Lidenza (Lidocaine and Menthol) - Cream, Gel, Patch, Spray

Lidenza (Lidocaine and Menthol) is used in the form of Gels, Creams, Sprays, and Patches as OTC products for the temporary relief of aches and pains in the joints and muscles, and for skin soreness, irritation, and itching.

Lidocaine and menthol Uses:

Topical Anesthetic:
- OTC products:
  - Cream, gel, and spray:
    - It is used for the temporary relief of pain and itching associated with minor burns and cuts, scrapes, sunburn, skin irritations, or insect bites.
  - Patch:
    - It is used for the temporary relief of mild to moderate muscles or joint pains as in patients with arthritis, simple backache, bursitis, tendonitis, muscle soreness, stiffness, strains, sprains, or bruises.
    - It is used for the temporary relief of pain associated with minor cuts, scrapes, or skin irritations.
- RX products:
  - Cream:
    - It is used for the temporary relief of abrasions, minor burns, insect bites, pain, pruritic eczemas, soreness, pruritus, and discomfort due to anal fissures, hemorrhoids, anal pruritus, pruritus vulvae, and similar conditions of the skin and mucous membranes.

Lidenza (Lidocaine and Menthol) Dose in Adults:

Lidenza (Lidocaine and Menthol) Dose in adults as a topical anesthetic:

OTC products:
- Cream:
  - Apply a thin film to the affected area 3 to 4 times a day.
- Gel, spray:
  - Apply to the affected areas up to a maximum of 4 times a day.
- Patch:
  - Avalin, Lidozen:
    - Apply the patch to the affected area up to a maximum of 4 times a day.
    - The patch may remain in place for up to 8 hours. Avoid using it for more than 5 consecutive days.
  - LidoPatch:
    - Apply the patch to the affected area.
    - The patch may remain in place for up to 12 hours to a maximum of 1 patch/24 hours.
  - Lidothol:
    - Apply the patch to the affected area.
    - The patch may remain in place for 8 to 12 hours to a maximum of 2 patches/24 hours.
  - Siterol:
    - Apply the patch to the affected area.
    - Keep the patch in place for up to 8 hours to a maximum of 4 patches/24 hours. Avoid using it for more than 5 consecutive days.
  - Solmara, Terocin:
    - Apply the patch to the affected area once or twice a day.
- Rx products:
  - Cream:
    - Apply a thin film to the affected area twice or three times a day.

Lidenza (Lidocaine and Menthol) Dose in Childrens:

Lidenza (Lidocaine and Menthol) Dose as a topical anesthetic:

OTC products:
- Cream:
  - Children ≥2 years and Adolescents:
    - Apply a thin film to the affected area 3 to 4 times a day.
- Spray:
  - Children ≥2 years and Adolescents:
    - Apply to affected areas up to a maximum of 4 times a day.
- Patch:
  - Avalin:
    - Children ≥2 years and Adolescents:
      - Apply the patch to the affected area up to a maximum of 4 times a day.
      - Patch may remain in place for up to 8 hours. Avoid using it for longer than 5 consecutive days.
  - Lidothol:
    - Children ≥12 years and Adolescents:
      - Apply the patch to the affected area. Allow the patch in place for 8 to 12 hours up to a maximum of 2 patches/24 hours.
  - Solmara, Terocin:
    - Children ≥12 years and Adolescents:
      - Apply the patch to the affected area once or two times a day.

Pregnancy Risk Factor B

This combination has not been used in studies on human and animal reproduction.
Talk to individual agents.

Breastfeeding: Lidocaine and Menthol

It is unknown whether breastmilk contains menthol or lidocaine, if used in combination.
It is recommended that you use it with caution if you are breastfeeding.
Talk to individual agents.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Side effects of Lidenza (Lidocaine and Menthol):

Central nervous system:
- Burning sensation
- Localized warm feeling
- Paresthesia (localized)
- Stinging sensation
Dermatologic:
- Localized erythema
Local:
- Localized edema

Contraindications to Lidenza (Lidocaine and Menthol):

Allergy to lidocaine, Lidocaine, menthol, the local anesthetic type of the amide, or any component in the formulation
Bacterial infection at application site
Traumatized mucosa

Warnings and precautions

Local effects
- Local reactions include irritation, sensitivity and. The application site may be infected. Stop using the medication if you experience side effects.

Lidocaine and menthol: Drug Interaction

Risk Factor C (Monitor therapy)
Antiarrhythmic Agents (Class III)	Lidocaine (Topical) may enhance the arrhythmogenic effect of Antiarrhythmic Agents (Class III). Antiarrhythmic Agents (Class III) may increase the serum concentration of Lidocaine (Topical). This mechanism specifically applies to amiodarone and dronedarone.
Aprepitant	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Beta-Blockers	May increase the serum concentration of Lidocaine (Topical).
Clofazimine	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
CYP3A4 Inhibitors (Moderate)	May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors).
Dapsone (Topical)	May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents.
Disopyramide	May enhance the arrhythmogenic effect of Lidocaine (Topical). Disopyramide may increase the serum concentration of Lidocaine (Topical). Specifically, the unbound/free fraction of lidocaine.
Duvelisib	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Erdafitinib	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Fosaprepitant	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Fosnetupitant	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Larotrectinib	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Local Anesthetics	Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased.
Methemoglobinemia Associated Agents	May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased.
Netupitant	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Nitric Oxide	May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia.
Palbociclib	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Prilocaine	Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine in infants receiving such agents.
Simeprevir	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Sodium Nitrite	Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia.
Risk Factor D (Consider therapy modification)
CYP3A4 Inhibitors (Strong)	May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors). Risk
MiFEPRIStone	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Risk
Stiripentol	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Use of stiripentol with CYP3A4 substrates that are considered to have a narrow therapeutic index should be avoided due to the increased risk for adverse effects and toxicity. Any CYP3A4 substrate used with stiripentol requires closer monitoring. Risk
Risk Factor X (Avoid combination)
Conivaptan	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Fusidic Acid (Systemic)	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).
Idelalisib	May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).

Monitoring Parameters:

None mentioned.

How to administer Lidenza (Lidocaine and Menthol)?

It should be used only on external surfaces.
Application inside the oral cavity, genital areas, and into the eyes should be avoided.
It should not be used over wounds, cuts, mucous membranes, or damaged areas.
Some products may not be suitable for use with bandages.

Patch:

Apply the patch to a dry and clean area.
Remove the protective film and then apply the patch.
After applying the patch, wash your hands.
Avoid exposing the site to external heat sources such as heating pads, heat lamps, hot tubs, and electric blankets.