Comprehensive medication guide to Lidocaine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$60 copay; generic lidocaine is Tier 1–2 on most commercial plans and Medicare Part D; OTC formulations typically not covered but reimbursable via FSA/HSA; prescription 5% patches covered by ~81% of insurance plans at $60–$80 copay.
Estimated Cash Pricing
$10–$85 retail depending on formulation; generic lidocaine 5% patches start around $15/box, brand-name options up to $85; with GoodRx coupons as low as $8.78 for OTC/patch forms or $50.46 for prescription lidocaine.
Medfinder Findability Score
40/100
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Lidocaine is an amide-type local anesthetic and Class Ib antiarrhythmic drug. First synthesized in 1943 and FDA-approved in 1948, it has become one of the most widely used medications in medicine. Its combination of rapid onset, favorable safety profile, and versatility across dozens of formulations makes it indispensable across virtually every medical specialty.
Brand names include
Xylocaine (injectable), Lidoderm (5% transdermal patch), ZTLido (1.8% hydrogel patch), Glydo (2% jelly), and LMX 4/LMX 5 (topical creams). Generic forms are available for all major formulations.
Lidocaine is used across an extraordinary range of clinical settings: dental offices, operating rooms, emergency departments, dermatology clinics, pain management practices, and even at home via prescription patches. It is not a controlled substance — there are no DEA scheduling restrictions on its prescribing or dispensing.
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Lidocaine works by
blocking voltage-gated sodium channels in neuronal and cardiac cell membranes. These channels are microscopic gates that allow sodium ions to rush into the cell — generating the electrical signal (action potential) that transmits pain information to the brain. When lidocaine blocks these channels, the signal cannot propagate and the patient feels no pain.
An important property called differential nerve blockade means that at typical doses, lidocaine preferentially blocks small pain-sensing nerve fibers before it affects larger motor nerve fibers — so you can lose pain sensation while retaining movement. This is why dental patients can still move their jaw even though their tooth is completely numb.
For its antiarrhythmic effect, the same sodium channel blockade stabilizes the electrical conduction system in the heart — reducing automaticity in the His-Purkinje system and raising the depolarization threshold, making it harder for abnormal electrical signals to trigger a dangerous arrhythmia. Lidocaine is metabolized by the liver via CYP1A2 and CYP3A4 enzymes, with a half-life of approximately 1.5 to 2 hours.
0.5% — injectable solution
Local infiltration anesthesia
1% — injectable solution
Local and regional anesthesia, nerve blocks
2% — injectable solution
Regional anesthesia, epidurals, IV cardiac use
5% — transdermal patch (Lidoderm)
Postherpetic neuralgia; applied up to 12 hours/day
1.8% — hydrogel patch (ZTLido)
Postherpetic neuralgia; newer smaller patch format
4% — topical patch (OTC)
OTC minor skin pain relief
2% — topical jelly (Glydo)
Urethral procedures, catheterization, intubation
2% — viscous oral solution
Mouth/throat numbing, mucositis pain
4% / 5% — topical cream (LMX 4/LMX 5)
Skin numbing before procedures
2.5% (with prilocaine 2.5%) — EMLA cream
Skin numbing before IV placement or minor procedures
Lidocaine is in an active FDA/ASHP-tracked shortage as of 2026, primarily affecting injectable formulations. The shortage stems from a manufacturing duopoly — only Pfizer and Fresenius Kabi USA produce injectable lidocaine in the United States — combined with no domestic API suppliers, low profit margins, and surging demand from an aging population and post-pandemic procedure rebound.
Injectable vials (0.5%, 1%, 2%) are most severely affected. Lidocaine viscous 2% oral solution has also been listed. Topical patches and OTC creams face less severe but still real localized stock-outs depending on region and pharmacy. Some alternative manufacturers (Eugia US, Sintetica) have available inventory through major distributors, but supply is inconsistent.
If you're having trouble finding lidocaine at your pharmacy, medfinder is a paid service that calls pharmacies near you to find which ones currently have your medication in stock — and texts you the results.
