Last update May 6, 2022

Lidocaine Hydrochloride

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Medication which is compatible with breastfeeding in its multiple applications: local anesthetic (dermatological, dental), antiarrhythmic and epidural anesthesia.

It is excreted in breastmilk in insignificant quantities (Galderma 2012, Giuliani 2001, Dryden 2000, Ortega 1999, Lebedevs 1993, Zeisler 1986) and no problems have been observed in infants whose mothers were taking it. (Ortega 1999)

There is controversy about whether or not neuraxial analgesia during labor can affect the initiation and success of lactation. (Heesen 2021, see analgesia epidural)

As a TOPICAL ANESTHETIC (dermatological, stomatological-dental, ophthalmological and otological preparations) it has virtually no systemic absorption (Reece 2017, Cobb 2015, Harrison 1987). Do not apply to the breast or, if necessary, apply after a feed and clean thoroughly with water before the next one.

With prilocaine it forms a eutectic mixture (EMLA) which is useful for dermatological anesthesia. Application over large areas or orally can cause methemoglobinemia. (PDR 2014, Touma 2001, Essink 1999, Vickers 1997)

Local infiltration of lidocaine and epinephrine in the incision area of ​​a caesarean section, before and after the incision was associated with earlier first breastfeeding. (Tharwat 2016, Fouladi 2013).

The manufacturer (Galderma 2012) and several medical associations and expert consensus consider the use of this medication to be safe during breastfeeding. (Reece 2017, Cobb 2015, Butler 2014, Jürgens 2009, Schaefer 2007 p632, Howie 2006, Mahadevan 2006, Giuliani 2001, Tan 2001) 

American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)

List of WHO essential medicines: compatible with breastfeeding. (WHO / UNICEF 2002)

See below the information of this related product:


We do not have alternatives for Lidocaine Hydrochloride since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Lidocaine Hydrochloride is also known as Lidocaine. Here it is a list of alternative known names::

Lidocaine Hydrochloride in other languages or writings:


Main tradenames from several countries containing Lidocaine Hydrochloride in its composition:


Variable Value Unit
Oral Bioavail. 35 %
Molecular weight 234 daltons
Protein Binding 66 - 70 %
VD 1.3 - 1.5 l/Kg
pKa 13.78 -
Tmax 0.01 (Derm: 4-10h) hours
1.8 hours
M/P ratio 0.4 -
Theoretical Dose 0.01 - 0.12 mg/Kg/d
Relative Dose 0.8 - 4 %
Ped.Relat.Dose 0.8 - 4 %


  1. Heesen P, Halpern SH, Beilin Y, Mauri PA, Eidelman LA, Heesen M, Orbach-Zinger S. Labor neuraxial analgesia and breastfeeding: An updated systematic review. J Clin Anesth. 2021 Feb;68:110105. Consulted on Feb. 22, 2021 Abstract
  2. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  3. Tharwat AA, Yehia AH, Wahba KA, Ali AE. Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(1):1-5. Abstract Full text (link to original source) Full text (in our servers)
  4. Cobb B, Liu R, Valentine E, Onuoha O. Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk. Transl Perioper Pain Med. 2015;1(2):1-7. Abstract Full text (link to original source) Full text (in our servers)
  5. EMLA. Drug Summary. 2014 Full text (in our servers)
  6. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  7. Fouladi RF, Navali N, Abbassi A. Pre-incisional, post-incisional and combined pre- and post-incisional local wound infiltrations with lidocaine in elective caesarean section delivery: a randomised clinical trial. J Obstet Gynaecol. 2013 Abstract
  8. Galderma. LIdocaine & Tetracaine (Pliagis). Drug Summary. 2012 Full text (in our servers)
  9. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009 Abstract
  10. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  11. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  12. Howie WO, McMullen PC. Breastfeeding problems following anesthetic administration. J Perinat Educ. 2006 Abstract Full text (link to original source) Full text (in our servers)
  13. Nice FJ, De Eugenio D, Dimino TA, Freeny IC, Rovnack MB, Gromelski JS. Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and Other Healthcare Professionals. Part I. J Pharm Technol 2004;20:17-27. doi: 10.1177/875512250402000106.
  14. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  15. Touma S, Jackson JB. Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa. J Am Acad Dermatol. 2001 Abstract
  16. Giuliani M, Grossi GB, Pileri M, Lajolo C, Casparrini G. Could local anesthesia while breast-feeding be harmful to infants? J Pediatr Gastroenterol Nutr. 2001 Abstract
  17. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  18. Tan HL, Lie KI. Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J. 2001 Abstract Full text (link to original source) Full text (in our servers)
  19. Dryden RM, Lo MW. Breast milk lidocaine levels in tumescent liposuction. Plast Reconstr Surg. 2000 Abstract
  20. Ortega D, Viviand X, Lorec AM, Gamerre M, Martin C, Bruguerolle B. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand. 1999 Abstract
  21. Essink-Tebbes CM, Wuis EW, Liem KD, van Dongen RT, Hekster YA. Safety of lidocaine-prilocaine cream application four times a day in premature neonates: a pilot study. Eur J Pediatr. 1999 Abstract
  22. Vickers ER, Marzbani N, Gerzina TM, McLean C, Punnia-Moorthy A, Mather L. Pharmacokinetics of EMLA cream 5% application to oral mucosa. Anesth Prog. 1997 Abstract
  23. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett K. Excretion of lignocaine and its metabolite monoethylglycinexylidide in breast milk following its use in a dental procedure. A case report. J Clin Periodontol. 1993 Sep;20(8):606-8. Abstract
  24. Harrison RF, Brennan M. Evaluation of two local anaesthetic sprays for the relief of post-episiotomy pain. Curr Med Res Opin. 1987 Abstract
  25. Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986 Abstract

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