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Articles

Safety in Lactation: Drugs for rectal and anal disorders

21 October 2020Additional information relating to breastfeeding To be used in conjunction with individual drug entries for specific information and guidance. Rectal glyceryl nitrate and diltiazem (unlicensed)…

Safety in Lactation: Local anaesthetic eye preparations

15 October 2020Local anaesthetics for ophthalmic use have limited systemic absorption in the mother, and pose negligible risk to a breastfed infant. Systemic absorption from eye drops…

Safety in Lactation: Local anaesthesia

25 September 2020Local anaesthetics are generally considered to be compatible with breastfeeding. They are used in a variety of clinical situations (surgery including Caesarean sections, labour and…

Safety in Lactation: Drugs for oral ulceration and inflammation

21 September 2020The use of oropharyngeal anti-inflammatories/analgesics is not considered to present any risk to a breastfeeding infant. Doxycycline is considered to present negligible risk when used…

What is the clinical significance of potential drug interactions with local anaesthetic preparations used in primary care dentistry?

30 July 2020This updated Medicines Q&A explores the clinical significance of potential interactions between dental local anaesthetic preparations and other medicines as listed in the BNF and…
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Lactation Safety Information

Intravenous as anti-arrhythmic

Intravenous
as anti-arrhythmic
Yes
-
Small amounts in breast milk
Moderate published evidence of use in breastfeeding
Minimal absorption from the infant’s GI tract
Used in full-term neonates from birth
30 July 2020

For local anaesthesia

For local anaesthesia
Yes
Limited published evidence of safety
This entry applies to all uses (infiltration, regional and surface anaesthesia and nerve blocks) and formulations (injection/topical) of lidocaine for local anaesthesia, including injections with adrenaline
Small amounts in breast milk and minimal absorption from the infant’s GI tract
30 July 2020

For ophthalmic use

For ophthalmic use
Yes
Only available in combination with fluorescein for which there are no additional risks
30 July 2020

Ointment/spray for orophayngeal use

Ointment/spray for orophayngeal use
Yes
30 July 2020

Rectal

Rectal
Yes
-
Topical/rectal use for short periods in combination with a corticosteroid considered to present minimal risk to breastfed infant
30 July 2020

New Medicines

Topical anaesthesia for moderate acute pain during cervical and intrauterine procedures, in adults and adolescents from 15 years of age

Information

New formulation
Gedeon Richter
Not Known

Development and Regulatory status

Approved (Licensed)
None
None
Sep 20No plans to launch in the UK anytime soon [4].
Jul 20Lidocaine (Lidbree) 42 mg/mL intrauterine gel was approved in the UK for topical anaesthesia for moderate acute pain during cervical and intrauterine procedures, in adults and adolescents from 15 years of age [1].

Category

Lidocaine is a local anaesthetic of the amide type. Lidocaine reversibly stabilises neuronal membranes and prevents initiation and conduction of nerve impulses, thus providing local anaesthesia [1].
Some women feel no or only mild pain during a hysteroscopy, but for others the pain can be severe [2]. Cervical biopsy and cervical curettage are associated with visual analogue scale (VAS) pain scores ranging from four to six on a 10-point scale. Endometrial biopsies done have VAS scores of five to seven. Pain with intrauterine device insertion varies from two to seven, and pain scores during laminaria insertions with paracervical block range from five to seven [3].
Topical anaesthesia for moderate acute pain during cervical and intrauterine procedures, in adults and adolescents from 15 years of age
Intrauterine

Evidence based evaluations

SPC