Lox 10% Spray

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What Is Lox 10% Spray?

Lox 10% Spray is a 10% lidocaine topical spray supplied as a 50 ml metered pump bottle by Neon Laboratories. Each metered actuation delivers approximately 10 mg of lidocaine as an aqueous/ethanolic spray that rapidly coats skin or accessible mucosal surfaces. The same lidocaine 10% topical spray is sold as Xylocaine 10% Spray (AstraZeneca) in many countries and as generic alternatives globally.

Lidocaine is the world's most widely used amide-type local anaesthetic. It is on the WHO List of Essential Medicines. At 10% concentration in a spray, its dominant clinical use is surface numbing of mucosal tissues and skin immediately before a brief, painful procedure. The spray format is preferred over a 2% gel when rapid coverage of a large area is needed (e.g. oropharynx before intubation) or where a fine liquid mist reaches angles that a gel cannot.

Lox 10% Spray is niet the same as injectable lidocaine used for infiltration anaesthesia (dentist's syringe), nor the same as the cream forms (EMLA, ELA-Max) used for intact skin analgesia — those creams contain 2.5% lidocaine and need 30–60 minutes under occlusion to work. Surface spray takes only minutes but does not penetrate intact thick skin deeply enough for a full skin biopsy; it numbs the surface mucosa only.

How Does Lox 10% Spray Work?

Lidocaine reversibly blocks voltage-gated sodium channels in nerve membranes. Without the sodium flux that triggers action potentials, pain signals cannot travel along the nerve — the area becomes numb until the drug diffuses away and is metabolised. Lidocaine preferentially blocks small, fast-firing pain fibres (A-delta and C) before larger motor fibres, which is why patients keep motor function in the treated area while losing sharp pain sensation.

After topical application to mucosa, onset of numbing is 1–3 minutes; peak effect at 5–10 minutes; duration 30–60 minutes. Lidocaine is metabolised in the liver by CYP1A2 and CYP3A4 to MEGX and GX metabolites and excreted renally — plasma half-life is around 1.5–2 hours.

Toepassingen en Indicaties

• Dentistry — surface numbing of gingiva before needle insertion for infiltration anaesthesia; minor periodontal instrumentation; scaling
• Intubation and airway instrumentation — numbing of the oropharynx, tongue base and vocal cords before laryngoscopy, bronchoscopy, tracheal intubation or transoesophageal echo
• Upper GI endoscopy — spray to oropharynx before scope passage
• ENT procedures — anterior and posterior rhinoscopy, middle-ear examination, direct laryngoscopy, indirect laryngoscopy, removal of foreign bodies from ear/nose
• Gynaecology and urology — cervical instrumentation (IUD insertion, biopsy), urethral meatus spray before catheterisation or cystoscopy
• Rectal procedures — proctoscopy, anoscopy (spray to anal verge only; not for deep rectal use)
• IV cannulation — surface spray 1–2 minutes before needle in needle-phobic or paediatric patients (adjunctive to EMLA/creams)
• Dermatology — surface numbing before curettage of small lesions, electrocautery of skin tags, minor biopsies (thin lesions only)
• Off-label for premature ejaculation — a measured dose applied to the glans penis 10–15 minutes before intercourse can delay ejaculation. Wipe residue before penetration to avoid partner numbing; use a condom. Discuss with a clinician; for persistent PE, dapoxetine is the licensed oral option.

Lox 10% Spray is not appropriate for: infiltration anaesthesia (use injectable lidocaine), deep skin biopsies (surface spray does not penetrate thick skin), eye/conjunctival use (specific ophthalmic products are needed), or wound irrigation (use injectable lidocaine or sterile saline).

Lox 10% Spray Dosage

Adult maximum single session: 20 sprays (200 mg lidocaine). Do not exceed 3 mg/kg of lidocaine total for any patient in any single session. In debilitated, elderly or hepatic-impaired patients, reduce to 50% of the usual dose.

