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BONDLIDO lidocaine 200 mg System

by MEDRx USA, Inc. · 1 CARTON in 1 PATCH (83708-111-01) / 28 SYSTEM in 1 CARTON (83708-111-28)
NDC 83708-0111-01
🏷️ FDA NDC (as labeled) 83708-111-01 billing pads the product segment with a zero
Rx only Brand On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

⚠️
Other active recalls for Lidocaine (different manufacturers) — 1 · tap to view
These affect other manufacturers’ products for the same ingredient — not necessarily the exact NDC on this page.
Class III · Apr 20, 2023 — Labeling: Typographical error on the upper left-hand side of the box and individual patch label that has the incorrect dosage form stating, each tablet contains instead of each adhesive patch contains. (Bryant Ranch Prepack, Inc.) · FDA recall D-0556-2023
Each entry is an official FDA enforcement report — look up any recall number in the FDA recall database ↗

🆔 Identity & classification

FDA NDC (as labeled) 83708-111-01
Product NDC 83708-111
11-digit billing NDC 83708011101
UNII 98PI200987
Application # NDA215029
SPL Set ID 17e69028-d2c2-4080-8090-cb0cab570196
Established class (EPC) Amide Local Anesthetic; Antiarrhythmic
Physiologic effect Local Anesthesia
Chemical class Amides
DEA schedule Non-controlled
Marketing category NDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2025-10-08
Route TOPICAL
Dosage form SYSTEM
Substance LIDOCAINE
Why two NDCs? The FDA registers this code as 83708-111-01 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 83708-0111-01. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏭 Manufacturer & labeler

LabelerMEDRx USA, Inc.
Application holderMEDRX USA INC
FDA applicationNDA215029 (NDA)
Labeler code83708
First marketedOct 2025
Product typeHuman Prescription Drug
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

📗 Our plain-language guide HelloPharmacist
  • It's best to avoid using two lidocaine products at the same time unless your doctor says it's okay. When you use multiple products containing a local anesthetic, the total amount a...
  • Can I use a lidocaine patch and a lidocaine cream at the same time?
  • No — please don't do this. Heat significantly increases how much lidocaine is absorbed through your skin, which can push drug levels in your blood higher than they should be. Stick...
  • Can I put a heating pad on the area where I applied a lidocaine patch?
📖 Read our full Lidocaine guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII SLW8D5K6WL
    A waxy substance made from glycerin and fatty acids. It acts as an emulsifier to help mix oil and water ingredients, and as a binder to hold the medicine's ingredients together.
  • UNII 33X04XA5AT
    Lactic acid is a naturally occurring organic acid derived from milk or plant sources. It lowers and maintains pH in formulations, helps preserve the product, and can enhance ingredient stability and absorption.
  • UNII 7YC686GQ8F
    A synthetic oily substance made from castor oil. It works as a solubilizer and emulsifier to help mix oily and water-based ingredients together in the medicine.
  • UNII 8D08K3S51E
    Propylene carbonate is a clear liquid solvent derived from propylene. It helps dissolve or suspend active ingredients in liquid medicines and can improve how well the product flows and mixes.
  • UNII K7S96QM8DV
    A synthetic rubber-like plastic made from linked chains of styrene and isoprene. It's used in medicines as a binder to hold ingredients together and as a film-former to create protective coatings on tablets or capsules.
  • UNII W4888I119H
    Tartaric acid is a natural organic acid found in grapes and tamarinds. In medicines, it works as a buffer to control acidity, an antioxidant to prevent spoilage, and sometimes a flavoring or binding agent.
  • UNII GR35AH6YDN
    A sticky plant-derived resin containing terpenes, natural compounds from trees and plants. Used as a binder and adhesive in some tablet and capsule formulations to help hold ingredients together.

7 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMed — ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eachPer package
Retail pharmacies payNADAC · weekly Not in the retail survey — common for institutional, discontinued, or low-volume packs.
Medicaid paysCMS SDUD · 12 mo No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data.
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
ℹ️
No price is published for this exact package yet. CMS surveys NADAC per package size, so a different pack of the same drug often has one.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Bondlido 200 mgthis 83708-0111-01 MEDRx 1 patch — — FDA listed —
About this product: this is the brand-name version. FDA-approved generic versions are listed, and recent pricing/market data suggests they may be available.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

⏳ Availability & generic status

🏛️
2025
First FDA approval
Sep 2025
📍
2026
Currently FDA-listed
1 year listed
🛡️
2028
Latest patent/protection listed
not a guaranteed launch date
✅Generic appears available

FDA-approved generic versions are listed, and recent pricing/market data suggests they may be available — see Therapeutic equivalents.

