which will be subjected to surgery. In many cases this means that the nerves to the muscles in the area will also be blocked, causing temporary weakness or paralysis.
The ingredients in LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP are:
Medicinal ingredient(s): lidocaine hydrochloride and epinephrine
Non-medicinal ingredients: Citric acid, Methylparaben for multi-dose vials only, Sodium chloride, Sodium hydroxide and/or hydrochloric acid, Sodium metabisulfite, Water for injection.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP comes in the following dosage form(s):
Sterile solutions of 1 % and 2 % lidocaine hydrochloride with epinephrine contain:
-Lidocaine hydrochloride 10 mg/mL and epinephrine 0.01 mg/mL: 20 mL in multidose vials;
-Lidocaine hydrochloride 20 mg/mL and epinephrine 0.01 mg/mL: 20 mL in multidose vials; and
-Lidocaine hydrochloride 20 mg/mL and epinephrine 0.005 mg/mL: 20 mL in single-use vials
Do not use LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP if:
- you are allergic to lidocaine, any other “-caine”type anesthetics, or any of the non-medicinal ingredients in the product;
- you are allergic to sodium metabisulfite;
- you are allergic to methylparaben (preservative used in some solutions) or PABA.
Lidocaine Hydrochloride and Epinephrine Injection USP containing methylparaben should not be used for epidural or spinal anesthesia.
Because of the potential for irreversible joint damage, pain following joint surgery should not be managed by infusing Lidocaine Hydrochloride and Epinephrine Injection USP into the joint (i.e., by use of a post-operative “pain pump”).
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP. Talk about any health conditions or problems you may have, including if you:
- have now or have had health problems in the past;
- are taking other medicines, including ones you can buy without a prescription;
- if you are taking other medicines such as drugs used to treat irregular heart activity (anti-arrhythmics) or other heart problems such as heart block;
- think you may be allergic or sensitive to any ingredients in Lidocaine Hydrochloride and Epinephrine Injection USP (see above). Sodium metabisulfite might cause allergic reactions (e.g., facial swelling and respiratory difficulties) in susceptible people, especially those with a history of asthma or allergy;
- are allergic to any other drugs, including any other local anesthetics;
- have a severe heart, kidney or liver disease;
- have inflammation and/or sepsis in the region of the injection;
- have sepsis;
- have neurological disease, spinal deformities, septicemia and severe high blood pressure (in case of lumbar and caudal epidural anesthesia);
- have poorly controlled hyperthyroidism and diabetes (in case of use of solutions with epinephrine);
- have epilepsy;
- have or have a family history of porphyria;
- have a condition called hypovolemia;
- have a blood circulation condition called 'peripheral vascular disorder';
- have problems with the blood supply to your brain because of obstructed arteries;
- are experiencing severe shock;
are pregnant, plan to become pregnant or are breastfeeding;
Others warnings you should know about:
Driving and using machines: In addition to the temporary loss of feeling and numbness, Lidocaine Hydrochloride and Epinephrine Injection USP may have an effect on your mental function and coordination. This may impair your ability to move and decrease your alertness. Avoid driving or operating machinery on the day you receive Lidocaine Hydrochloride and Epinephrine Injection USP.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP:
- other local anesthetics;
- erythromycin, a medication used to treat bacterial infections;
- itraconazole, a medication used to treat fungal infections;
- propranolol, a medication used to treat high blood pressure;
- cimetidine, a medication used to treat heartburn and peptic ulcers;
- medications used to treat irregular heartbeat such as mexiletine or amiodarone;
- medications used to treat depression such as fluvoxamine, imipramine, triptyline drugs and monoamine oxidase inhibitors;
- certain medications used to treat headaches and migraines
- medications used to treat psychosis such as phenothiazine or butyphenones
- sedative medications
- inhaled anesthetics such as halothane or enflurane
- opioid medicines, such as fentanyl (used to treat severe pain during and/or following surgery);
- other medicines that decrease the nervous system, breathing and blood pressure activities;
- certain medications used to treat epilepsy such as phenytoin, phenobarbitone and carbamazepine
alcohol
- certain medications used to relax muscles, such as suxamethonium
How to take LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP:
Usual dose:
Lidocaine Hydrochloride and Epinephrine Injection USP should be administered by a doctor. The dose to be given is decided by the doctor, based on the clinical need and your physical condition.
