Lidocaine Maximum Dose

Determine maximum lidocaine dose (mg) and volume (mL) for infiltration or nerve blocks based on IFU recommendations for formulations with or without epinephrine.

Maximum 4.5 mg/kg (up to 300 mg) when no epinephrine is used.

Maximum Dose

Maximum lidocaine

300 mg

4.5 mg/kg × 70.0 kg (capped at 300 mg).

Maximum volume

30.0 mL

Concentration 10 mg/mL (1 mg per 0.1 mL).

Do not inject the full maximum dose routinely—use clinical judgement. Consider patient comorbidities (hepatic disease, pregnancy), site of injection, and concomitant local anesthetics.

How to Use This Calculator

1

Confirm patient weight

Accurate weight measurement is essential for safe local anesthetic dosing.

2

Select concentration and epinephrine status

Epinephrine increases the safe dose by reducing systemic absorption.

3

Compare to planned volume

Ensure planned infiltration volume remains below maximum to avoid toxicity.

Formula

Max dose (mg) = Weight (kg) × Max mg/kg (4.5 mg/kg plain, 7 mg/kg with epi).

Based on FDA labeling and American Society of Regional Anesthesia recommendations.

Frequently Asked Questions

What about mixing anesthetics?

Sum the fractional doses of each agent relative to their maximums (additive toxicity).

Is epinephrine contraindicated anywhere?

Avoid in end-arterial fields (fingers, toes, nose, penis) unless specifically indicated.

Can I exceed the maximum for tumescent anesthesia?

Tumescent techniques allow higher doses but require specialized protocols. Use dedicated calculators.

How to manage local anesthetic systemic toxicity (LAST)?

Stop injection, call for help, manage airway, seizures, hypotension. Administer lipid emulsion therapy per ASRA guidelines.

What if patient has hepatic dysfunction?

Use lower doses due to impaired metabolism. Mepivacaine/prilocaine may be preferable; consult anesthesia.