🛡️ Latest patent/protection date listed: FDA patent/protection data lists protections through Sep 2028. This may affect when a full generic version becomes widely available, but it is not a guaranteed launch date.
📅 FDA approved Sep 24, 2025 RLD RS ⏳ ~2 yr to latest listed protection

Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.

Patents & exclusivity — FDA Orange Book
Exclusivity NP
2025 2027
Today
LOE
Substance patent Formulation patent Method-of-use patent Exclusivity Pediatric +6mo
🏛️FDA exclusivity
FDA-granted marketing protection. It’s separate from patents and may be shorter than patent protection.
🧪Product / substance patents
Patents covering the active ingredient, product, formulation, or related drug features.
🎯Method-of-use patents
Patents covering specific approved uses. These can sometimes be carved out with a “skinny label,” but not always.
🛈 What do these terms mean?
Patent
Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
Substance patent
Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
Formulation (product) patent
Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
Method-of-use patent
A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
Skinny label
A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
Exclusivity
FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
Paragraph IV
A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
RLD / RS
Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
TE / AB rating
FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
LOE (loss of exclusivity)
The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.

Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.

FDA exclusivity
CodeWhat it grantsExpires
NPNew ProductSep 24, 2028
Common questions
Is there a generic version of this drug?
Yes — an FDA-approved generic equivalent is listed in the FDA Orange Book for this drug. See the alternatives section for substitutable, lower-cost products.
The FDA approved a generic — why can’t I get it at my pharmacy yet?
FDA approval and pharmacy availability are two different things. The FDA can approve a generic years before it actually reaches pharmacies, because the brand company may still hold patents or have a settlement that delays the launch. A manufacturer also has to choose to make and sell it, and have supply ready. So a drug can be “FDA-approved generic exists” and still be brand-only at the counter today.
Why do different websites show different generic release dates?
Generic availability is not based on one single date. Some sources use the first exclusivity expiration, some use the last product patent, and others use the latest method-of-use patent. Patent challenges, settlements, licenses, and label carve-outs can also change the real-world launch date. This page shows the underlying Orange Book dates so you can see why estimates may differ.
What does “FDA listed” mean?
It means the product appears in the FDA’s official NDC directory. That’s a good sign a product exists and is intended for the U.S. market, but on its own it does not confirm a pharmacy can fill it today. Where we have recent retail pricing data (NADAC) for a product, we label it “Availability likely” instead.
What does a patent or protection date mean here?
It’s the latest date currently listed in the FDA Orange Book for a patent or exclusivity on the brand product. It can affect when a full generic version becomes widely available — but it is not a guaranteed generic launch date. Generics sometimes arrive earlier (through a settlement or patent challenge) or later (a manufacturer still has to make and sell one).
What does “current Orange Book estimate” mean?
It means we are using the latest patent and exclusivity dates currently listed in the FDA Orange Book. It is not a guaranteed launch date.
Can a generic come out before the last patent expires?
Sometimes. A generic company may challenge a patent, settle with the brand manufacturer, receive a license, or obtain approval with a narrower label that avoids a patented use. In other cases, the last listed protection may delay full-label generic competition.
Can a generic come out after the listed dates?
Yes. Even after patents or exclusivity expire, a generic still needs FDA approval and a manufacturer must choose to market it. Supply, litigation, business decisions, or regulatory issues can delay actual availability.
What is the difference between patents and exclusivity?
Patents are legal protections usually issued by the U.S. Patent and Trademark Office. FDA exclusivity is marketing protection granted by the FDA. They are separate, and either one can affect generic timing.
Why are there multiple patent dates?
One drug can have several patents covering different things: the active ingredient, a formulation, a manufacturing process, or a specific approved use. That is why a page may show several expiration dates instead of one simple generic date.
Built from FDA Orange Book patent and exclusivity data. Dates are refreshed from public FDA data when available; the marker is max(latest patent expiry, latest exclusivity expiry). Paragraph-IV settlements and first-filer 180-day exclusivity can shift the real date; a method-of-use patent may allow an earlier skinny-label generic for non-protected indications. Generic launch timing is an estimate, not a guarantee.
Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Lidocaine (matched by generic name) — the program that covers self-administered drugs. 17 manufacturers.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Lidocaine. CMS lists 8 products for this generic; we show the highest-spend one. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$53.12M
Claims incl. refills
593.7K
Beneficiaries
367.9K
Spend / beneficiary
$144.39
Spend / claim
$89.46
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for BONDLIDO (this brand).

