Premature ejaculation can be caused by increased sensitivity of the head of the penis. In order to increase the duration of intimacy, you should use special condoms with an anesthetic. You can also reduce the sensitivity of the head of the genital organ using a product such as lidocaine spray.
Good day, here is Alexander Burusov, an expert at the Viva Man men’s club. Today we will talk about this method of prolonging sexual intercourse by using lidocaine in the form of a spray.
Indications for use, contraindications
Medicines intended to prolong intimacy should be used if the following indications exist:
- ejaculation occurs within the first ten seconds after erection;
- The duration of sexual intercourse is less than one minute. In this case, an erection without intimacy persists for a long time.
There are certain contraindications to the use of the medication. Lidocaine spray must not be applied if the stronger sex has an allergic reaction to the components of the product. It is not recommended for use in severe diseases of the cardiovascular system. If a man has chronic pathologies of the kidneys or liver, the dosage of the medicine should be reduced (to one spray).
Lidocaine 10% 50ml 38g spray for topical use dosed
pharmachologic effect
Local anesthetic for superficial anesthesia.
The action is due to the blockade of voltage-dependent sodium channels, which prevents the generation of impulses at the endings of sensory nerves and the conduction of pain impulses along nerve fibers. When applied topically, it dilates blood vessels and does not have a local irritating effect. Has an analgesic effect.
The effect develops 1-5 minutes after application to mucous membranes or skin and lasts 30-60 minutes.
Composition and release form Lidocaine 10% 50ml 38g spray for topical use, dosed
Spray - 1 dose/1 bottle:
- Active substance: lidocaine 4.6 mg 3.8 g.
- Excipients: peppermint leaf oil, propylene glycol, ethanol 96%.
38 g (650 doses) - dark glass bottles with a capacity of 50 ml (1) with a dosing pump with a spray head - cardboard packs.
Description of the dosage form
Spray for topical use dosed in the form of an almost colorless alcohol solution with a characteristic menthol odor.
Characteristic
Acetanilide derivative.
Directions for use and doses
The drug is used locally, externally. The dose depends on the indications and the area of the anesthetized surface.
1 dose of spray, released by pressing the dosing valve, contains 4.8 mg of lidocaine.
To avoid high concentrations of lidocaine in blood plasma, the lowest dose that provides a satisfactory effect should be used. Usually 1-2 sprays are sufficient, although 15-20 sprays or more are used in obstetrics (maximum dose - 40 sprays/70 kg body weight).
Recommended doses for various indications:
| Application area | Dose (number of sprays) |
| Dentistry | 1-3 |
| Oral surgery | 1-4 |
| Otorhinolaryngology | 1-4 |
| Endoscopy | 2-3 |
| Obstetrics | 15-20 |
| Gynecology | 4-5 |
| Dermatology | 1-3 |
The drug can also be applied using a cotton swab soaked in it.
When performing dental procedures and surgeries in children, it is preferable to apply Lidocaine spray using a cotton swab, which avoids the fear of spraying the drug, as well as the tingling sensation (a common side effect).
Pharmacokinetics
Suction
Rapidly absorbed from mucous membranes (especially the pharynx and respiratory tract). The degree of absorption of the drug is determined by the degree of blood supply to the mucous membrane, the total dose of the drug, the localization of the site and the duration of application. After application to the mucous membrane of the upper respiratory tract, it is partially swallowed and inactivated in the gastrointestinal tract. The time to reach Cmax when applied to the mucous membrane of the oral cavity and upper respiratory tract is 10-20 minutes.
Distribution
Protein binding depends on the concentration of the drug and is 60-80% at a drug concentration of 1-4 μg/ml (4.3-17.2 μmol/l). It is distributed quickly (T1/2 phases of distribution - 6-9 minutes), first enters well-supplied tissues (heart, lungs, brain, liver, spleen), then into adipose and muscle tissue. Penetrates the BBB and placental barrier, secreted into breast milk (40% of the concentration in maternal plasma).
Metabolism and excretion
Metabolized in the liver (90-95%) with the participation of microsomal enzymes by dealkylation of the amino group and cleavage of the amide bond with the formation of metabolites that are less active compared to lidocaine (monoethylglycine xylidine and glycine xylidine), T1/2 of which is 2 hours and 10 hours, respectively.
Excreted with bile and kidneys (up to 10% unchanged).
Pharmacokinetics in special groups of patients
In liver diseases, the metabolic rate decreases and ranges from 50% to 10% of the normal value.
In chronic renal failure, accumulation of metabolites is possible.
Indications for use Lidocaine 10% 50ml 38g spray for topical use, dosed
For terminal (superficial) anesthesia of mucous membranes.
