Today's post comes from both cancer.org (see link below) and a blog reader/neuropathy patient and discusses the effectiveness of lidocaine patches (sometimes known as Versatis, Lidoderm, or Xylocaine) in treating neuropathic pain. They are generally prescribed for post-herpetic neuralgia but will work on the effects other neurological disorders too. A full explanation of the workings and possible side effects and interactions with other medications can be found in this article from cancer.org. Following that is a short personal experience of using lidocaine patches to relieve neuropathic symptoms.
It is important to remember that not every country has approved the use of lidocaine patches and not every insurance company will pay for them. In the UK and USA, there seem to be few problems but it's worth checking with your own pharmacist or insurance company to see whether they are available and you're covered. Certainly, they clearly work for some people and if they can substitute or reduce other drug treatments, they may well be worth thinking about. Talk to your doctor or specialist.
Lidocaine Patches
(lie-doe-cane)
Trade/other name(s): Lidoderm
Why would this drug be used?
The lidocaine patch is used to help control neuropathic pain (numbness, tingling, burning, shooting, or electric-shock-like pain), such as pain in areas affected by shingles, called post-herpetic neuralgia.
How does this drug work?
Lidocaine blocks the signals from nerve endings, causing numbness in the area where it is applied. Because of this, it is known as a local anesthetic.
Before taking this medicine
Tell your doctor…
If you are allergic to anything, including medicines, dyes, additives, or foods, especially if you have had a problem with similar anesthetics such as procaine, tetracaine, or benzocaine.
If you have any medical conditions such as liver disease (including hepatitis), which may require closer monitoring during treatment.
If you are taking any medicine for an irregular heartbeat. Lidocaine can affect the rhythm of the heart.
If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy.
If you are breast-feeding. Small amounts of this drug pass into breast milk and may affect the baby.
About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.
Interactions with other drugs
Drugs that help stop abnormal heart rhythms, such as disopyramide (Norpace), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), procainamide (Procanabid, Pronestyl), propafenone (Rhythmol), quinidine (Quinidex), or tocainide (Tonocard), may affect the heart more if given with lidocaine.
If you get other types of local anesthesia, such as from dental work, your body may absorb too much, which can cause side effects.
Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.
Interactions with foods
No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.
Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.
How is this drug taken or given?
This drug comes in the form of a sticky patch, about 4 by 5 ½ inches in size. When ready to use, take it out of its child-resistant wrapper, remove the liner, and apply it to the most painful area of skin. Apply only to intact skin. Do not place on skin that is inflamed, broken, cut, or irritated in any way. The patch can be left on up to 12 hours out of each 24-hour period.
Before its protective liner is removed, a patch may be cut into smaller pieces if needed. Cut the patches to the size and shape to cover the most painful areas. Talk to your doctor about how many patches to use. Most people can use up to 3 patches at one time if the painful area is large. It is OK to wear clothes over the patch.
After you take off a patch, fold it over on itself so that it sticks together. Throw the used patches away out of the reach of children, pets, and others. If a new or used patch is chewed or swallowed, it can cause serious harm.
Wash your hands after you handle any patch. Be careful not to touch your eyes until your hands are clean. Do not let the patch or liner touch your eye. If any of the medicine gets into your eye, flush with water or saline and protect it until the feeling returns.
Use this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the unused patches in their original child-resistant wrap with the zipper seal closed, out of the reach of children and pets.
Precautions
If you notice burning, irritation, swelling, redness, blistering, or peeling where you have applied the patch, remove the patch and wait until the problem has gone away before re-applying. Usually this takes a few minutes to a few hours.
Because very little of the medicine in the patch is absorbed into the body, the lidocaine patch has few side effects. If it is applied to broken skin, or if for some reason more medicine is absorbed, it can cause lightheadedness, blurred vision, tremors, numbness of other parts of your body, vomiting, and other symptoms. Remove the patch and call your doctor if this happens to you.
Allergic reactions with symptoms like trouble breathing, itching, skin welts (hives), dizziness, faintness, and swelling of the face, mouth, or throat rarely occur. If you have any of these symptoms, get emergency help.
Possible side effects
You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.
Less common
rash or swelling at the patch site
abnormal feeling at patch site
dizziness
headache
nausea
Rare
allergic reaction, with swelling of the face or throat, trouble breathing*
blurred vision*
tremors*
vomiting*
*See "Precautions" section for more detailed information.
There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.
FDA approval
Yes – patch form first approved in 1999.
Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.
I have been using them for about 2 years now. They are on Prescription and they are free on our NHS....the equivalent of insurance.
A maximum of 3 plasters can be used at any one time....I usually use two...They can only be used for 12 hours at a time because they are cocaine based after all and are sodium channel blockers....prolonged use can affect the heart causing irregular heart rhythm...