Top reported reactions

Pain3,169
Fatigue3,039
Nausea3,029
Headache2,802
Dyspnoea2,167
Pneumonia2,002
Diarrhoea1,965

Age at onset

Neonate144
Infant62
Child363
Adolescent258
Adult4,906
Elderly3,132

Reporter sex

48,649 reports
Male · 37%
Female · 63%
Unknown · 0%

Serious outcomes

Death4,963
Life-threatening4,199
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 5,398 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
83708-0111-01 You're viewing this 1 CARTON in 1 PATCH (83708-111-01) / 28 SYSTEM in 1 CARTON (83708-111-28) 2025-10-08 Active

🧭 About this NDC listing & data coverage

Finished prescription product
What data is (and isn’t) available for this NDC — tap to expand
NDC identity (package / product / labeler codes) ✓ Available
Labeler ✓ Available
Product & package description ✓ Available
Marketing category & status ✓ Available
Active ingredient / dosage form / route ✓ Available
FDA label (SPL via DailyMed) ✓ Available
Package photos — Not published for this NDC No photo available yet for this listing.
Inactive ingredients (structured) ✓ Available
NADAC pharmacy acquisition price (CMS) — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey.
Orange Book / therapeutic-equivalence data ✓ Available
HCPCS J-code billing crosswalk — Not published for this NDC Most self-administered / retail products have no J-code — that is normal.
Medicaid utilization (CMS SDUD) — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold.
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.

Questions about this listing

Why is there no price listed?
The pricing shown on our NDC pages comes from CMS NADAC, a voluntary survey of retail community pharmacy invoices. CMS does not publish a NADAC for every NDC — packages outside the retail survey (institutional and hospital products, bulk packages, discontinued items, and many OTC items) may never receive one. A missing price reflects the survey's scope, not this product's actual cost, and does not mean the product is free or unavailable.
Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The FDA registers it as 83708-111-01, which is what is printed on the packaging and shown on DailyMed. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero: 83708-0111-01, written without dashes as 83708011101. The Identity section at the top of this page lists every form of this code.
What do the three segments of this NDC mean?
In 83708-0111-01, the first segment (83708) is the labeler code FDA assigned to MEDRx USA, Inc.; the middle segment (0111) identifies this specific product — its ingredient, strength, and dosage form; and the last segment (01) identifies this exact package size and type. Together they name one specific package of one specific product.
Is this package still being marketed?
Yes, per the latest FDA NDC Directory data on this page: this package is listed as actively marketed, with no marketing end date reported by MEDRx USA, Inc.. Listing status can change — the directory data on this page refreshes weekly.
Who lists this product with the FDA?
MEDRx USA, Inc. is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ⏱️ Dosage and Administration 💊 Dosage Forms and Strengths ⛔ Contraindications ⚠️ Warnings and Cautions 🤒 Adverse Reactions 🔄 Drug Interactions 👥 Use in Specific Populations 🤰 Pregnancy 🧒 Pediatric Use 🧓 Geriatric Use 🆘 Overdosage 🧬 Clinical Pharmacology 🧬 Mechanism of Action 📦 How Supplied / Storage and Handling 📦 Storage and Handling 📋 Description 💬 Information for Patients
🎯 Indications and Usage 46 words ▾

1 INDICATIONS AND USAGE BONDLIDO (lidocaine topical system 10%) is indicated in adults for relief of pain associated with post-herpetic neuralgia (PHN). BONDLIDO contains lidocaine, an amide local anesthetic, and is indicated in adults for relief of pain associated with post-herpetic neuralgia (PHN) ( 1 ).

⏱️ Dosage and Administration ~2 min read ▾

2 DOSAGE AND ADMINISTRATION Due to differences in bioavailability, the efficacy of a lidocaine topical system does not necessarily correlate with dosage strength. Refer to the dosing instructions for the specific product being used ( 2 ). Apply BONDLIDO to intact skin to cover the most painful area.

Apply the prescribed number of topical systems (maximum of two) only once for up to 12 hours in a 24-hour period (2) . Apply firm pressure for 20 seconds to ensure adequate adherence.

2.1Important Dosage and Administration Information Due to differences in bioavailability, the efficacy of a lidocaine topical system does not necessarily correlate with dosage strength (i.e., concentration). Comparing different products on a nominal percentage-for-percentage basis may be misleading and the appropriate strength for a given indication may vary by product. Refer to the dosing instructions for the specific product being used. [see Clinical Pharmacology (12.3) ] .

