Lidocaine viscous

Local Anaesthetic·Analgesia - Topicals & Local

Stomatitis, pharyngitis, post-tonsillectomy pain, preparation for endoscopy

TOPICALXylocaine Viscous 2%S3TGA

Max Dose

15 mL q3h

Onset

1-2 mins

Aspiration

HIGH RISK

Seizures

SYSTEMIC TOX

Rapid Summary

Overview

Thick, gel-like topical amide local anaesthetic. Used to numb the oral cavity and upper GI tract for severe mucositis or instrumentation.

Maximum Dose

Max 15 mL every 3 hours (Adults). Paediatric doses strictly weight-based.

Clinical Focus

Numbs the gag reflex. Patients MUST remain Nil By Mouth (NBM) for 60 minutes post-dose to prevent fatal aspiration of fluids into the lungs.

Bottom Line

Lidocaine viscous is a topical local anaesthetic for oropharyngeal pain relief, but carries risk of systemic toxicity if swallowed excessively and can suppress the gag reflex increasing aspiration risk.

Formulation & Access

Brand Names

Xylocaine Viscous 2%

Topical Routes

Oral viscous solution (20 mg/mL).

Prescribing & PBS

Pharmacy Medicine (S2/S3).

Indications & Use

Primary

TGA

Stomatitis, pharyngitis, post-tonsillectomy pain, preparation for endoscopy.

Clinical Place

Highly effective for acute oral pain preventing eating/drinking, especially in chemotherapy-induced mucositis.

Quick reference

Class & Role

Local Anaesthetic — Thick, gel-like topical amide local anaesthetic.

Route / Formulation

Oral viscous solution (20 mg/mL). (Xylocaine Viscous 2%)

Usual Dose & Max

PO 15 mL (2% solution) swished around the mouth and spat out, or swallowed if esophageal pain. Max q3h.

Key Indication Doses

Severe Mucositis / Sore Throat: PO 15 mL (2% solution) swished around the mouth and spat out, or swallowed if esophageal pain. Max q3h. Elderly / Paediatrics: Calculate dose strictly by weight (Max 3-4 mg/kg per dose) to prevent systemic toxicity.

Best Uses

Avoid / Cautions

Patients with severely impaired swallowing mechanisms or absent gag reflex prior to administration. History of amide anaesthetic allergy (rare). Pregnancy Category A.

Key Risks

Respiratory: Loss of gag reflex leading to silent aspiration, pneumonia, or choking. Neurological: Local Anaesthetic Systemic Toxicity (LAST) if swallowed in massive quantities: perioral numbness, tinnitus, metallic taste, leading to violent seizures and coma. Cardiovascular: Arrhythmias and cardiovascular collapse (only in severe systemic toxicity).

Key Interactions

Additive toxicity with Class I antiarrhythmics (e.g., Flecainide) or other local anaesthetics (e.g., concurrent bupivacaine infusions).

Monitoring

Place a 'NIL BY MOUTH' sign above the bed for 60 minutes after every dose. No food, no water, no pills. No specific routine laboratory tests required.

Clinical Pearl

For mouth ulcers (e.g., Hand, Foot, and Mouth), instruct the patient to swish and spit. Swallowing the viscous liquid provides no benefit to the mouth and only increases the risk of systemic absorption and seizure toxicity.

Access

Xylocaine Viscous 2%

Brand: Xylocaine Viscous 2%

Lidocaine viscous

Local Anaesthetic·Analgesia - Topicals & Local

Stomatitis, pharyngitis, post-tonsillectomy pain, preparation for endoscopy

TOPICALXylocaine Viscous 2%S3TGA

Max Dose

15 mL q3h

Onset

1-2 mins

Aspiration

HIGH RISK

Seizures

SYSTEMIC TOX

Rapid Summary

Overview

Thick, gel-like topical amide local anaesthetic. Used to numb the oral cavity and upper GI tract for severe mucositis or instrumentation.

Maximum Dose

Max 15 mL every 3 hours (Adults). Paediatric doses strictly weight-based.

Clinical Focus

Numbs the gag reflex. Patients MUST remain Nil By Mouth (NBM) for 60 minutes post-dose to prevent fatal aspiration of fluids into the lungs.

Bottom Line

Formulation & Access

Brand Names

Xylocaine Viscous 2%

Topical Routes

Oral viscous solution (20 mg/mL).

Prescribing & PBS

Pharmacy Medicine (S2/S3).

Indications & Use

Primary

TGA

Stomatitis, pharyngitis, post-tonsillectomy pain, preparation for endoscopy.

Clinical Place

Highly effective for acute oral pain preventing eating/drinking, especially in chemotherapy-induced mucositis.

Quick reference

Class & Role

Local Anaesthetic — Thick, gel-like topical amide local anaesthetic.

Route / Formulation

Oral viscous solution (20 mg/mL). (Xylocaine Viscous 2%)

Usual Dose & Max

PO 15 mL (2% solution) swished around the mouth and spat out, or swallowed if esophageal pain. Max q3h.

Key Indication Doses

Best Uses

Avoid / Cautions

Patients with severely impaired swallowing mechanisms or absent gag reflex prior to administration. History of amide anaesthetic allergy (rare). Pregnancy Category A.

Key Risks

Key Interactions

Additive toxicity with Class I antiarrhythmics (e.g., Flecainide) or other local anaesthetics (e.g., concurrent bupivacaine infusions).

Monitoring

Place a 'NIL BY MOUTH' sign above the bed for 60 minutes after every dose. No food, no water, no pills. No specific routine laboratory tests required.

Clinical Pearl

Access

Xylocaine Viscous 2%

Brand: Xylocaine Viscous 2%