INSTILLAGEL® LIDO GEL 2%W/W [SIN17294P]

Product Info

INSTILLAGEL® LIDO GEL 2%W/W

[SIN17294P]

Indication

2. What is Instillagel® lido gel 2% w/w used for?
Instillagel® lido gel 2% w/w is indicated as a surface anaesthetic and lubricant for:

• The male and female urethra during cystoscopy, catheterisation, exploration by sound and other endourethral procedures.

• Nasal and pharyngeal cavities in endoscopic procedures such as gastroscopy and bronchoscopy.

• During proctoscopy and rectoscopy.

• Tracheal intubation.

• Symptomatic treatment of pain in connection with cystitis and urethritis.

Dosing

5. How much and how often should you use Instillagel® lido gel 2% w/w?
As with any local anaesthetic, the safety and effectiveness of lidocaine depend on the proper dosage, the correct technique, adequate precautions and readiness for emergencies.
The following dosage recommendations should be regarded as a guide. The clinician’s experience and knowledge of the patient’s physical status are of importance in calculating the required dose.
Absorption from mucous membranes is variable but especially high from the bronchial tree. The absorption of lidocaine gel from the nasopharynx is usually lower than with other lidocaine products. Blood concentrations of lidocaine after instillation of the gel in the intact urethra and bladder in doses up to 400 mg are fairly low and below toxic levels.
Debilitated or elderly patients, children over 12 years of age, acutely ill patients or patients with sepsis should be given doses commensurate with their age, weight and physical condition.
In children under the age of 12 years the dose should not exceed 4 mg/kg.
No more than four doses should be given in a 24-hour period.

Urethral anaesthesia
Surface anaesthesia of the male adult urethra: for adequate analgesia in males 20 ml (=400 mg lidocaine hydrochloride) gel is required. The gel is instilled slowly until the patient has a feeling of tension or until 10 ml (= 200 mg lidocaine hydrochloride). A penile clamp is then applied for several minutes at the corona, after which the rest of the gel is installed.
When anaesthesia is especially important, e.g. during sounding or cystoscopy, a larger quantity of gel (e.g. 30–40 ml) may be instilled in 3–4 portions and allowed to act for 10 minutes before insertion of the instrument. The gel instilled into the bladder is also effective for procedures in this region.
Surface anaesthesia of the female adult urethra: instill 5–10 ml in small portions to fill the whole urethra. In order to obtain adequate anaesthesia, several minutes should be allowed to elapse prior to performing urological procedures.

Endoscopy
The instillation of 10–20 ml is recommended for adequate analgesia and a small amount may be applied to the lubricating instrument. When combined with other lidocaine products (e.g. for bronchoscopy), the total dose of lidocaine should not exceed 400 mg.

Lubrication for endotracheal intubation
About 2 ml applied to the surface of the tube just prior to insertion. Care should be taken to avoid introducing the product into the lumen of the tube.

Contraindications

6. When should you not take Instillagel® lido gel 2% w/w?
Hypersensitivity to local anaesthetics of the amide type, or to any of the excipients.