Heating Pad Lidoderm Patch ((LINK))
Results: The focus of this case report are the interesting neuro-otologic signs of central lidocaine toxicity that occurred after a patient fell asleep on a heating pad with his Lidoderm patches in place. Hearing improvement, tinnitus reduction, and severe dizziness and ataxia were present for approximately 48 hours before spontaneous resolution. Based upon his symptoms we estimate an 11-fold increase in plasma concentrations of lidocaine.
Heating Pad Lidoderm Patch
Discussion: Transdermal delivery of medication affords ease of application, ability to provide continuous pharmacological therapy, and ability to supply medication to the affected site. Due to the superficial application of these medications, external environmental factors may influence the pharmacokinetics of drug delivery. This case highlights the complications that can arise from the combination of heating pads and transdermal pain therapies.
Heat can cause the lidocaine in the patch to be absorbed into your body faster. This may increase the chance of serious side effects or an overdose. While you are using this medicine, do not use a heating pad, electric blanket, heat or tanning lamps, sauna, a sunlamp, or a heated water bed. Do not sunbathe. However, you may apply Ztlido patch on the skin after exposure to moderate heat (eg, after 15 minutes of heating pad use on a medium setting).
Prescription lidocaine transdermal comes as a 5% patch (Dermalid, Lidoderm) and as a 1.8% topical system (Ztlido) to apply to the skin. Prescription lidocaine transdermal is applied only once a day as needed for pain. Never apply more than 3 of the lidocaine 5% patch or lidocaine 1.8% topical systems at one time, and never wear them for more than 12 hours per day (12 hours on and 12 hours off). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use lidocaine transdermal exactly as directed. Do not apply it more or less often than prescribed by your doctor.
Nonprescription lidocaine transdermal comes as a 4% patch (Absorbine Jr, Aspercreme, Lidocare, Salonpas, others) to apply to the skin. It is applied up to 3 times daily and for no more than 8 hours per application. Use nonprescription lidocaine patches exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than directed by the package instructions.
Your doctor will tell you how many lidocaine patches or topical systems you may use at one time and the length of time you may wear the patches. Applying too many patches or topical systems or leaving them on for too long may cause serious side effects.
Apply the lidocaine patch or topical system to clean, dry, intact skin as directed. Choose an area where the patch will not be rubbed by tight clothing. Do not apply the patch or topical system to an open wound or cut, to skin that is irritated or red, or to skin that is affected by a rash, burn, or other skin problem. If irritation or a burning sensation occurs during lidocaine application, remove the lidocaine patch or system and do not reapply it until the irritation is gone. Prescription patches and topical systems may be cut into smaller sizes with scissors prior to removal of the release liner. Be sure to remove the current patch before you apply a new one.
While you are wearing a lidocaine transdermal patch or system, protect the treated area from direct heat such as heating pads or electric blankets. You can apply the lidocaine 1.8% topical system after moderate heat exposure, such as 15 minutes of heating pad exposure on a medium setting. Do not bandage the affected area tightly.
Do not shower, bathe, or go swimming while you are wearing the prescription lidocaine 5% transdermal patch. If you are using the prescription lidocaine 1.8% topical system, you may shower for up to 10 minutes or wear it while immersed in water for up to 15 minutes. If the lidocaine 1.8% topical system becomes wet, gently pat the skin, but do not rub the skin or lidocaine 1.8% topical system.
This medication is usually used as needed. If your doctor has told you to use lidocaine patches or topical systems regularly, apply the missed patch or topical system as soon as you remember it. However, if it is almost time for the next dose, skip the missed patch and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not store patches and topical systems outside the sealed envelope. Fold used patches or topical systems so that the adhesive side sticks to itself and then safely discard into trash and where children and pets cannot get to them.
If you wear too many lidocaine transdermal patches or topical systems or wear them for too long, too much lidocaine may be absorbed into your blood. In that case, you may experience symptoms of an overdose.
LIDODERM (lidocaine patch 5%) is comprised of an adhesive material containing 5% lidocaine, which is applied to a non-woven polyester felt backing and covered with a polyethylene terephthalate (PET) film release liner. The release liner is removed prior to application to the skin. The size of the patch is 10 cm x 14 cm.