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

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.

• Tell your doctor if you are using a MAO inhibitor (MAOI) medicine, such as Eldepryl®, Marplan®, Nardil®, or Parnate®. You should also tell your doctor if you use medicine for depression, such as amitriptyline (Elavil®), doxepin (Sinequan®), or nortriptyline (Pamelor®).
• Make sure your doctor knows if you are using a phenothiazine medicine, such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®. These medicines can be used to treat severe vomiting, psychiatric (mental) problems, or other conditions.
• Tell you doctor about any other medicine or dietary supplement you have used recently.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breast feeding.
• Tell your doctor if have heart disease or any nervous system disease, such as multiple sclerosis ("MS"). You should also tell your doctor if you have liver disease, spinal cord problems, severe high blood pressure, or blood poisoning.
• Numbness may last for several hours after using this medicine, such as below your waist.
• Some of this medicine may get into your spinal cord because the medicine is put into your back. Your care giver should discuss this with you before you receive the medicine.

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
• Anxiety, blurred vision, confusion (trouble thinking), depression, dizziness, or drowsiness.
• Light-headedness, nervousness, restlessness, blurred or double vision, twitching, or tremors.
• Loss of bladder or bowel control.
• Loss of feeling between your legs.
• Loss of ability to have sex.
• Ringing in ears, or seizures (convulsions).
• Uneven, pounding, fast, or slow heartbeat.

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

• Backache.
• Headache.
• Pain or swelling where the needle went into your back.

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