Frequently asked questions and resources

JELIDO^® (lidocaine hydrochloride jelly) is indicated for:²

• Surface anaesthesia and lubrication for:
  • The male and female urethra during cystoscopy, catheterization, exploration
    by sound, and other endourethral operations
  • Nasal and pharyngeal cavities in endoscopic procedures such as gastroscopy and bronchoscopy
  • Proctoscopy and rectoscopy
  • Tracheal intubation
• Symptomatic treatment of pain in connection with cystitis and urethritis

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Children (2 to 12 years):¹

• < 12 years of age: Maximum amount of lidocaine per dose should not exceed 6 mg/kg or 3 mL/10 kg.
• > 12 years of age: Dosing should be adjusted according to the patient’s weight and physical condition
• No more than 4 doses in a 24-hour period

Other populations:¹

• Debilitated, elderly, or acutely ill patients should receive reduced doses, adjusted to account for the patient’s weight and physical condition

The lowest dosage that results in effective anaesthesia should be used to avoid high plasma levels and serious adverse effects.

Elderly patients may also be more sensitive to systemic effects due to increased plasma levels of lidocaine following repeated doses and may therefore require dose reductions.

INSTILLAGEL^® should be used with caution in patients with epilepsy, impaired cardiovascular conduction, bradycardia, and impaired hepatic or renal function.

INSTILLAGEL^® should be used with caution in patients with impaired cardiovascular function since they may be less able to compensate for functional changes associated with the prolongation of A-V conduction produced by amide-type local anaesthetics.

Lidocaine should be used with caution in patients with severe shock.

The lowest dosage that results in effective anaesthesia should be used to avoid high plasma levels and serious adverse effects.

It is reasonable to assume that a large number of pregnant women and women of childbearing age have been given lidocaine. No specific disturbances to the reproductive process have so far been reported (e.g., no increased incidence of malformations). However, care should be taken during early pregnancy when maximum organogenesis takes place. It is not known whether chlorhexidine gluconate crosses the placenta.

Labour and delivery: Lidocaine and chlorhexidine are not contraindicated in labour and delivery. Should INSTILLAGEL^® be used concomitantly with other products containing lidocaine and/or chlorhexidine, the total dose contributed by all formulations must be kept in mind.

Nursing women: Lidocaine and its metabolites are excreted in the breast milk. At therapeutic doses, the quantities of lidocaine and its metabolites in breast milk are small and generally are not expected to be a risk for the infant. It is not known whether chlorhexidine gluconate is distributed into milk.

Serious adverse experiences are generally systemic in nature. The following are the most commonly reported:

Central Nervous System (CNS): CNS manifestations are excitatory and/or depressant and may be characterized by circumoral paresthesia, light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, hyperacusis, tinnitus, blurred vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression, and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest.

Drowsiness following the administration of lidocaine is usually an early sign of a high lidocaine plasma level and may occur as a consequence of rapid absorption.

Cardiovascular: Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, arrhythmia, and cardiovascular collapse, which may lead to cardiac arrest.

Allergic: Allergic reactions are characterized by cutaneous lesions, urticaria, oedema, or, in the most severe instances, anaphylactic shock. Allergic reactions of the amide type are rare and may occur as a result of sensitivity to either the local anaesthetic agent or to other components in the formulation.

Chlorhexidine: Irritative skin reactions can occasionally occur. Generalized allergic reactions to chlorhexidine have also been reported but are extremely rare.