Overdose:
Serious side effects resulting from getting too much Lidocaine Hydrochloride and Epinephrine Injection USP need special treatment and the doctor treating you is trained to deal with these situations. Early signs that too much Lidocaine Hydrochloride and Epinephrine Injection USP has been given include:
- numbness of the lips and around the mouth
- light-headedness or dizziness
- blurred vision
- hearing problems
- tingling in the ears
In the event of a serious overdosage or a misplaced injection, trembling, seizures or unconsciousness may occur.
If the early signs of overdosage are noticed and no further Lidocaine Hydrochloride and Epinephrine Injection USP is given, the risk of serious side effects occurring rapidly decreases. If you have any of these symptoms, or you think you have received too much Lidocaine Hydrochloride and Epinephrine Injection USP, tell your doctor immediately.
If you think you, or a person you are caring for, have taken too much [BRAND NAME], contact a healthcare professional, hospital emergency department, regional poison control centre or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.
Possible side effects from using LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP:
These are not all the possible side effects you may have when taking LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP. If you experience any side effects not listed here, tell your healthcare professional.
Serious side effects and what to do about them
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| Common | |||
| Dizziness, abnormal sensations (pins and needles) | X | ||
| Feeling of sickness/nausea*, vomiting* | X | ||
| Bradycardia (abnormally slow heartbeat) | X | ||
| Hypertension (high blood pressure): shortness of breath, fatigue, dizziness or fainting, chest pain or pressure, swelling in your ankles and legs, bluish colour to your lips and skin, racing pulse or heart palpitations | X | ||
| Hypotension*(low blood pressure): dizziness, fainting, light-headedness, blurred vision, nausea, vomiting, fatigue (may occur when you go from lying or sitting to standing up) | X | ||
| Uncommon | |||
| Toxicity symptoms: convulsions, seizures, lightheadedness, | X | ||
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| numbness of the lips and around the mouth, numbness of the tongue, hearing, visual, or speech disturbances, trembling. | |||
| Rare | |||
| Cardiac arrest and/or irregular heartbeat | X | ||
| Allergic reactions: difficulty swallowing or breathing, wheezing, feeling sick to your stomach and throwing up, hives or rash, swelling of the face, lips, tongue or throat | X | ||
| Nervous system disorders: weakness or paralysis of limbs or face, tingling of extremities, difficulty speaking, confusion, disorientation, trembling | X | ||
| Double vision | X | ||
| Unknown | |||
| Kounis syndrome (heart problems caused by an allergic reaction): chest pain, chest pressure or discomfort, heart palpitations, sweating, shortness of breath (may occur with symptoms of an allergic reaction; see above in this table) | X | ||
* These side effects occur more frequently after epidural block
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting side effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
- Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
- Calling toll-free at 1-866-234-2345.
NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.
Storage:
Lidocaine Hydrochloride and Epinephrine Injection USP should be stored at controlled room temperature (20 °C to 25 °C). Lidocaine Hydrochloride and Epinephrine Injection USP containing epinephrine should be protected from light. Protect from freezing. Keep out of the reach and sight of children.
Your doctor or the hospital will normally store Lidocaine Hydrochloride and Epinephrine Injection USP. The staff is responsible for storing, dispensing and disposing of Lidocaine Hydrochloride and Epinephrine Injection USP in the correct way.
Keep out of reach and sight of children.
If you want more information about LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE INJECTION USP:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website (Drug Product Database: Access the database); the manufacturer’s website www.pfizer.ca; or by calling 1-800-463-6001.
Date of Authorization: 2026-01-07