Designed for post-herpetic neuralgia, this patch works by releasing a continuous supply of lidocaine, an anesthetic that operates as a sodium channel blocker.  In essence, it works to block the nerve impulses from the local region that might otherwise travel to the spinal cord.  Systemic blood levels of the drug are not achieved, which should alleviate concerns that the patch could alter heart and lung function . . . the primary worry of most doctors when it comes to lidocaine.

Research on regional pain has shown that this patch can often be effective.  Charles Argoff, M.D., of Bethpage, NY, provided three important concepts regarding the Lidoderm Patch.  First, repeated daily use of the patch improves its pain-relieving effectiveness during the first seven days.  Second, using up to four patches a day in a diverse group of patients (but none with FMS) produced favorable results after three weeks.  Referring to the lidocaine patch, Argoff says, “It was not only helpful in reducing pain, but it was also helpful in allowing people to sleep more comfortably, walk more comfortably, and so on.”  Finally, Argoff presented a study in which pain patients took a centrally-acting pain reliever, gabapentin (Neurontin), along with the lidocaine patch.  The goal was to measure the benefit of combining a peripheral with a central acting agent.  Describing the outcome, Argoff says, “There was certainly improvement in using two agents instead of just the gabapentin.” 

Argoff says that the primary side effect of Lidoderm is skin rash, but this can be reduced by limiting the hours per day of patch use at a given area.  Thirty 4″ x 6″ patches cost roughly $185. 

2. Argoff CE. Curr Pain Headache Rep 7(1):34-38, 2003

Posted on September 29th, 2008 by cher
Filed under: Front Page