Greetings,

I am working with a mother who has been prescribed transdermal 
lidocaine.  The dose is 700 mg and the patch is to be worn for 12 hours, 
then removed for 12 hours.  I haven't found info on how this method of 
delivery might differ from the intravenous lidocaine.

Thomas W. Hale points out that lidocaine has poor oral bioavailability, and 
he presents information on this medication as used by injection.

Is it appropriate to view transdermal lidocaine in the same light as the 
intravenous application?  On the one hand lidocaine has a relatively low 
molecular weight of 234, and only 70% maternal protein binding, so it will 
pass into mother's milk.   On the other hand the milk/plasma ratio is low 
at 0.4. and the breastfeeding risk category of L2.  Can anyone please point 
me to a reference that might help this mother decide about her treatment 
with transdermal lidocaine?

Sincerely,

Jeanne Badman, St. Paul, MN, USA
with new snow falling 

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