Can Lidocaine Patches Be Cut to Smaller Size?

Q. Though they help with my chronic headache pain, lidocaine patches can be cumbersome to apply. My local pharmacists are in disagreement: One says patches cannot be cut, but the other said I could cut my lidocaine patch to a size more suitable to my needs. Who is correct?

By Paul Phelps, M.D., Chairman, Department of Anesthesia, Southwest Healthcare System, Murrieta, California CASE For over 20 years, Roger, aged 54, has had severe, intermittent headaches. These headaches are characterized by an intense burning pain on one side of his head, accompanied by tearing in his eye and a runny nose. When they strike, the attacks typically occur several times a day and usually last about an hour. Roger can be headache free for months at a time, but the attacks always return. He has seen several healthcare providers, including headache specialists, with little or no improvement.

Lidocaine is an anesthetic agent, usually injected to produce numbness in a small area of skin. Lidocaine 4% aqueous solution can be applied intranasally for the treatment of headaches such as migraine and cluster headaches. It is available only by prescription. When it is used in cluster headaches, a pre-dosing spray of neo-synephrine 0.5% may be needed to alleviate some of the nasal congestion which may accompany cluster headaches.