When better analgesia demands multimodal therapy for PHN patients, lidocaine patches may augment therapeutic response1-3

Without opioids

Offers a non-opioid alternative (instead of titrating opioids to higher doses

Offers a non-opioid alternative
(instead of titrating opioids to higher doses)

Without delay

Begins relieving pain 30 minutes after application4*

Begins relieving pain 30 minutes after application4*

Without titration

Does not require titration5,6

Does not require titration5,6

Without adding to safety concerns

Does not add to burden of systemic adverse events or drug-drug interactions3,5,7

Does not add to burden of systemic adverse events or drug-drug interactions3,5,7

What are the other proven clinical benefits of lidocaine patches?

In open-label studies, lidocaine patches were proven to:

  • Boost overall efficacy, remain well tolerated when used with pregabalin/gabapentin3,8

  • Provide support for systemic therapy when monotherapy response is inadequate1,5,9

  • Offer synergistic mechanism of action that targets multiple sites on pain pathway1-3

  • Target peripheral mechanisms for a localized approach while systemic agents (such as oral treatments) target central mechanisms2,3,7,9,10

*Although the majority of patients experience pain relief within 1 week, consider at least 2 weeks of treatment to evaluate if patch provides meaningful benefits.11-15

Important Safety Information

Contraindications

ZTLIDO is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type, or to any other component of the product.

Warnings and Precautions

Accidental exposure can occur even after a ZTLIDO patch has been used. Small children or pets could suffer serious adverse effects from chewing or ingesting a new or used ZTLIDO patch. Store and dispose of patches properly and keep out of reach of children and pets.

Excessive dosing or overexposure to lidocaine can occur. Longer duration of application, application of more than the recommended number of patches, smaller patients, or impaired elimination may all contribute to increased blood concentration levels of lidocaine. If lidocaine overdose is suspected, check drug blood concentration. Management of overdose includes close monitoring, supportive care, and symptomatic treatment.

Cases of methemoglobinemia have been reported with local anesthetic use, although patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, or concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. Signs and symptoms include cyanotic skin discoloration and/or abnormal coloration of the blood and may occur immediately or may be delayed after exposure. Methemoglobin levels may continue to rise leading to more serious central nervous system and cardiovascular adverse effects. Discontinue ZTLIDO and any other oxidizing agents. Depending on severity of the symptoms, patients may respond to supportive care or may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen.

Application site reactions can occur during or immediately after treatment with ZTLIDO. This may include development of blisters, bruising, burning sensation, depigmentation, dermatitis, discoloration, edema, erythema, exfoliation, irritation, papules, petechia, pruritus, vesicles, or may be the locus of abnormal sensation. These reactions are generally mild and transient, resolving spontaneously within a few minutes to hours. Inform patients of these potential reactions and that severe skin irritation may occur with ZTLIDO if applied for a longer period than instructed.

Hypersensitivity cross-reactions may be possible for patients allergic to PABA derivatives. Manage hypersensitivity reactions by conventional means.

Eye exposure with ZTLIDO should be avoided. If eye contact occurs, immediately wash out the eye with water or saline and protect the eye (eg, eye glasses/eye wear) until sensation returns.

Adverse Reactions

Side effects of ZTLIDO include application site reactions such as, irritation, erythema, and pruritus. These are not all of the adverse reactions that may occur. Please see full Prescribing Information for more information.

Use in Specific Populations

Use of ZTLIDO during lactation should be used with caution as lidocaine is excreted into breast milk. The limited human data with lidocaine in pregnant women are not sufficient to inform drug-associated risk for major birth defects and miscarriage.

To report SUSPECTED ADVERSE REACTIONS, contact SCILEX Pharmaceuticals Inc. at 1-866-SCILEX3 or contact FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please see full Prescribing Information.

REFERENCES

  1. Toth C, Moulin DE, eds. Neuropathic Pain: Causes, Management, and Understanding. New York, New York: Cambridge University Press; 2013.

  2. Argoff CE. Review of current guidelines on the care of postherpetic neuralgia. Postgrad Med. 2011;123(5):134-142.

  3. White WT, Patel N, Drass M, Nalamachu S. Lidocaine patch 5% with systemic analgesics such as gabapentin: a rational polypharmacy approach for the treatment of chronic pain. Pain Med. 2003;4(4):321-330.

  4. Rowbotham MC, Davies PS, Verkempinck C, Galer BS. Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain. 1996;65(1):39-44.

  5. de Leon-Casasola OA, Mayoral V. The topical 5% lidocaine medicated plaster in localized neuropathic pain: a reappraisal of the clinical evidence. J Pain Res. 2016;9:67-79.

  6. Baron R, Allegri M, Correa-Illanes G, et al. The 5% lidocaine-medicated plaster: its inclusion in international treatment guidelines for treating localized neuropathic pain, and clinical evidence supporting its use. Pain Ther. 2016;5(2):149-169.

  7. Lussier D, Beaulieu P, eds. Adjuvant Analgesics. New York, New York: Oxford University Press; 2015.

  8. Rehm S, Binder A, Baron R. Post-herpetic neuralgia: 5% lidocaine medicated plaster, pregabalin, or a combination of both? A randomized, open, clinical effectiveness study. Curr Med Res Opin. 2010;26(7):1607-1619.

  9. Watson CPN, Gershon AA, Oxman MN, eds. Herpes Zoster: Postherpetic Neuralgia and Other Complications: Focus on Treatment and Prevention. Switzerland: Springer International Publishing; 2017.

  10. Hadley GR, Gayle JA, Ripoll J, et al. Post-herpetic neuralgia: a review. Curr Pain Headache Rep. 2016;20(3):17.

  11. Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113-e88.

  12. Schmader K. Herpes zoster. Clin Geriatr Med. 2016;32(3):539-553.

  13. Sacks GM. Unmet need in the treatment of postherpetic neuralgia. Am J Manag Care. 2013;19(1 Suppl):S207-S213.

  14. Katz NP, Gammaitoni AR, Davis MW, Dworkin RH; Lidoderm Patch Study Group. Lidocaine patch 5% reduces pain intensity and interference with quality of life in patients with postherpetic neuralgia: an effectiveness trial. Pain Med. 2002;3(4):324-332.

  15. Geha PY, Baliki MN, Chialvo DR, Harden RN, Paice JA, Apkarian AV. Brain activity for spontaneous pain of postherpetic neuralgia and its modulation by lidocaine patch therapy. Pain. 2007;128(1-2):88-100.

Modernize your treatment 
approach
with ZTlido®

Important Safety Information

Contraindications

ZTLIDO is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type, or to any other component of the product.

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