Local Anaesthetic·Analgesia - Topicals & Local

Lidocaine patch

Post-herpetic neuralgia

Authority requiredPBSTOPICALVersatis 5%700 mg+2

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At a glance

Max Dose

3 Patches/day

Onset

30-60 mins

Caution: 12hr Off

MANDATORY

Systemic Abs.

MINIMAL

Cautions

Avoid / Cautions

Do not apply over unhealed, active, blistering shingles lesions. Skin must be fully healed and intact. Pregnancy Category A.

Where it stands

Rapid Summary

Overview

5% Lidocaine infused hydrogel patch. Provides targeted, non-systemic blockade of damaged peripheral nerves. The absolute gold-standard topical agent for post-herpetic neuralgia (Shingles pain).

Clinical Focus

The patch MUST be removed after 12 hours. The skin requires a 12-hour 'patch-free' period every day to prevent toxicity and skin breakdown.

Bottom Line

Lidocaine patch is a topical local anaesthetic patch for localised neuropathic pain (post-herpetic neuralgia), but provides only local relief and should not be applied to broken skin or used with other local anaesthetics.

Formulation & Access

Brand Names

Versatis 5%

Topical Routes

Adhesive hydrogel patches (700 mg lidocaine per patch).

Prescribing & PBS

Authority Required (PBS) specifically for post-herpetic neuralgia.

Indications & Use

Primary

PBSTGA

Post-herpetic neuralgia.

Off-Label

OFF

Localized neuropathic pain, severe localized rib fractures.

Clinical Place

Outstanding opioid-sparing option for localized surface pain. Acts entirely locally with < 3% systemic absorption.

Quick reference

Class & Role

Local Anaesthetic — 5% Lidocaine infused hydrogel patch.

Route / Formulation

Adhesive hydrogel patches (700 mg lidocaine per patch). (Versatis 5%)

Usual Dose & Max

Topical Apply 1 to 3 patches directly over the painful intact skin. Leave on for 12 hours, then remove for 12 hours (e.g., 8 AM to 8 PM). Patches can be cut to size. Max 3 patches applied simultaneously per day.

Best Uses

Key Risks

Dermatological: Erythema, rash, pruritus at the application site (usually mild due to the cooling hydrogel). Systemic: Toxicity (seizures/arrhythmias) is virtually impossible unless patches are applied over massive areas of broken, bleeding skin.

Key Interactions

Extremely safe to use alongside systemic neuropathic agents like Pregabalin or Amitriptyline (highly recommended synergistic combo).

Monitoring

Ensure nursing staff actually remove the patch. Leaving it on for 24 hours causes severe skin maceration and reduced efficacy.

Clinical Pearl

Unlike Fentanyl or Buprenorphine patches (which contain a liquid drug reservoir that leaks if cut and kills the patient), the Versatis patch is a hydrogel matrix. It is perfectly safe and encouraged to cut it with scissors to fit the exact shape of the pain.

Access

Authority requiredVersatis 5%

Brand: Versatis 5%
PBS status: Authority required

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