Topical Lidocaine Vs. Marcaine: Drug Comparison

Lidocaine topical is a local anesthetic used to numb specific areas of the skin to relieve pain and discomfort from conditions such as minor burns, insect bites, and hemorrhoids. It works by blocking nerve signals in the body, providing temporary relief from pain and itching. Available in various forms such as creams, gels, and patches, lidocaine topical begins to take effect within minutes and can last for several hours. While generally safe, it can cause side effects such as redness, swelling, and rare allergic reactions at the application site.

Lidocaine topical has many different types and names. The information below is about lidocaine 4% topical anesthetic cream.

Marcaine^® (bupivacaine hydrochloride) is a local anesthetic used to provide prolonged anesthesia during surgical procedures, dental work, and labor. Marcaine works by blocking nerve signals in the body, providing effective pain relief for several hours. When combined with epinephrine, the vasoconstrictive properties of epinephrine help to prolong the anesthetic effect and reduce bleeding in the area of administration. These medications must be used cautiously as they can cause side effects, such as hypotension, bradycardia, and, in rare cases, central nervous system toxicity or cardiac arrest.

Amide local anesthetic

Amide local anesthetic

Topical anesthetic that temporarily relieves pain and itching due to:

• Minor cuts

• Minor scrapes

• Sunburn

• Minor burns

• Minor skin irritations

• Insect bites

Marcaine (bupivacaine hydrochloride) is indicated:

• In adults for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures

• Typically applied externally to the affected area up to 3–4 times daily

• Comes as a topical cream

• See the Full Prescribing Information for important administration instructions

• Comes as an injection

Stop use and ask a doctor if:

• Allergic reaction occurs

• Condition worsens or does not improve within 7 days

• Symptoms clear up and return within a few days

• Redness, irritation, swelling, pain or other symptoms begin or increase

Most common adverse reactions are related to the central nervous system and the cardiovascular system

• Do not use in or near the eyes

• Do not use in large quantities, particularly over raw surfaces or blistered areas

• Obstetrical paracervical block anesthesia

• Intravenous regional anesthesia (Bier block)

• Known hypersensitivity to bupivacaine or to any local anesthetic agent of the amide-type or to other components of Marcaine

• Drug interactions: Local anesthetics, monoamine oxidase inhibitors and tricyclic antidepressants, ergot-type oxytocic drugs, nonselective beta-adrenergic antagonists, drugs associated with methemoglobinemia, potent inhalation anesthetics

• For external use only

• If swallowed, get medical help or contact a Poison Control Center right away

• Dose-related toxicity

• Methemoglobinemia

• Chondrolysis with intra-articular infusion

• Risk of cardiac arrest with intravenous regional anesthesia use (Bier block)

• Allergic-type reactions to sulfites in Marcaine with epinephrine

• Risk of systemic toxicities with unintended intravascular or intrathecal injection

WARNING: RISK OF CARDIAC ARREST WITH USE OF MARCAINE IN OBSTETRICAL ANESTHESIA

There have been reports of cardiac arrest with difficult resuscitation or death during use of Marcaine for epidural anesthesia in obstetrical patients. In most cases, this has followed use of the 0.75% (7.5 mg/mL) concentration. Resuscitation has been difficult or impossible despite apparently adequate preparation and appropriate management. Cardiac arrest has occurred after convulsions resulting from systemic toxicity, presumably following unintentional intravascular injection. The 0.75% (7.5 mg/mL) concentration of Marcaine is not recommended for obstetrical anesthesia and should be reserved for surgical procedures where a high degree of muscle relaxation and prolonged effect are necessary.

*This information is from the lidocaine 4% topical anesthetic cream label used by Oncor Pharmaceuticals. See the full label for more complete information. Lidocaine topical has many different types and names, and this information may not be accurate for all medications that include the active ingredient lidocaine topical.

*This information is from the label for brand name Marcaine^® used by Hospira, Inc. See the Full Prescribing Information for more complete information. Bupivacaine, the active ingredient in Marcaine, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient bupivacaine.