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Drug Safety-related Labeling Changes (SrLC)

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LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE (NDA-017584)

(LIDOCAINE HYDROCHLORIDE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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08/17/2026 (SUPPL-44)

Approved Drug Label (PDF)

4 Contraindications

PLR conversion; please refer to label for complete information.


5 Warnings and Precautions

The following subsections were created to comply with Physician Labeling Rule (PLR); please refer to label for complete information.

5.1 Central Nervous System Depression or Irritability

5.2 Cardiovascular Toxicity

5.3 Malignant Hyperthermia

5.4 Methemoglobinemia


6 Adverse Reactions

7 Drug Interactions

PLR conversion; please refer to label for complete information.


8 Use in Specific Populations

8.1 Pregnancy

PLLR conversion.

Risk Summary

There are risks to the mother and fetus associated with untreated ventricular arrhythmias; therefore, life-sustaining therapy for ventricular arrhythmias should not be withheld (see Clinical Considerations). Available published data and decades of clinical use with lidocaine in pregnant women have not identified any drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes.

Clinical Considerations

Disease-associated maternal and/or embryo/fetal risk

The incidence of ventricular tachycardia is increased and may be more symptomatic during pregnancy. Ventricular arrhythmias most often occur in pregnant women with underlying cardiomyopathy, congenital heart disease, valvular heart disease, or mitral valve prolapse. Breakthrough arrhythmias may also occur during pregnancy, as therapeutic treatment levels may be difficult to maintain due to the increased volume of distribution and increased drug metabolism inherent in the pregnant state.

Maternal adverse reactions

During treatment of systemic toxicity, which may appear as maternal hypotension or fetal bradycardia, the pregnant woman should be maintained in the left lateral decubitus position if possible or manual displacement of the uterus off the great vessels be accomplished. Elevating the patient’s legs will also help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable.

8.2 Lactation

PLLR conversion.

Risk Summary

Published data report the presence of lidocaine and its metabolites in human milk in low amounts, along with poor oral bioavailability. There are no data on the effect of lidocaine on the breastfed infant or the effect on milk production.

8.4 Pediatric Use

PLR conversion; please refer to label for complete information.


17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT COUNSELING INFORMATION

Newly added section to comply with Physician Labeling Rule (PLR); please refer to label for complete information.