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Lidocaine gel

Anesthetic · Rx
Trade namesAkten 3.5%
Drug classTopical amide anesthetic (gel)
Strength3.5% ophthalmic gel
AvailabilityRx
Mechanism of actionAmide-type sodium-channel blocker in a gel vehicle that pools in the fornix, giving prolonged surface anesthesia without the epithelial toxicity of repeated drops.
Indication / reason for useOcular surface anesthesia for procedures, cataract surgery (topical anesthesia technique), intravitreal injections, longer minor procedures.
Usual adult dosing2 drops of gel applied to the ocular surface; may reapply. Do not exceed the labelled maximum.
PreservativePreservative-free , a preservative-free option exists
Contact lensesRemove lenses; reinsert after sensation returns.
Common / important adverse effectsConjunctival hyperemia, corneal epithelial changes, headache, transient blur from the gel.
Contraindications & cautionsKnown amide-anesthetic hypersensitivity; not for home use.
Pregnancy / lactationProcedural use considered low risk.
Practice notesAmide agent, an option if a patient reports ester (proparacaine/tetracaine) allergy.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.

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