When BONDLIDO is used concomitantly with other products containing local anesthetic agents, the total amount of drug absorbed from all formulations must be considered.

2.2Application Instructions Clearly instruct and advise patients: to apply BONDLIDO to intact skin to cover the most painful area. Apply the prescribed number of topical systems (maximum of 2), only once for up to 12 hours within a 24-hour period. Safety has not been established for application of more than 2 BONDLIDO topical systems per day. to apply firm pressure for 20 seconds to ensure an adequate adherence. that clothing may be worn over the area of application. to remove BONDLIDO if irritation or a burning sensation occurs during application.

Advise patients not to reapply until the irritation subsides. to wash hands immediately after handling BONDLIDO and to avoid contact with eyes [see Warnings and Precautions (5.5) , Patient Counseling Information (17) ]. to not store BONDLIDO outside of the sealed pouch. to apply immediately after removal from the protective pouch. to fold used BONDLIDO so that the adhesive side sticks to itself. to safely discard used BONDLIDO where children and pets cannot get to them. to never apply external heat sources, such as heating pads or electric blankets, directly to BONDLIDO because plasma lidocaine levels may be increased [see Warnings and Precautions (5.2) , Patient Counseling Information (17) ]. that BONDLIDO may not stick if it gets wet and to avoid contact with water, such as bathing, swimming, or showering, while a BONDLIDO topical system is applied.

If the BONDLIDO topical system comes off completely and will not stick to the skin, advise patients that they may apply a replacement BONDLIDO topical system and take the replacement BONDLIDO topical system off at the usual removal time. Advise patients not to wear BONDLIDO for more than 12 hours within a 24-hour period.

💊 Dosage Forms and Strengths 43 words ▾

3 DOSAGE FORMS AND STRENGTHS BONDLIDO Topical System: 10% lidocaine. BONDLIDO is a rectangular topical system with blue printing on one side and a release liner on other and is packaged in an individual unit-dose pouch. Topical System: 10% lidocaine ( 3 ).

⛔ Contraindications 57 words ▾

4 CONTRAINDICATIONS BONDLIDO is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type, or to any other component of the product. BONDLIDO is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type, or to any other component of the product ( 4 ).

⚠️ Warnings and Cautions ~3 min read ▾

5 WARNINGS AND PRECAUTIONS Accidental Exposure : A used BONDLIDO topical system contains residual lidocaine after use. It is important for patients to store and dispose of BONDLIDO out of the reach of children, pets, and others (5.1). Excessive Dosing : Applying BONDLIDO to larger surface areas or for a longer duration than recommended could result in increased absorption and high blood concentrations of lidocaine, leading to serious adverse effects ( 5.2 ).

Non-Intact Skin : May result in higher blood concentrations of lidocaine from increased absorption ( 5.2 ). External Heat Sources : External heat sources may increase drug exposure, leading to overexposure of lidocaine ( 5.2 ). Methemoglobinemia : Cases of methemoglobinemia have been reported in association with local anesthetic use ( 5.3 ).

Application Site Reactions : Severe skin irritation may occur with BONDLIDO if applied for a longer period than instructed ( 5.4 ). Hypersensitivity Reactions : Patients with an allergy to PABA derivatives may have cross-sensitivity to BONDLIDO( 5.5 ). Eye Exposure : If eye contact occurs, immediately wash out the eye with water or saline and protect the eye using, for example, eyeglasses/eye wear, until sensation returns ( 5.6 ).

5.1Accidental Exposure A used BONDLIDO topical system contains residual lidocaine after use. The potential exists for a small child or a pet to suffer serious adverse effects from chewing or ingesting new or used BONDLIDO. It is important for patients to store and dispose of BONDLIDO properly, and keep out of the reach of children, pets, and others [see Dosage and Administration (2) ] .

5.2Excessive Dosing Lidocaine toxicity could be expected at lidocaine blood concentrations above 5 µg/mL. The blood concentration of lidocaine is determined by the rate of systemic absorption and elimination. Longer duration of application, application of more than the recommended number of BONDLIDO, smaller patients, or impaired elimination may all contribute to increasing the blood concentration of lidocaine.

