Lidocaine Rectal

Lidocaine rectal is an over-the-counter (OTC) product used for pain, itching, and burning associated with hemorrhoids and other anorectal disorders.

Lidocaine rectal is available under the following different brand names: RectiCare, LMX5, Topicaine 5, Dr. Numb, and H-Releve Hemorrhoidal.

Anorectal Cream

• 4% (H-Releve Hemorrhoidal)
• 5% (RectiCare, LMX5, Dr. Numb)

Anorectal Gel

• 5% (Topicaine 5)

Dosage Considerations

Hemorrhoids or Anorectal Pain

• Indicated for pain, itching, and burning associated with hemorrhoids and other anorectal disorders
• Adults and children 12 years and older: Apply to perianal region up to 6 times/day
• Children under 12 years: Safety and efficacy not established

Administration

• Not to be used inside the rectum
• When practical, clean area with soap and water, and gently pat dry before use

Side effects of Lidocaine Rectal include:

• Application site reactions
• Abnormal sensation
• Pallor or blanching when the application time is very prolonged (more than 2 hours)
• Alterations in temperature sensations
• Swelling
• Itching
• Rash

Systemic reactions

• Unlikely due to the small dose absorbed; may occur with repeated doses or application to large surface area
• Central nervous system (CNS) excitation and/or depression
• Lightheadedness, nervousness, apprehension, euphoria, confusion
• Dizziness
• Drowsiness
• Ringing in the ears (tinnitus)
• Blurred or double vision
• Vomiting
• Sensations of heat, cold or numbness
• Twitching, tremors, convulsions
• Unconsciousness, respiratory depression, and arrest
• Cardiovascular problems (e.g., slow heart rate, low blood pressure, and cardiovascular collapse leading to arrest)

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Lidocaine rectal has no listed severe interactions with other drugs.
• Lidocaine rectal has no listed serious interactions with other drugs.
• Lidocaine rectal has no listed moderate interactions with other drugs.
• Lidocaine rectal has no listed mild interactions with other drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

This medication contains lidocaine rectal. Do not take RectiCare, LMX5, Topicaine 5, Dr. Numb, or H-Releve Hemorrhoidal if you are allergic to lidocaine rectal or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity to amide-type anesthetics

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Lidocaine Rectal?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Lidocaine Rectal?"

Cautions

• Do not apply to eyes, ears, or mucous membranes
• Severe hepatic impairment

Discontinue if:

• Rectal bleeding occurs
• Condition worsens or does not improve within 7 days
• Allergic reaction occurs
• Symptom being treated does not subside or if redness, irritation, swelling, pain or other symptoms develop or increase
• Symptoms clear up and return within a few days

Extensive systemic absorption

• Can result in plasma levels that could, in susceptible individuals, produce a systemic pharmacologic response
• Increased absorption may occur with:
  • Application to broken or inflamed skin
  • Application to 2,000 cm² or greater of skin of an adult
  • Application to 600 cm² or greater in children 10-20 kg body weight or 100 cm² or greater in children up to 10 kg

Pregnancy and Lactation

Lidocaine rectal may be acceptable for use during pregnancy. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risk.

Lidocaine rectal is distributed in human breast milk with extensive systemic absorption.

Pregnant or breastfeeding patients should seek advice of a health professional before using over-the-counter (OTC) drugs.