This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Lidocaine pump spray


Pump spray containing lidocaine

Drugs List

  • lidocaine 10mg pump spray sugar-free
  • XYLOCAINE 10mg pump spray
  • Therapeutic Indications


    Local anaesthesia during obstetric delivery
    Local anaesthetic for minor surgery of nasal cavity, pharynx and epipharynx
    Local anaesthetic for mucous membranes for bronchoscopy,bronchography, etc
    Local anaesthetic for mucous membranes for endotracheal intubation
    Local anaesthetic for mucous membranes for laryngoscopy,oesophagoscopy,etc
    Local anaesthetic for mucous membranes in dentistry

    Provides topical anaesthesia for pain associated with:

    Puncture of the maxillary sinus and minor surgical procedures in the nasal cavity, pharynx and epipharynx.


    During the final stages of delivery and before episiotomy and perineal suturing as supplementary pain management.

    Introduction of instruments and catheters into the respiratory and digestive tract
    Provides surface anaesthesia for the oropharyngeal and tracheal areas to reduce reflex activity, attenuate haemodynamic response and to facilitate insertion of the tube/instrument during endotracheal intubation, laryngoscopy, bronchoscopy, and oesophagoscopy.

    Prior to injections, dental impressions, X-ray photography and removal of calculus.


    As with any local anaesthetic, the minimal effective dose should be employed to reduce the incidence of reactions and complications.

    Anaesthesia usually occurs within 5 minutes.


    No more than 20 spray applications (200mg lidocaine base) should be used. The number of sprays depends on the extent of the area to be anaesthetised.

    Dental practice: 1 to 5 applications to the mucous membranes.
    Otorhinolaryngology: 3 applications for puncture of the maxillary sinus.
    Obstetrics (during delivery): Up to 20 applications (200mg lidocaine base).
    Introduction of instruments and catheters into the pharynx, larynx and trachea: Up to 20 applications (200mg lidocaine base) for procedures in the pharynx, larynx and trachea.


    (See Dosage; Adult)

    Elderly patients should be given a dosage commensurate with their age and physical condition.


    Children should be given a dosage commensurate with their age, weight, and physical condition.

    Anaesthesia of mucous membranes of oropharynx, trachea, or respiratory tract
    Up to 3 mg/kg (maximum 200mg per dose).


    None known

    Precautions and Warnings

    Children under 18 years
    Cardiac conduction defects
    Cardiac failure
    Cardiovascular disorder
    Epileptic disorder
    Hepatic impairment
    Myasthenia gravis
    Respiratory impairment
    Severe renal impairment

    Advise ability to drive/operate machinery may be affected by side effects
    Contains alcohol
    Contains propylene glycol: may cause irritation
    Damages endotracheal cuffs made of plastic (PVC + non PVC)
    Avoid broken or inflamed skin
    Avoid contact with eyes
    Do not allow contact with middle ear
    Not to be applied to infected skin
    Resuscitation facilities must be immediately available
    Anaesthesia of the pharynx may occur with increased risk of choking
    Anaesthetic effect may impair swallowing

    Higher concentrations in the blood may occur in paralysed patients under general anaesthesia.

    Oropharyngeal administration may impair swallowing and consequently produce a risk of aspiration. This is of particular relevance in children due to their frequency of eating. Numbness of the tongue or buccal mucosa may lead to an increased risk of biting trauma. Avoid use of this medication on the pharynx before meals.

    Since cardiac effects may be additive, patients treated with antiarrhythmic drugs class 3 (e.g. Amiodarone) should be kept under close supervision and ECG monitoring should be considered.

    Pregnancy and Lactation


    Lidocaine is considered safe for use in pregnancy.

    There is limited data regarding the safety of lidocaine administration during pregnancy, however it has been widely used for many years and no ill effects have been documented. Animal studies also indicate no hazard.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Lidocaine is considered safe for use in breastfeeding.

    Lidocaine is excreted in human breast milk, however at therapeutic doses, the excreted amounts are not high enough to be of risk to the infant.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Allergic reaction
    Anaphylactic shock
    Blurred vision
    Cardiac arrest
    Cardiovascular effects
    CNS effects
    Irritation at application site
    Muscle twitch
    Myocardial depression
    Peripheral vasodilatation
    Respiratory arrest
    Respiratory depression
    Sensation of cold
    Sensation of heat
    Sore throat
    Voice changes


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: May 2015

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Martindale: The Complete Drug Reference. 39th Edition. London: Brayfield A (ed). Pharmaceutical Press; 2017.

    Medications and Mothers' Milk, Sixteenth Edition (2014) Hale, T and Rowe, H, Hale Publishing, Plano, Texas.

    Summary of Product Characteristics: Xylocaine Spray. AstraZeneca UK Limited. Revised February 2015.

    The Renal Drug Handbook. Fourth Edition (2014) ed. Ashley, C and Dunleavy, A, Radcliffe Publishing Ltd, London.

    NICE Evidence Services Available at: Last accessed: 08 September 2017

    UK Drugs in Lactation Advisory Service.
    Available at:
    Last accessed: 21 May 2015

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Lidocaine. Last revised: 08 July 2014
    Last accessed: 21 May 2015

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.