If lidocaine overdose is suspected, check drug blood concentration. Management of overdose includes close monitoring, supportive care, and symptomatic treatment [see Overdosage (10) ]. Improper Application and Duration of Use : Application of more than the recommended number of BONDLIDO or applying BONDLIDO for longer than the recommended wearing time (12 hours of every 24 hours) could result in increased absorption and high blood concentrations of lidocaine, leading to adverse effects.

Advise patients on proper application and duration [see Patient Counseling Information (17) ] . Hepatic Disease : Impaired elimination may contribute to increasing blood concentrations of lidocaine. Patients with severe hepatic disease are at greater risk of developing toxic blood concentrations of lidocaine because of their inability to metabolize lidocaine normally.

Non-Intact Skin : Application to broken or inflamed skin, although not tested, may result in higher blood concentrations of lidocaine from increased absorption. BONDLIDO is only recommended for use on intact skin. Advise patients not to apply BONDLIDO to non-intact skin [see Patient Counseling Information (17) ] .

External Heat Sources : External heat sources may increase drug exposure, leading to overexposure to lidocaine. Advise patients not to apply external heat sources to BONDLIDO during administration [see Patient Counseling Information (17) ].

5.3Methemoglobinemia Cases of methemoglobinemia have been reported in association with local anesthetic use. Although all patients are at risk for methemoglobinemia, patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, c…

🤒 Adverse Reactions ~1 min read ▾

6 ADVERSE REACTIONS The following serious adverse reactions are described elsewhere in the labeling: Accidental Exposure [see Warnings and Precautions (5.1) ] Excessive Dosing/Overexposure to Lidocaine [see Warnings and Precautions (5.2) ] Methemoglobinemia [see Warnings and Precautions (5.3) ] Application Site Reactions [see Warnings and Precautions (5.4) ] Hypersensitivity Reactions [see Warnings and Precautions (5.5) ] Eye Irritation [see Warnings and Precautions (5.6) ] The following adverse reactions associated with the use of lidocaine were identified in clinical trials or postmarketing reports for lidocaine.

Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Skin and subcutaneous tissues : blisters, bruising, burning sensation, depigmentation, dermatitis, discoloration, edema, erosions, erythema, exfoliation, flushing, irritation, papules, petechia, pruritus, vesicles, and abnormal sensation. Immune system : angioedema, bronchospasm, dermatitis, dyspnea, hypersensitivity, laryngospasm, pruritus, shock, and urticaria.

Central Nervous System : lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, somnolence, respiratory depression and arrest. Cardiovascular : bradycardia, hypotension, and cardiovascular collapse leading to arrest. Other : asthenia, disorientation, headache, hyperesthesia, hypoesthesia, metallic taste, nausea, pain exacerbated, paresthesia, taste alteration, and vomiting.

Common adverse reactions are application site reactions such as irritation, erythema, and pruritus ( 6 ). To report SUSPECTED ADVERSE REACTIONS, contact MEDRx USA, Inc. at TELEPHONE or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

🔄 Drug Interactions ~1 min read ▾

7 DRUG INTERACTIONS Antiarrhythmic Drugs: When BONDLIDO is used in patients receiving Class I antiarrhythmic drugs (such as tocainide or mexiletine), the toxic effects are additive and potentially synergistic. Consider risk/benefit during concomitant use ( 7.1 ). Local Anesthetics: When BONDLIDO is used concomitantly with other products containing local anesthetic agents, the effects are additive.

The amount absorbed from all formulations must be considered for safe use ( 7.2 ).

7.1Antiarrhythmic Drugs When BONDLIDO is used in patients receiving Class I antiarrhythmic drugs (such as tocainide or mexiletine), the toxic effects are additive and potentially synergistic. Consider risk/benefit during concomitant use.

7.2Local Anesthetics When BONDLIDO is used concomitantly with other products containing local anesthetic agents, the effects are additive. The amount absorbed from all formulations must be considered for safe use.

7.3Drugs That May Cause Methemoglobinemia When Used with BONDLIDO Patients who are administered local anesthetics are at increased risk of developing methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics: Examples of Drugs Associated with Methemoglobinemia : Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine

👥 Use in Specific Populations ~3 min read ▾

8 USE IN SPECIFIC POPULATIONS Lactation: Lidocaine is excreted into human milk. Caution should be exercised when BONDLIDO is administered to a nursing mother, especially when administered with other local anesthetics ( 8.2 ).

8.1Pregnancy Risk Summary The limited human data with lidocaine in pregnant woman are not sufficient to inform drug-associated risk for major birth defects and miscarriage. The use of lidocaine for labor neuraxial analgesia has not been associated with an increased incidence of adverse fetal effects either during delivery or during the neonatal period [see Data ]. Should BONDLIDO be used concomitantly with other products containing lidocaine, consider total drug doses contributed by all formulations.

