Calculators · Anaesthesiology · Dose

Lidocaine maximum dose (plain / with adrenaline)

Also called lignocaine max dose, Xylocaine maximum dose, local anaesthetic toxic dose, LAST dose limit

US-label maximum single dose of lidocaine for healthy adults, as mg and as mL of the chosen strength.

Solution
Strength

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Formula and scoring

Plain: 4.5 mg/kg, total ≤ 300 mg. With adrenaline: 7 mg/kg, total ≤ 500 mg. Volume (mL) = dose (mg) ÷ (% × 10 mg/mL). IV regional anaesthesia: ≤ 4 mg/kg in adults.

Exam and ward pearls

  • 1% = 10 mg/mL – the conversion examiners expect you to do in your head.
  • The label figure is a guide for healthy adults, not a guarantee of safety.

When not to rely on it

  • Label figures are not evidence-based thresholds (Rosenberg 2004); toxicity depends on site, rate and patient factors. Children: label gives no simple maximum – use paediatric references.
  • Bupivacaine and ropivacaine are not calculated here: their current US labels give no mg/kg ceiling (bupivacaine: do not exceed 400 mg in 24 h; ropivacaine nerve-block MRHD 250 mg, up to 770 mg/24 h tolerated postoperatively).

Source

  1. Xylocaine (lidocaine HCl and epinephrine) injection – US prescribing information, Maximum Recommended Dosages (DailyMed, accessed 8 Nov 2026). Link
  2. Marcaine and Marcaine with epinephrine (bupivacaine) – US prescribing information (DailyMed). Link
  3. Naropin (ropivacaine) – US prescribing information (DailyMed). Link
  4. Rosenberg PH, et al. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med. 2004;29(6):564-75. doi:10.1016/j.rapm.2004.08.003 · PMID 15635516

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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