When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to lidocaine or other types of local anesthetic (numbing medicine).

How to Use This Medicine:
Injectable

• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using amiodarone (Cordarone®), amprenavir (Agenerase®), atazanavir (Reyataz®), digoxin (Lanoxin®), phenytoin (Dilantin®) or St. John's wort. Tell your doctor if you use ergot medicines such as Cafergot®. Make sure your doctor knows if you use phenothiazines such as Compazine®, Phenergan®, Thorazine®, or Trilafon®. Your doctor will need to know if you are using blood pressure medicine such as metoprolol, nadolol, propranolol, Corgard®, Inderal®, or Toprol®. Also, tell your doctor if you are using medicine for depression such as amitriptyline, nortriptyline, Norpramin®, or Vivactil®.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• If you are not receiving this medicine for childbirth, make sure your doctor knows if you are pregnant or breast feeding. Tell your doctor if you have asthma, diabetes, liver disease, kidney disease, or seizures (epilepsy). Make sure your doctor knows if you have thyroid problems, circulation problems, high blood pressure, low blood pressure, or a blood-iron disorder called methemoglobinemia.
• Tell your doctor if you have any heart problems such as congestive heart failure or heart rhythm disorders (especially Wolff-Parkinson-White syndrome).
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• It may be easier to hurt yourself while your treated body area is still numb. Be careful to avoid injury until you have regained all the feeling and are no longer numb.
• If you are receiving this medicine as an epidural to ease labor pains, it may take longer than normal for you to push your baby out. It is also possible that the baby may have unwanted effects after birth (sleepiness, slow responses). Talk to your doctor if you have questions about how this medicine might affect your baby.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bluish colored lips or fingernails, pale skin.
• Chest pain or uneven heartbeat.
• Light-headedness or fainting.
• Numbness in another part of your body that is not being treated.
• Unusual bleeding, bruising, or weakness.

If you notice these less serious side effects, talk with your doctor:

• Back pain.
• Constipation, nausea, or vomiting.
• Headache.
• Numbness, tingling, or burning of treated areas in the hours or days after surgery.
• Pain, redness, or swelling where the needle was placed.
• Shivering, shaking, or tremors.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088