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What Is the Connection between Epinephrine and Lidocaine?

Tricia Christensen
By
Updated: Mar 03, 2024

Epinephrine and lidocaine are connected because they are often combined in an injection form to treat pain that might occur during local medical procedures, such as stitching a wound or removing a growth. They are useful when employed together because the drug, epinephrine, extends the length of time that lidocaine — which provides a numbing or local anesthetic sensation — will work. Though these medications are often combined, some people may react poorly to one or both of the drugs used in this injection.

Anyone with a simple injury, such as a burn or a wound that needs stitching, might be a candidate for an injection of epinephrine and lidocaine. Alternately, those individuals undergoing minor skin procedures could receive an injection of these two medicines to numb the area and reduce pain. Medical workers often use these two drugs together because they are very effective in combination.

The action of epinephrine and lidocaine on each other is what makes them work so well. Lidocaine causes numbness or a reduction in sensation that helps doctors provide comfort to patients while skin procedures are performed. The medication accomplishes this by interrupting the signals to the brain that create painful sensations.

Epinephrine, in contrast, is a vasoconstrictor. In other words, it constricts the veins around the area where it is injected, keeping the lidocaine active in the same place for longer so that brain signals remain interrupted. As long as lidocaine stays in the general area where it has been injected, continued sensations of numbness are expected. Essentially, epinephrine helps lidocaine work for longer periods of time, reducing the likelihood of additional injections to control a patient’s pain.

While there are many advantages of using epinephrine and lidocaine together, the combination drug is not always appropriate. For instance, some patients have allergic reactions to lidocaine. Another problem occurs when people with heart or blood pressure problems are exposed to epinephrine. This drug may have an effect on cardiac function, either raising or lowering heart rate or blood pressure.

The two medications are, thus, not advised for people with many heart conditions, with history of stroke or with high or low blood pressure. Additionally, lidocaine and epinephrine usually aren’t used in patients with thyroid disease, or disease of the kidneys or liver. The presence of certain infections also contraindicates the combination injection’s use because constricting the blood vessels with epinephrine may delay injury healing time.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.
Discussion Comments
By bluedolphin — On Apr 14, 2013

I was given these two medications before I had a cyst removed. I was not given general anesthesia, so they numbed me with these two drugs and it worked very well. I didn't feel anything.

By donasmrs — On Apr 14, 2013

@anamur-- People who have allergies may have epinephrine with them. It's called an epi pen, it can potentially save their life during a severe allergic reaction. When someone goes into anaphylaxis, they cannot breathe and epinephrine will let them breathe again. A doctor prescribes epinephrine as far as I know.

Lidocaine is available as a topical ointment over-the-counter. I don't think liquid lidocaine is available over the counter.

As for the epinephrine and lidocaine combination, I have not seen these vials anywhere other than the hospital. It can only be injected and only a medical professional can do that safely.

By serenesurface — On Apr 13, 2013

This combination drug is not available over the counter correct? Why would someone who hasn't had any procedure or surgery done need these drugs?

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
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