Because lidocaine is not a controlled substance, any licensed prescriber with full prescribing authority can prescribe it without DEA-specific restrictions. This includes physicians, NPs, PAs, and dentists. The prescribing authority for lidocaine extends to all outpatient and inpatient settings.
Telehealth prescribing is available for topical lidocaine formulations (patches, viscous) for established indications since lidocaine is not a controlled substance. Injectable lidocaine requires in-person clinical administration and cannot be self-administered.
No. Lidocaine is
not a DEA-scheduled controlled substance. There are no special DEA registration requirements for prescribers, no limitations on refills based on controlled substance scheduling, and no quantity restrictions related to DEA scheduling. Any licensed prescriber — including nurse practitioners and physician assistants — can write for lidocaine without any DEA-specific restrictions.
Prescription-strength lidocaine products (5% patches, injectable solutions, viscous solution) do require a valid prescription from a licensed healthcare provider. Over-the-counter formulations (4% patches, LMX 4 cream) are available without a prescription. Injectable lidocaine is for clinical use only — it requires administration by trained healthcare personnel and should not be self-administered.
Topical forms (patches, creams, gels):
Injectable forms (minor systemic effects):
Serious side effects (seek emergency care immediately):
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Bupivacaine (Marcaine)
Long-acting amide local anesthetic (4–12 hours); used for surgical and obstetric anesthesia; higher cardiac toxicity risk than lidocaine.
Ropivacaine (Naropin)
Amide anesthetic with lower cardiac toxicity than bupivacaine; duration 4–8 hours; preferred for obstetric epidurals and regional blocks.
Mepivacaine (Carbocaine)
Rapid-onset amide anesthetic with intermediate duration (2–3 hours); low vasodilatory effect; widely used in dental procedures.
Benzocaine (Orajel, Hurricaine)
OTC ester-type topical anesthetic; for surface use only (not injectable); higher allergic reaction risk than amide anesthetics.
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Class I Antiarrhythmics (quinidine, flecainide, procainamide)
majorAbsolute contraindication — additive cardiac toxicity with serious risk of cardiovascular collapse.
MAOIs and Tricyclic Antidepressants
majorMay produce severe, prolonged hypertension when combined with lidocaine injections; concurrent use should be avoided.
Nonselective Beta-Blockers (propranolol, nadolol)
majorMay cause severe hypertension and bradycardia; avoid concurrent use.
Ergot Oxytocic Drugs
majorMay cause severe persistent hypertension or cerebrovascular accidents; concurrent use contraindicated.
CYP3A4/CYP1A2 Inhibitors (cimetidine, fluvoxamine, ciprofloxacin)
moderateMay increase serum lidocaine levels and risk of toxicity; monitor closely and consider dose reduction.
Drugs Associated With Methemoglobinemia (nitrates, dapsone, sulfonamides)
moderateAdditive risk of methemoglobinemia when combined with lidocaine; monitor for bluish skin discoloration.
Other Local Anesthetics
moderateToxic effects are additive; avoid combining with other local anesthetics without specific clinical justification.
Lidocaine is one of the most important and versatile medications in modern medicine. From numbing a tooth to treating a life-threatening cardiac arrhythmia, its range of applications is unmatched. Its well-understood mechanism, strong safety record when used appropriately, and wide availability in multiple formulations make it a cornerstone of clinical care.
The ongoing shortage of injectable lidocaine in 2026 underscores a broader problem with the US pharmaceutical supply chain: essential, inexpensive generics are vulnerable because they are economically unattractive to manufacture in quantity. Until structural reforms are made — more domestic manufacturing, more API suppliers, appropriate financial incentives — intermittent shortages will continue.
For patients who need lidocaine patches or other outpatient forms and are struggling to find them, medfinder is a paid service that contacts pharmacies near you to find which ones have your medication in stock. Don't spend hours on hold — let medfinder do the work for you.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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