How to Use Lox 10% Spray Properly

1. Shake the bottle gently and prime by holding it vertical and pressing the pump 1–2 times into a tissue or the air, away from the patient's face.
2. Hold the nozzle 5–10 cm from the target. Aim away from the patient's eyes — lidocaine on the cornea causes immediate severe stinging but is not dangerous.
3. Press the pump once per metered dose. Each actuation delivers ~10 mg. Count doses aloud or note them on paper to track total.
4. Wait 1–3 minutes for onset before beginning the procedure. Mucosa will look slightly blanched; patient should report loss of sharp-touch sensation.
5. Do not exceed the per-session maximum — track spray count, especially in long procedures.
6. Wipe the external nozzle after each use to avoid cross-contamination; ideally use a new dose each patient, or single-patient bottles in clinical settings.
7. After the procedure, advise the patient not to eat or drink for 1 hour after oropharyngeal spray — the gag reflex is impaired and aspiration risk is real.

Side Effects of Lox 10% Spray

Common (usually transient):

• Brief stinging or burning on application
• Bitter taste after oropharyngeal use
• Mild erythema at the application site
• Numbness persisting 30–60 minutes after the procedure
• Reduced gag reflex after oropharyngeal spray (1 hour NPO needed)

Minder vaak:

• Contact dermatitis (amide hypersensitivity is rare; ester anaesthetic hypersensitivity is more common)
• Methaemoglobinaemia — particularly with high total dose, in infants, or with benzocaine co-application
• Dizziness, lightheadedness (early systemic toxicity sign)

Serious — Local Anaesthetic Systemic Toxicity (LAST), stop and treat:

• Perioral numbness, metallic taste, tinnitus — earliest CNS signs
• Slurred speech, tremor, dysarthria — progression
• Seizures — mid-severity CNS toxicity
• Hypotension, bradycardia, arrhythmia — cardiovascular toxicity (very high doses)
• Cardiac arrest — if any of these develop, stop, support airway/breathing/circulation, and consider intralipid 20% IV (1.5 ml/kg bolus then 0.25 ml/kg/min infusion)

Waarschuwingen en voorzorgsmaatregelen

• Track total dose. Absolute maximum is 3 mg/kg or 200 mg in an adult — whichever is lower. Count sprays.
• Avoid broken skin, inflamed mucosa or traumatised tissue — absorption rises sharply and LAST becomes more likely.
• Hepatic impairment reduces lidocaine clearance — use half the usual dose.
• Cardiac conduction disease (high-grade AV block, pacemaker dependency): use cautiously; lidocaine prolongs AV conduction.
• Heart failure reduces hepatic blood flow and clearance — halve the dose.
• Elderly / debilitated: reduce to 50% dose; lidocaine plasma half-life is longer.
• Infants and small children: calculate 3 mg/kg max carefully. Avoid in infants under 2 except under anaesthetic supervision.
• Post-oropharyngeal spray: 1 hour NPO (nothing by mouth) — aspiration risk.
• Do not spray into the eye — severe irritation. Use ophthalmic lidocaine (0.5%) if eye anaesthesia needed.
• Pregnancy: FDA Category B — small topical doses are considered safe; discuss with obstetrician.

Contra-indicaties

• Known hypersensitivity to lidocaine, other amide-type local anaesthetics, or any formulation excipient
• Second- or third-degree AV block (without pacemaker)
• Wolff-Parkinson-White syndrome (relative)
• Severe sinoatrial or intraventricular conduction disease
• Porphyria — lidocaine can precipitate an acute attack
• Infants under 2 years (relative; specialist-only decision)

Geneesmiddelinteracties

Opslag

• Store below 25°C in a dry place.
• Keep the bottle upright to ensure the pump primes correctly.
• Do not expose to direct sunlight, flame or sparks — the propellant vehicle contains ethanol and is flammable.
• Discard 12 months after first opening.
• Keep out of reach of children.