In a published animal reproduction study, pregnant rats administered lidocaine by continuous subcutaneous infusion at a dose approximately 12 times the maximum recommended daily dose (MRDD) of 400 mg in BONDLIDO during the period of organogenesis resulted in lower fetal body weights. In a published animal reproduction study, pregnant rats administered lidocaine, containing 1:100,000 epinephrine, injected into the masseter muscle of the jaw or into the gum of the lower jaw at approximately 0.14 times the MRDD on Gestation Day 11 resulted in developmental delays in neonates [see Data ].

The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies carry some risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Data Human Data In 22 parturient women given 1.5% lidocaine epidural anesthesia, there were no effects on neonatal behavior, using the early neonatal neurobehavioral scale (ENNS). Neuraxial analgesia also did not affect fetal heart rate, beat-to-beat variability, or uterine activity. Animal Data Reproductive studies with lidocaine have been performed in rats at doses up to 30 mg/kg (0.73 times the maximum recommended daily dose [MRDD] of 400 mg from BONDLIDO on a mg/m 2 basis) subcutaneously and have revealed no evidence of harm to the fetus due to lidocaine.

In a published study, lidocaine administered to pregnant rats by continuous subcutaneous infusion during the period of organogenesis at 100, 250, and 500 mg/kg/day, did not produce any structural abnormalities, but did result in lower fetal weights at 500 mg/kg/day dose (approximately 12 times the MRDD on a mg/m 2 basis) in the absence of maternal toxicity. In a published study, lidocaine containing 1:100,000 epinephrine at a dose of 6 mg/kg (approximately 0.14 times the MRDD on a mg/m 2 basis) injected into the masseter muscle of the jaw or into the gum of the lower jaw of pregnant Long-Evans hooded rats on Gestation Day 11 resulted in developmental delays in the neonates.

Developmental delays were observed for negative geotaxis, static righting reflex, visual discrimination response, sensitivity and response to thermal and electrical shock stimuli, and water maze acquisition. The developmental delays of the neonatal animals were transient, with responses becoming comparable to untreated animals later in life. The clinical relevance of these animal data is uncertain.

8.2Lactation Risk Summary Lidocaine is excreted into human milk. A milk:plasma ratio of 1.07 (for AUC) was observed when lidocaine was used as an epidural anesthetic for cesarean section in 27 women. Lactating women undergoing a dental procedure had a 0.4 milk:plasma ratio.

In another dental procedure study, a single patient was administered 20 mg of lidocaine and the milk:plasma ratio was reported as 1.1 at five to six hours after injection. These data, and the low concentrations of lidocaine in the plasma after topical administration of BONDLIDO in recommended doses, suggest that a small amount of lidocaine would be ingested orally by a suckling infa…

🤰 Pregnancy ~2 min read ▾

8.1Pregnancy Risk Summary The limited human data with lidocaine in pregnant woman are not sufficient to inform drug-associated risk for major birth defects and miscarriage. The use of lidocaine for labor neuraxial analgesia has not been associated with an increased incidence of adverse fetal effects either during delivery or during the neonatal period [see Data ]. Should BONDLIDO be used concomitantly with other products containing lidocaine, consider total drug doses contributed by all formulations.

In a published animal reproduction study, pregnant rats administered lidocaine by continuous subcutaneous infusion at a dose approximately 12 times the maximum recommended daily dose (MRDD) of 400 mg in BONDLIDO during the period of organogenesis resulted in lower fetal body weights. In a published animal reproduction study, pregnant rats administered lidocaine, containing 1:100,000 epinephrine, injected into the masseter muscle of the jaw or into the gum of the lower jaw at approximately 0.14 times the MRDD on Gestation Day 11 resulted in developmental delays in neonates [see Data ].

The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies carry some risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Data Human Data In 22 parturient women given 1.5% lidocaine epidural anesthesia, there were no effects on neonatal behavior, using the early neonatal neurobehavioral scale (ENNS). Neuraxial analgesia also did not affect fetal heart rate, beat-to-beat variability, or uterine activity. Animal Data Reproductive studies with lidocaine have been performed in rats at doses up to 30 mg/kg (0.73 times the maximum recommended daily dose [MRDD] of 400 mg from BONDLIDO on a mg/m 2 basis) subcutaneously and have revealed no evidence of harm to the fetus due to lidocaine.

