THIS MEDICATION CAN CAUSE HARM TO YOUR BABY:
Lidocaine should only be used during pregnancy if medically necessary, as determined by your doctor. Always ask your doctor before using any over-the-counter product containing lidocaine during pregnancy. Treatment with lidocaine during pregnancy can lead to health problems in your baby, including abnormal heart rate and breathing problems. These effects typically depend on the amount of lidocaine to which the baby is exposed. The cumulative exposure from all forms of lidocaine, including topical lidocaine that is applied to the skin, should be considered when assessing the possible risks to the baby.
What is lidocaine?
Lidocaine is a medication that numbs pain. It is available in many different forms, including injections used during surgery and creams, gels, or patches that are applied to the skin. Some forms of this medication are available without a prescription.
What is lidocaine used to treat?
Lidocaine patches, creams, or gels that are applied to the skin are used to numb pain, including nerve pain, pain from sunburn, and back pain. Oral lidocaine liquid is used to numb pain on the inside of the mouth or throat. Injectable lidocaine is used for local anesthesia so that you do not feel pain during surgeries or dental procedures. Lidocaine can also be used to treat some types of heart arrythmias (ventricular arrythmias). An arrythmia is when the rhythm or rate of your heartbeat is abnormal. Some ventricular arrythmias can occur after a heart attack or heart surgery and can be life-threatening.
How does lidocaine work?
Lidocaine stops pain by preventing your nerves from sending pain signals to your brain. Lidocaine is also an antiarrhythmic medication that works by changing electrical signals in your heart.
If I am using or have received lidocaine, can it harm my baby?
Lidocaine should only be used during pregnancy if medically necessary, as determined by your doctor. You should always ask your doctor before using any over-the-counter products containing lidocaine during pregnancy. There is very little data on the use of lidocaine in human pregnancies, and most of the data describes the use of lidocaine as a local anesthetic during labor and delivery. No sufficient and well-controlled studies have looked at the safety of lidocaine in expecting moms. Lidocaine crosses the placenta and enters the baby’s blood. This medication could cause harm to the baby’s brain or heart. It is unknown how much lidocaine your baby will be exposed to if the medication is applied to the mother's skin. However, cumulative exposure to all forms of lidocaine, including topical forms, should be considered when assessing the possible risks to the baby. Your doctor will determine if treatment with lidocaine is medically necessary and if the benefits of treatment outweigh the potential risks.
Evidence from animal studies
Animal studies in rats at 6.6 times the human dose have not associated lidocaine with any harm to the offspring.
Evidence from studies in humans
Lidocaine has been given by continuous epidural infusion for pain relief to a small group of 26 moms during labor, with no effects noted in the newborns from lidocaine.
A small study looked at 28 babies whose moms had received continuous infusions of either lidocaine or another anesthetic before delivery. These babies had significantly reduced muscle strength and tone.
When high concentrations of lidocaine are given to the mom (typically by injection or infusion), the baby can develop slowed brain activity, slowed breathing, and low Apgar scores. Apgar scores are a measure of a newborn’s health after delivery, and lower scores indicate that the baby may need breathing assistance or lifesaving intervention. Six babies experienced abnormal heart rates after lidocaine was injected into the cervix of moms. These abnormal heart rates led to a dangerous condition, called acidosis (a buildup of acid in the blood) in the babies. Acidosis is caused by lack of oxygen in the blood and can lead to long-term neurological impairments, including brain damage, or death.
If lidocaine is injected during labor and delivery, it is possible that the medication could be accidentally injected into the baby, which could cause serious health problems. A report described a newborn who was accidentally injected with lidocaine. The baby stopped breathing, experienced seizures, and had low muscle strength and a fast heart rate.
A study looked at the effects of lidocaine use during the first trimester of pregnancy. A higher risk of some specific birth defects was found (birth defects of the respiratory tract, tumors, and inguinal hernia). The significance of this higher risk is unknown, and more studies are needed to confirm this data.
A report has also described the use of lidocaine injection and infusion for the treatment of ventricular arrythmia in a mom who had been resuscitated after cardiac arrest at 18 weeks of pregnancy. No health problems were reported in the baby. In moms who are experiencing cardiac arrest (a life-threatening condition), appropriate treatment medications should not be withheld due to concerns of birth defects in the baby. Lidocaine can be used to treat some life-threatening arrythmias. In these cases, your doctor may determine that the benefits of treatment with lidocaine outweigh the potential risks to the baby.
Bottom line: Lidocaine should only be used during pregnancy if medically necessary, as determined by your doctor. Treatment with lidocaine during pregnancy can lead to health problems in your baby, including abnormal heart rate and breathing problems. Lidocaine can be used to treat some potentially life-threatening arrythmias. In these cases, your doctor may determine that the benefits of treatment with lidocaine outweigh the potential risks to the baby.
If I am using or have received lidocaine and become pregnant, what should I do?
If you have received or are using lidocaine and become pregnant, you should contact your doctor immediately. Your doctor will determine if treatment with lidocaine is medically necessary and if your medications should be adjusted.
If I am using or have received lidocaine, can I safely breastfeed my baby?
Caution should be used if lidocaine is given to or used by breastfeeding moms. Small amounts of lidocaine pass into human breast milk. However, this medication is not expected to cause side effects in the breastfed baby. Lidocaine is classified as a medication that is usually compatible with breastfeeding by the American Academy of Pediatrics. There is very little data on the use of lidocaine in breastfeeding moms. A small study described the use of lidocaine during delivery in 14 moms; no side effects from the lidocaine were reported in their breastfed babies. Another small study reported the use of lidocaine in 14 breastfeeding moms with no side effects observed in their babies. Your doctor will determine if treatment with lidocaine is medically necessary and if breastfeeding should be continued.
Bottom line: Caution should be used if lidocaine is given to or used by breastfeeding moms. This medication passes into breast milk in small amounts, and there is very little data on its use while nursing.
If I am using or have received lidocaine, will it be more difficult to get pregnant?
No studies have been located that have looked at the effects of lidocaine on fertility.
If I am using or have received lidocaine, what should I know?
Lidocaine should only be used during pregnancy if medically necessary, as determined by your doctor. Treatment with lidocaine during pregnancy can lead to health problems in your baby, including abnormal muscle strength, heart rate, and breathing. Lidocaine can be used to treat some potentially life-threatening arrythmias. In these cases, your doctor may determine that the benefits of treatment with lidocaine outweigh the potential risks to the baby.
Caution should be used if lidocaine is given to or used by breastfeeding moms. Lidocaine passes into breast milk, and very little data is available on its use while nur
sing. Your doctor will determine if treatment with lidocaine is medically necessary and if breastfeeding should be continued.
If I am taking any medication, what should I know?
This report provides a summary of available information about the use of lidocaine during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert reports about the individual medications used to treat pain here and our report about pain here. Additional information can also be found in the resources below.
For more information about lidocaine during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link.
Lexicomp: Lidocaine (systemic): Drug information
Lexicomp: Lidocaine (topical): Drug information
U.S. National Library of Medicine: Lidocaine Transdermal Patch
U.S. National Library of Medicine: Arrythmia
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.