Gerelateerde alternatieven op MedsBase

• Crocin Advance (paracetamol 500 mg, fast-dispersing) — rapid-onset analgesic
• Meftal (mefenamic acid 250 / 500 mg) — NSAID for period pain and inflammation
• Hyloric (allopurinol 100 / 300 mg) — gout prophylaxis

Veelgestelde vragen

Is Lox 10% Spray the same as Xylocaine 10% Spray?

Yes — the formulation (lidocaine 10% topical spray, ~10 mg per actuation, 50 ml bottle) is clinically interchangeable with Xylocaine 10% Spray (AstraZeneca) and other generic 10% lidocaine sprays worldwide. The drug, concentration and delivery method are identical.

How long does Lox 10% Spray last?

Onset is 1–3 minutes; full anaesthetic depth at 5–10 minutes; surface numbness persists 30–60 minutes. For oropharyngeal use, the gag reflex remains impaired for around 1 hour — do not eat or drink during that window to avoid aspiration.

What is the maximum safe dose?

3 mg/kg of lidocaine, or 200 mg total, whichever is lower. For an adult that is 20 sprays in a single session. For a 30 kg child, it is 90 mg / 9 sprays. Halve the dose in elderly, hepatic-impaired and cardiac-failure patients.

Can I use Lox 10% Spray for premature ejaculation?

Some men apply a measured dose (1–2 sprays) to the glans penis 10–15 minutes before intercourse to delay ejaculation. This is off-label — efficacy is real but three practical issues matter: (1) residual lidocaine numbs the partner, so wipe thoroughly and use a condom; (2) do not exceed 2 sprays per use — more does not improve the effect but does increase LAST risk; (3) for persistent PE, dapoxetine (sold as Poxet, Priligy and Super Vilitra/Super P-Force in combination with PDE5 inhibitors) is the licensed oral option with better sustained efficacy. Discuss with a clinician.

Can Lox 10% Spray be used on children?

Yes, with care. Calculate maximum total dose as 3 mg/kg (one spray = 10 mg). For a 20 kg child the ceiling is 60 mg = 6 sprays in a single session. Avoid in infants under 2 except under anaesthetic supervision — the skin/mucosa absorption in infants is higher and methaemoglobinaemia risk is greater.

What are the first signs of lidocaine toxicity (LAST)?

The earliest CNS signs are perioral numbness, metallic taste, tinnitus, and lightheadedness — these develop within minutes of a high dose. If any appear, stop applying, call for help and place the patient in a safe position. Progression is to slurred speech, tremor, seizures, then cardiovascular collapse. Treatment is airway/breathing/circulation support and intralipid 20% IV in severe cases.

Can Lox 10% Spray be used on open wounds?

No. Absorption from broken skin or inflamed mucosa is far higher than from intact surfaces — systemic toxicity risk rises. For wound cleaning or small open lacerations, use injectable lidocaine for infiltration anaesthesia (different product).

Is Lox 10% Spray safe during pregnancy?

Lidocaine is FDA Pregnancy Category B — small topical doses are widely considered safe during pregnancy (e.g. dental and obstetric use). Avoid high total doses and discuss with your obstetrician if used for any non-urgent procedure.

Why does my spray sting when I first apply it?

Brief stinging is the expected initial irritation of the ethanolic vehicle before numbness sets in — it resolves within 1–2 minutes as the anaesthetic takes effect. Severe persistent pain, rash, swelling, or difficulty breathing after application is niet normal and may indicate an allergic reaction — stop use and seek medical review.

Lox 10% Spray delivers fast surface numbing at high concentration, but for catheterisation, cystoscopy, or sustained PE-delay use that benefits from a sterile lubricating gel format, switch to Lox 2% Jelly (lidocaine 2% topical/urethral) — same lidocaine molecule, lower concentration, longer contact dwell.

Lox 10% Spray gives rapid mucosal lignocaine anaesthesia, and for deeper infiltration the same active is often paired with Hynidase Injection (hyaluronidase 1500 IU), a spreading enzyme that helps the anaesthetic diffuse evenly across a wider tissue field.

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