In dentistry:
- anesthesia of the injection area before local anesthesia;
- suturing the mucous membrane;
- removal of mobile baby teeth;
- removal of tartar;
- anesthesia of the gums before fixing a crown or bridge;
- in children during surgery for excision of the frenulum of the tongue and opening of salivary gland cysts.
In otorhinolaryngology:
- operations on the nasal septum;
- carrying out electrocoagulation.
In obstetrics and gynecology:
- episiotomy and incision debridement;
- removal of seams;
- interventions on the vagina and cervix.
For instrumental and endoscopic studies:
- insertion of a probe, rectoscopy, intubation, etc.;
- X-ray examination (to eliminate nausea and pharyngeal reflex).
In surgery and dermatology:
- as an analgesic drug for burns (including sunburn), small wounds (including scratches);
- superficial anesthesia of the skin during minor surgical interventions.
Contraindications
- Use for tonsillectomy and adenotomy in children under 8 years of age;
- hypersensitivity to lidocaine and other components of the drug.
The drug should be used with caution during instrumental studies (rectoscopy) in patients with hemorrhoidal bleeding, local infection in the area of application, trauma to the mucous membrane or skin in the area of application, severe somatic pathology, epilepsy, bradycardia, impaired cardiac conduction, impaired liver function, severe shock, in young children, elderly patients, during pregnancy and lactation.
Application Lidocaine 10% 50ml 38g spray for topical use dosed during pregnancy and breastfeeding
There are no results from controlled clinical studies in pregnant women. If local anesthesia is necessary and there is no safer treatment, lidocaine spray can be used during pregnancy.
Lidocaine is excreted in breast milk, but after topical use in normal therapeutic doses, the amount excreted in milk is too small to cause any harm to a nursing infant.
Use in children
In children under 2 years of age, it is preferable to use the drug by applying it with a swab, which avoids the fear that appears when spraying, as well as the burning sensation.
It should be borne in mind that in children the swallowing reflex occurs much more often than in adults.
Lidocaine in aerosol form is not recommended for local anesthesia before tonsillectomy and adenotomy in children under 8 years of age.
special instructions
It is important to prevent lidocaine from entering the respiratory tract (risk of aspiration). Application to the throat requires special attention.
Application to the buccal mucosa is associated with a risk of dysphagia and subsequent aspiration, especially in children. If the sensitivity of the tongue and mucous membrane of the cheeks is impaired, the risk of biting them increases.
Lidocaine is well absorbed through mucous membranes (especially in the trachea) and damaged skin. This should be taken into account, especially when treating large areas of tissue in children.
In cases of using the spray during surgical operations in the pharynx or nasopharynx, it should be taken into account that lidocaine, suppressing the pharyngeal reflex, enters the larynx and trachea and suppresses the cough reflex, which can lead to bronchopneumonia. This is especially important in children, as they are more likely to trigger their swallowing reflex. In this regard, the spray is not recommended for local anesthesia before tonsillectomy and adenotomy in children under 8 years of age.
Caution should be exercised when applying lidocaine to damaged mucous membranes and/or infected areas.
The drug should be used with caution in patients with epilepsy, as well as bradycardia, cardiac conduction disorders, liver dysfunction and severe shock, especially when significant amounts of the drug can be expected to be absorbed when large areas of tissue are treated with high doses.
The drug in lower doses should be used in weakened and elderly patients, in acute diseases, as well as in children - in accordance with age and general condition.
In children under 2 years of age, it is recommended to apply Lidocaine spray with a cotton swab dipped in the drug.
During application of the drug, the bottle should be kept as vertical as possible. The spray should not get into your eyes. Do not open the bottle or heat it.
Impact on the ability to drive vehicles and operate machinery
During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Overdose
Symptoms: increased sweating, pale skin, dizziness, headache, blurred vision, ringing in the ears, diplopia, decreased blood pressure, bradycardia, arrhythmia, drowsiness, chills, numbness, tremor, anxiety, agitation, convulsions, methemoglobinemia, cardiac arrest.
Treatment: when the first signs of intoxication appear (dizziness, nausea, vomiting, euphoria), further administration is stopped and the patient is transferred to a horizontal position; oxygen inhalation is prescribed; for convulsions - 10 mg diazepam intravenously; for bradycardia - m-anticholinergic blockers (atropine), vasoconstrictors (norepinephrine, phenylephrine). Dialysis is ineffective.
Side effects Lidocaine 10% 50ml 38g spray for topical use dosed
Local reactions: a slight tingling sensation that disappears as the anesthetic effect develops (within 1 minute); Transient erythema, swelling and sensory disturbances may occur.
