Lidocaine 5% Medicated Plaster

How it works

Lidocaine blocks voltage-gated sodium channels in local sensory nerve fibres, reducing ectopic nerve firing and dampening pain signalling in the area of application.

Prescribing in practice

• Apply only to intact, non-irritated, non-broken skin, as application to damaged skin increases systemic absorption and the risk of toxicity.
• Plasters are applied for a defined wear period followed by a plaster-free interval as stated in the SPC, and should be cut to size rather than overlapped where appropriate.
• Systemic adverse effects are uncommon with correct use, but caution is advised in severe hepatic impairment and with other local anaesthetic exposure.

Monitoring

Monitor the application site for local skin reactions and review analgesic benefit to justify continued use.

Counselling the patient

• Apply the plaster to healthy, unbroken skin over the painful area and follow the on/off timing you are given.
• Remove the plaster if it causes skin irritation, and wash your hands after handling it.
• Keep used and unused plasters away from children and pets.

Evidence & guidelines

The lidocaine medicated plaster is an established option for localised neuropathic pain such as post-herpetic neuralgia.