Lidocaine/ Chlorhexidine

Registered South African indications:

• Urethral catheterisation and instrumentation

Contraindications

• Hypersensitivity to the active ingredients or any of the excipients in this combination product
• Severe bradycardia
• Children under the age of 18 years
• Should not be used in patients with hypovolaemia
• Heart block or other conduction disturbances
• Urethral trauma
• Urethral inflammation

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Acute illness or sepsis
• Debilitated patients
• Children
• Cardiovascular disease
• History of seizures
• Severe shock
• Contact with eyes
• Familial hypothermia
• Broken or inflamed skin
• Excessive dosing
• Short dosing intervals

Forms avail. in SA and covered in this monograph: jel

Urethral catheterisation and instrumentation

Lidocaine/ Chlorhexidine
2/0.05 (g/100g)

• Urethral (jel): Slowly instill the contents of 1 accordion syringe, 10-20 minutes prior to procedure

Ensure that the urethra is not traumatised during application, as this may cause rapid absorption of lidocaine, possibly resulting in severe adverse effects and systemic toxicity

See additional prescribing points for administration directions

Not approved for use in South Africa for children below 18 years

Recommendations for this combination product as per highest risk category when comparing individual active ingredients

Pregnancy

• FDA Pregnancy Category C (Chlorhexidine)

Breastfeeding

• Caution (Lidocaine, Chlorhexidine)

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Yawning
• Restlessness
• Dizziness
• Tinnitus
• Seizures

Cardiovascular Disorders

• Myocardial depression
• Peripheral vasodilatation
• Hypotension
• Bradycardia
• Arrythmias
• Cardiac arrest

Gastrointestinal Disorders

• Nausea and vomiting

Musculoskeletal Disorders

• Muscle twitching
• Tremors

Skin and Subcutaneous Tissue Disorders

• Allergic skin conditions

Sensory Disorders

• Nystagmus
• Blurred vision

• Conivaptan
• CYP1A2 inhibitors
• CYP3A4 inhibitors
• Fusidic acid
• Idelalisib
• Mifepristone
• Stiripentol
• Vemurafenib

None routine

Administration directions

• Clean the external orifice of the urethra with an appropriate antiseptic agent
• Peel off the paper from the blister pack cover (possibly up to the waist of the transparent blister material)
• Break off the plastic rod at the top of the applicator cone
• One drop of gel may be released for easier insertion of the applicator
• Instillation is completed by applying steady pressure to the accordion syringe

Lidocaine
Lidocaine decreases the permeability of the neuronal membrane to sodium ions, which depolarises the membrane and thus blocks both the initiation and conduction of nerve impulses.

Chlorhexidine
Chlorhexidine is an antimicrobial whose affect is attributed to the attraction between chlorhexidine, a cation, and negatively charged bacterial cells. After chlorhexidine is absorbed into the organism's cell wall, it disrupts the integrity of the cell membrane and causes the leakage of intracellular components of the organisms.

COMBINATION PREPARATIONS

Lidocaine/ Chlorhexidine

Jelly (per 100g) 2g/0.05g

• Cathejell (Pharmaplan) originator (Discontinued: 20/12/19)