In a published study, lidocaine administered to pregnant rats by continuous subcutaneous infusion during the period of organogenesis at 100, 250, and 500 mg/kg/day, did not produce any structural abnormalities, but did result in lower fetal weights at 500 mg/kg/day dose (approximately 12 times the MRDD on a mg/m 2 basis) in the absence of maternal toxicity. In a published study, lidocaine containing 1:100,000 epinephrine at a dose of 6 mg/kg (approximately 0.14 times the MRDD on a mg/m 2 basis) injected into the masseter muscle of the jaw or into the gum of the lower jaw of pregnant Long-Evans hooded rats on Gestation Day 11 resulted in developmental delays in the neonates.

Developmental delays were observed for negative geotaxis, static righting reflex, visual discrimination response, sensitivity and response to thermal and electrical shock stimuli, and water maze acquisition. The developmental delays of the neonatal animals were transient, with responses becoming comparable to untreated animals later in life. The clinical relevance of these animal data is uncertain.

🧒 Pediatric Use 13 words ▾

8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.

🧓 Geriatric Use 85 words ▾

8.5Geriatric Use Clinical studies of BONDLIDO did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be done with caution, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

🆘 Overdosage 87 words ▾

10 OVERDOSAGE Lidocaine overdose from cutaneous absorption is rare but could occur. If there is any suspicion of lidocaine overdose, drug blood concentration should be checked. The management of overdose includes close monitoring, supportive care, and symptomatic treatment.

Dialysis is of negligible value in the treatment of acute overdose with lidocaine. In the absence of massive topical overdose or oral ingestion, evaluation of symptoms of toxicity should include consideration of other etiologies for the clinical effects, or overdosage from other sources of lidocaine or other local anesthetics.

🧬 Clinical Pharmacology ~3 min read ▾

12 CLINICAL PHARMACOLOGY

12.1Mechanism of Action Lidocaine is an amide-type local anesthetic and is suggested to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses.

12.2Pharmacodynamics The penetration of lidocaine into intact skin after application of BONDLIDO is sufficient to produce an analgesic effect, but less than the amount necessary to produce a complete sensory block.

12.3Pharmacokinetics Bioavailability for topical systems such as BONDLIDO is dependent on multiple factors, including formulation, and does not necessarily correlate with dosage strength. In a single-dose, crossover study conducted in 32 healthy volunteers, BONDLIDO (lidocaine topical system 10%) demonstrated equivalent systemic exposure (AUC) and peak concentration (C max ) of lidocaine to a lidocaine topical system 5%. Absorption The amount of lidocaine systemically absorbed from BONDLIDO topical system is directly related to both the duration of application and the surface area over which it is applied.

In a pharmacokinetic study, two BONDLIDO topical systems were applied on the back of the healthy volunteers for 12 hours. Blood samples were drawn for determination of lidocaine concentration during the topical system application and for 32 hours after removal of topical systems. The results are summarized in Table 1.

Table 1. Mean ± SD Pharmacokinetic Parameters of lidocaine from BONDLIDO in healthy volunteers (n = 32, 12-hour application time) Application Site Area (cm 2 ) C max (ng/mL) AUC 0-inf (ng∙hr/mL) T max (hr) median (min, max) 2 BONDLIDO topical system (2 × 200 mg = 400 mg total dose for 12 hours) Back 280 52.8 (38.9) 837 (37.7) 13.0 (8.0,18.0) Repeated application of three lidocaine topical systems 5% simultaneously for 12 hours (recommended maximum daily dose), once per day for three days, indicated that the lidocaine concentration does not increase with daily use.

The mean plasma pharmacokinetic profile for the 15 healthy volunteers is shown in Figure 1 . Figure 1. Mean lidocaine blood concentrations after three consecutive daily applications of three lidocaine topical systems 5% simultaneously for 12 hours per day in healthy volunteers (n = 15) The pharmacokinetics of lidocaine delivered by BONDLIDO topical system was assessed in 20 healthy volunteers undergoing exercise (four 30 minute sessions of moderate exercise over the 12 hour period of BONDLIDO application) and following application of a transparent film occlusive dressing over BONDLIDO for the full 12 hour period of BONDLIDO application (occlusion) and results were compared to those obtained under resting conditions.

