Lidocaine and Clonidine Transdermal Patch: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lidocaine
Clonidine Transdermal Patch
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced lidocaine absorption following combined epidural administration
Interaction Deep Dive
Combined epidural administration of clonidine 300 micrograms plus lidocaine 2% 20 mL resulted in greater than 50% reduction of peak serum lidocaine concentrations at 30 minutes following injection. No significant changes in other lidocaine pharmacokinetic parameters were noted1.
Why it happens (mechanism)
Clonidine-induced reduction in local blood flow reducing rate of lidocaine systemic absorption
Literature reports
2 reports — tap to read
a) Twenty-four ASA physical status 1 patients were randomized to receive 20 mL of 2% epidural lidocaine alone or in combination with either clonidine 300 micrograms, epinephrine 1:200000, or both clonidine and epinephrine. The only significant change in lidocaine pharmacokinetic parameters over the following 360 minutes was reduction of peak serum concentrations by 37% to 54% measured at 20 to 30 minutes following administration; the combination of lidocaine, clonidine, and epinephrine did not result in additive effects. No patient experienced a drop in systemic blood pressure greater than 25%. Lower clonidine doses (90 to 150 micrograms) have previously been shown to have no effect on lidocaine pharmacokinetics 1.
b) Clonidine prolongs lidocaine sensory block. Nine volunteers were enrolled in a study where microdialysis probe placement and local anesthetic blockade was performed. The addition of clonidine (10 mcg/mL) significantly prolonged the duration of lidocaine anesthesia (1%) to pin prick, touch, and cold sensation. Clonidine prolongs local anesthetic block, slowing lidocaine elimination from the injection site, is most pronounced in the first 60 minutes after injection, and is simultaneous with a reduction in local blood flow relative to plain lidocaine 2.
Common questions
Can I take Lidocaine and Clonidine Transdermal Patch together?
Reduced lidocaine absorption following combined epidural administration Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lidocaine and Clonidine Transdermal Patch interaction?
It is rated minor. Usually limited clinical impact.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Lidocaine or Clonidine Transdermal Patch need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
Keep reading about Lidocaine
Keep reading about Clonidine Transdermal Patch
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