Lidocaine on your skin: a safety profile
Low riskTopical application at OTC concentrations has low systemic absorption through intact skin. Local reactions are uncommon.
What is lidocaine?
Lidocaine is a local anesthetic, amide-type anesthetic, antiarrhythmic agent (Class Ib).
The IUPAC name is 2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide.
Also known as: Xylocaine, lignocaine, 2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide, Lidoderm.
- IUPAC name
- 2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide
- CAS number
- 137-58-6
- Molecular formula
- C14H22N2O
- Molecular weight
- 234.34 g/mol
- SMILES
- CCN(CC)CC(=O)NC1=C(C)C=CC(C)=C1
- PubChem CID
- 3676
Risk for people
Low riskTopical application at OTC concentrations has low systemic absorption through intact skin. Local reactions are uncommon.
Lidocaine patches (Lidoderm 5%) and creams deliver localized analgesia with minimal systemic absorption. Blood levels from topical use are typically 1/10th of those associated with systemic toxicity. Allergic contact dermatitis to amide anesthetics is rare (much less common than with ester-type anesthetics like benzocaine).
Regulatory consensus
4 regulatory and scientific bodies have classified Lidocaine. The classifications differ — that's the data.
| Agency | Year | Classification | Notes |
|---|---|---|---|
| FDA | — | Approved prescription drug (injectable, IV) and OTC (topical, up to 4-5%) | FDA-approved for local/regional anesthesia, ventricular arrhythmias (IV), and OTC topical pain relief. Pregnancy Category B. |
| WHO | — | Essential Medicine | Listed on WHO Model List of Essential Medicines — local anesthetic section. Considered one of the safest and most effective medicines. |
| EMA | — | Authorized pharmaceutical | Authorized across EU member states as prescription and non-prescription (topical) pharmaceutical. Subject to EU pharmaceutical regulations. |
| DEA | — | Not a controlled substance | Lidocaine is not a scheduled/controlled substance in the US. However, it is sometimes used as a cutting agent for illicit drugs, which is a law enforcement concern. |
Regulators apply different standards of evidence — animal-data weighting, exposure-pattern assumptions, epidemiological power thresholds — which is why two scientific bodies can review the same data and reach different conclusions. The disagreement is the data.
Where you encounter lidocaine
-
Dental Anesthesia
— Xylocaine dental cartridges, dental lidocaine with epinephrine
Most commonly used local anesthetic in dentistry worldwide
-
Topical Pain Relief
— Lidoderm patches (5%), EMLA cream (lidocaine + prilocaine), lidocaine creams and gels
OTC and prescription topical formulations for localized pain
-
Injectable Anesthesia
— Xylocaine injection, epidural anesthesia solutions, nerve block solutions
Prescription injectable for local/regional anesthesia and nerve blocks
-
Antiarrhythmic
— IV lidocaine for ventricular tachycardia
Class Ib antiarrhythmic for acute management of ventricular arrhythmias (ACLS protocol)
-
Hemorrhoid Treatments
— RectiCare, hemorrhoidal lidocaine ointments
Topical anorectal formulations for hemorrhoid pain relief
-
Personal Products
— numbing sprays, desensitizing products
Various OTC products utilizing local anesthetic properties
Frequently asked questions
Is lidocaine safe for you?
Topical application at OTC concentrations has low systemic absorption through intact skin. Local reactions are uncommon.
What products contain lidocaine?
Lidocaine appears in: Xylocaine dental cartridges (dental anesthesia); dental lidocaine with epinephrine (dental anesthesia); Lidoderm patches (5%) (topical pain relief); EMLA cream (lidocaine + prilocaine) (topical pain relief); Xylocaine injection (injectable anesthesia).
What should I do if my you is exposed to lidocaine?
Apply to intact skin only. Do not exceed recommended number of patches or application area. Remove if irritation occurs.
Why do regulators disagree about lidocaine?
Lidocaine has been classified by 4 agencies including FDA, WHO, EMA, DEA, with differing conclusions. Regulators apply different standards of evidence (animal data weighting, exposure-pattern assumptions, epidemiological power thresholds), which is why two scientific bodies can review the same data and reach different conclusions. See the regulatory consensus table on this page for the full picture.
See Lidocaine in the body app
Look up products containing lidocaine, compare to alternatives, and explore the full data record.
Open in body View raw API dataReference data, not professional advice. Aggregates publicly available regulatory and scientific data; not a substitute for veterinary, medical, legal, or regulatory advice. Why we built ALETHEIA →