Two hours of moderate exercise resulted in approximately 20% reduction in systemic exposure as measured by C max and AUC [0-inf] indicating a modest reduction in delivery from the topical system over the 12 hour period of topical system application. Exposure to total occlusion of the topical system for 12 hours produced no statistically significant changes in the absorption or pharmacokinetics of lidocaine from BONDLIDO topical system. Distribution When lidocaine is administered intravenously to healthy volunteers, the volume of distribution is 0.7 to

2.7L/kg (mean 1.5 ±

0.6SD, n = 15). At concentrations produced by application of a lidocaine topical system 5%, lidocaine is approximately 70% bound to plasma proteins, primarily alpha-1-acid glycoprotein. At much higher plasma concentrations (1 to 4 µg/mL of free base), the plasma protein binding of lidocaine is concentration dependent.

Lidocaine crosses the placental and blood brain barriers, presumably by passive diffusion. Elimination Metabolism: It is not known if lidocaine is metabolized in the skin. Lidocaine is metabolized rapidly by the liver to a number of metabolites, including monoethylglycinexylidide (MEGX) and glycinexylidide (GX), both of which have pharmacologic activity similar to, but less potent than that of lidocaine.

A minor metabo…

🧬 Mechanism of Action 30 words ▾

12.1Mechanism of Action Lidocaine is an amide-type local anesthetic and is suggested to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses.

📦 How Supplied / Storage and Handling 69 words ▾

16 HOW SUPPLIED/STORAGE AND HANDLING BONDLIDO (lidocaine topical system) 10% is a rectangular topical system with blue printing on one side and release liner on other. It is available as the following: Carton of 28 topical systems, packaged into individual child-resistant pouches. NDC 83708-111-28 Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Protect from light.

📦 Storage and Handling 25 words ▾

Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Protect from light.

📋 Description 147 words ▾

11 DESCRIPTION BONDLIDO (lidocaine topical system) 10% is a drug-in-adhesive topical delivery system containing 200 mg lidocaine with a non-woven polyethylene terephthalate (PET) backing membrane and a PET film release liner. Lidocaine, an amide local anesthetic, is chemically designated as acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl) (C 14 H 22 N 2 O), has a molecular weight of 234.34 g/mol, an octanol:water partition ratio of 43 at pH 7.4, is very soluble in methanol and in ethanol, is soluble in acetic acid and in diethyl ether, is practically in-soluble in water, dissolves in dilute hydrochloric acid, and has the following structure: Each BONDLIDO topical system is 10 cm × 14 cm × 0.066 cm and contains the following inactive ingredients: blue ink, hydrocarbon, lactic acid, mono- and di-glycerides, non-woven PET backing membrane, PET film, polyoxyl 40 hydrogenated castor oil, propylene carbonate, styrene/isoprene/styrene block copolymer, tartaric acid, and terpene resin.

Chemical Structure

💬 Information for Patients ~2 min read ▾

17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling (Instructions for Use). Accidental Exposure and Disposal Advise patients to store BONDLIDO out of the reach of children, pets, and others. Advise patients to dispose of used BONDLIDO by folding used BONDLIDO so that the adhesive side sticks to itself and safely discarding used BONDLIDO where children, pets, and others cannot come in contact with them. [see Dosage and Administration (2) , Warnings and Precautions (5.2) ] Proper Application Advise patients: to avoid getting BONDLIDO wet (e.g., bathing, swimming or showering) [see Dosage and Administration (2) ] . not to apply more than the prescribed number (up to 2 BONDLIDO) [see Dosage and Administration (2) , Warnings and Precautions (5.2) ] . not to wear BONDLIDO longer than the recommended wearing time (12 hours of every 24 hours) [see Dosage and Administration (2) , Warnings and Precautions (5.2) ] . not to apply BONDLIDO to non-intact skin [see Warnings and Precautions (5.2) ] .

Methemoglobinemia Inform patients that use of local anesthetics may cause methemoglobinemia, a serious condition that must be treated promptly. Advise patients or caregivers to stop use and seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue [see Warnings and Precautions (5.3) ] . Application Site Reactions Inform patients that skin irritation and other skin reactions may occur at the site of BONDLIDO application.

If skin reactions occur during wear, instruct patients to remove BONDLIDO and not to reapply until the skin reaction subsides [see Warnings and Precautions (5.4) ]. Eye Exposure Advise patients to wash hands immediately after handling BONDLIDO and to avoid contact with eyes. Instruct patients to, if eye contact should occur, immediately wash out the eye with water or saline and protect the eye until sensation returns [see Dosage and Administration (2) , Warnings and Precautions (5.5) ] .

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
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