Allergic reactions: very rarely - urticaria, angioedema, bronchospasm; in exceptional cases - anaphylactic shock. The use of the drug should be stopped immediately if any allergic reaction occurs.
The frequency of systemic effects after topical use of the drug is extremely low, because Only a very small amount of the active substance can enter the bloodstream.
From the side of the central nervous system: very rarely - nervous excitement, systemic dizziness, insomnia, loss of consciousness and respiratory paralysis.
From the cardiovascular system: decreased blood pressure, depression of myocardial function, bradycardia, cardiac arrest.
Drug interactions
Cimetidine and propranolol reduce the hepatic clearance of lidocaine (decreased metabolism due to inhibition of microsomal oxidation and decreased hepatic blood flow) and increase the risk of toxic effects (including stunned state, drowsiness, bradycardia, paresthesia, etc.).
Barbiturates, phenytoin, rifampicin (inducers of microsomal liver enzymes) reduce effectiveness (an increase in dose may be required).
When prescribed with ajmaline, phenytoin, verapamil, quinidine, amiodarone, the negative inotropic effect may be enhanced. Co-administration with beta-blockers increases the risk of bradycardia.
Curare-like drugs enhance muscle relaxation.
Procainamide increases the risk of developing central nervous system excitation and hallucinations.
With the simultaneous administration of lidocaine and hypnotics and sedatives, their inhibitory effect on the central nervous system may be enhanced.
With intravenous administration of hexobarbital or sodium thiopental against the background of the action of lidocaine, respiratory depression is possible.
Under the influence of MAO inhibitors, the local anesthetic effect of lidocaine may be enhanced.
With the simultaneous use of lidocaine and polymyxin B, an increased inhibitory effect on neuromuscular transmission is possible, so in this case it is necessary to monitor the patient's respiratory function.
Pros and cons of the product
Lidocaine spray has the following advantages :
- the drug is fast acting;
- the cost of the spray is quite low;
- the product is convenient to use: it is easy to apply;
- the drug has passed appropriate clinical trials;
- the product eliminates discomfort during intimacy, improving the quality of sexual life;
- the medication extremely rarely causes side effects and has virtually no contraindications;
- the drug is used very sparingly, so one package of the medicine lasts for a long time.
The drug also has disadvantages :
- Some representatives of the stronger sex note that due to a decrease in the sensitivity of the head of the penis, the pleasure a man receives from the body decreases.
- With frequent use of the drug, its effectiveness may decrease.
Adverse reactions
If used incorrectly, adverse reactions may occur:
- Dizziness, drowsiness, convulsions, sensory disturbances.
- Tinnitus.
- Changes in blood pressure, cardiac dysfunction.
- Nausea, vomiting.
- Feeling of heat, swelling at the injection site.
- Burning sensation, thrombophlebitis.
The list of adverse reactions is much wider, so it is necessary to monitor the patient’s condition after administration of the lidocaine solution.
Useful tips for use
There are certain rules for using products containing lidocaine:
- Before using the product, you should conduct a sensitivity test. To do this, the drug must be sprayed onto your hand. If irritation appears on the body within 20 minutes, you should stop using the medication.
- You need to know that Lidocaine spray does not interact well with medications that contain iodine.
- If side effects occur, you should stop using the drug.
When is lidocaine indicated?
The range of indications for Lidocaine solution includes the following conditions:
- Local anesthesia required for manipulations in ophthalmology, ENT practice, dentistry, and surgery.
- The use of cephalosporin group of antibacterial drugs as a solvent, the administration of which is characterized by a pronounced pain effect.
Lidocaine for injection allows you to anesthetize the desired area of skin or mucous membrane for several hours, which will be enough for medical manipulation accompanied by increased sensitivity.
special instructions
Lidocaine injection should only be done under the supervision of a physician. Treatment should be carried out under ECG control.
Before starting treatment, it is recommended to examine the level of potassium in the blood, since if its content is reduced, the effectiveness of the drug decreases.
The drug has an effect on the central nervous system, so it is not recommended to drive or engage in potentially life-threatening activities while using it.
Careful monitoring is required for patients prone to seizures, as even small doses may enhance the convulsive effect.
It is necessary to combine lidocaine with caution with those drugs that increase its bioavailability or slow down its elimination, which can be especially dangerous in case of end-stage renal failure.
With intramuscular administration of lidocaine solution, increased activity of creatine phosphokinase may be observed, which prevents the diagnosis of myocardial infarction.
Rapid administration of lidocaine solution can lead to a sharp decrease in blood pressure, with the possibility of collapse. In this case, the toxic effect of the drug with its cardiotoxic effect should also be considered.