You wait 12 hours....it's 12 hours on and 12 hours off. They really help at night!
The strength is standard...5%
I use them on the legs....using them on the feet does work but it is messy....I notice relief within half an hour....but prolonged use gives quicker relief....usually between 2 - 4 weeks."
(lie-doe-cane)
Trade/other name(s): Lidoderm
Why would this drug be used?
The lidocaine patch is used to help control neuropathic pain (numbness, tingling, burning, shooting, or electric-shock-like pain), such as pain in areas affected by shingles, called post-herpetic neuralgia.
How does this drug work?
Lidocaine blocks the signals from nerve endings, causing numbness in the area where it is applied. Because of this, it is known as a local anesthetic.
Before taking this medicine
Tell your doctor…
If you are allergic to anything, including medicines, dyes, additives, or foods, especially if you have had a problem with similar anesthetics such as procaine, tetracaine, or benzocaine.
If you have any medical conditions such as liver disease (including hepatitis), which may require closer monitoring during treatment.
If you are taking any medicine for an irregular heartbeat. Lidocaine can affect the rhythm of the heart.
If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy.
If you are breast-feeding. Small amounts of this drug pass into breast milk and may affect the baby.
About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.
Interactions with other drugs
Drugs that help stop abnormal heart rhythms, such as disopyramide (Norpace), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), procainamide (Procanabid, Pronestyl), propafenone (Rhythmol), quinidine (Quinidex), or tocainide (Tonocard), may affect the heart more if given with lidocaine.
If you get other types of local anesthesia, such as from dental work, your body may absorb too much, which can cause side effects.
Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.
Interactions with foods
No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.
Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.
How is this drug taken or given?
This drug comes in the form of a sticky patch, about 4 by 5 ½ inches in size. When ready to use, take it out of its child-resistant wrapper, remove the liner, and apply it to the most painful area of skin. Apply only to intact skin. Do not place on skin that is inflamed, broken, cut, or irritated in any way. The patch can be left on up to 12 hours out of each 24-hour period.
Before its protective liner is removed, a patch may be cut into smaller pieces if needed. Cut the patches to the size and shape to cover the most painful areas. Talk to your doctor about how many patches to use. Most people can use up to 3 patches at one time if the painful area is large. It is OK to wear clothes over the patch.
After you take off a patch, fold it over on itself so that it sticks together. Throw the used patches away out of the reach of children, pets, and others. If a new or used patch is chewed or swallowed, it can cause serious harm.
Wash your hands after you handle any patch. Be careful not to touch your eyes until your hands are clean. Do not let the patch or liner touch your eye. If any of the medicine gets into your eye, flush with water or saline and protect it until the feeling returns.
Use this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the unused patches in their original child-resistant wrap with the zipper seal closed, out of the reach of children and pets.
Precautions
If you notice burning, irritation, swelling, redness, blistering, or peeling where you have applied the patch, remove the patch and wait until the problem has gone away before re-applying. Usually this takes a few minutes to a few hours.
Because very little of the medicine in the patch is absorbed into the body, the lidocaine patch has few side effects. If it is applied to broken skin, or if for some reason more medicine is absorbed, it can cause lightheadedness, blurred vision, tremors, numbness of other parts of your body, vomiting, and other symptoms. Remove the patch and call your doctor if this happens to you.
Allergic reactions with symptoms like trouble breathing, itching, skin welts (hives), dizziness, faintness, and swelling of the face, mouth, or throat rarely occur. If you have any of these symptoms, get emergency help.
Possible side effects
You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.
Less common
rash or swelling at the patch site
abnormal feeling at patch site
dizziness
headache
nausea
Rare
allergic reaction, with swelling of the face or throat, trouble breathing*
blurred vision*
tremors*
vomiting*
*See "Precautions" section for more detailed information.
There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.
FDA approval
Yes – patch form first approved in 1999.
Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.
http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/lidocaine-patch
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Personal experience of a neuropathy sufferer
Personal experience of a neuropathy sufferer
"Lidocaine works very well for me, not in gel form though but on a 'plaster' but, there is always a 'but'...it can only be used for 12 hours at a time...but it's better than nothing
I have been using them for about 2 years now. They are on Prescription and they are free on our NHS....the equivalent of insurance.
A maximum of 3 plasters can be used at any one time....I usually use two...They can only be used for 12 hours at a time because they are cocaine based after all and are sodium channel blockers....prolonged use can affect the heart causing irregular heart rhythm...
You wait 12 hours....it's 12 hours on and 12 hours off. They really help at night!
The strength is standard...5%
I use them on the legs....using them on the feet does work but it is messy....I notice relief within half an hour....but prolonged use gives quicker relief....usually between 2 - 4 weeks."
Nigel (via e-mail)
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