How does it work?

Xylocaine with adrenaline injection contains two active ingredients, lidocaine hydrochloride (previously known as lignocaine hydrochloride in the UK) and adrenaline (also known as epinephrine).

Lidocaine is a type of medicine called a local anaesthetic. It is used to numb areas that would otherwise feel pain.

Pain is caused by the stimulation of pain receptors at the ends of nerves. The stimulation causes sodium to enter the nerve ending, which causes an electrical signal to build up in the nerve. When this electrical signal is big enough, it passes along the nerve to the brain, where the signal is interpreted as pain.

Lidocaine works by temporarily blocking this pathway of pain signals along nerves. It does this by stopping the sodium entering the nerve ending at the site of the pain. This prevents an electrical signal building up and passing along the nerve fibres to the brain.

Adrenaline is a naturally-occurring chemical produced in the body. One of its many effects is to constrict blood vessels, through its action on the adrenergic receptors found in the walls of blood vessels. It is used to control bleeding in surgery and to slow the dispersal, and thereby prolong the effect, of local anaesthetics such as lidocaine.

When lidocaine and adrenaline are injected, they prevent pain signals passing from the area of injection to the brain and so numb the area. This means otherwise painful procedures, such as certain medical procedures or surgery, can be performed without causing pain.The numbness will gradually wear off after the procedure.

What is it used for?

• Numbing a localised area to prevent pain (local anaesthesia) by local infiltration, minor and major nerve blocks and epidural block

Warning!

• This medicine must not be injected into a vein (intravenously).

Use with caution in

• Elderly people
• Weak or debilitated people
• Decreased liver function
• Severely decreased kidney function
• Heart disease
• Slow heart rate
• High blood pressure (hypertension)
• Low blood pressure (hypotension)
• History of stroke or mini-stroke (TIA)
• Breathing problems
• Asthma
• Epilepsy
• Thyrotoxicosis
• Advanced diabetes

Not to be used in

• Allergy to amide local anaesthetics, eg lidocaine
• Anaesthesia of the fingers, toes, tip of nose, ears or penis.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than the possible risk to the foetus, particularly in the first trimester. If used during the third trimester or labour the doctor or midwife will need to monitor the baby's heartbeat. Seek medical advice from your doctor.
• This medicine may pass into breast milk, but in such small amounts that there is generally no risk of this affecting the nursing baby.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Low blood pressure (hypotension)
• Dizziness
• Nausea
• Slow heart rate (bradycardia)
• Pins and needles sensations (paraesthesia)
• Shaking, usually of the hands (tremor)
• Sensation of ringing or other noise in the ears (tinnitus)
• Visual disturbances
• Reduced alertness
• Difficulty speaking
• Convulsions
• Allergic reactions
• Irregular heartbeats (arrhythmias)
• Slow, shallow breathing (respiratory depression)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor, pharmacist or the anaesthetist administering this medicine what medicines you are already taking, including those bought without a prescription and herbal medicines, before you are given this anaesthetic, so they can ensure that the combination is safe.

If you are taking a medicine to treat an irregular heartbeat (antiarrhythmic), for example amiodarone, your doctor may want to monitor your heartbeat with an ECG during the anaesthetic.

Due to the adrenaline component, this anaesthetic should be used with caution in people taking any of the following medicines, as there may be a risk of a rise in blood pressure:

• tricyclic antidepressants
• monoamine oxidase inhibitors
• potent general anaesthetics
• beta-blockers such as propranolol
• ergometrine.