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lidocaine hydrochloride (3268 / lignocaine, Anesiva / ALGRX 3268)

✓ Approved

Marathon Pharmaceuticals · SCN9A · Small Molecule

What is lidocaine hydrochloride?

lidocaine hydrochloride is a small molecule developed by Marathon Pharmaceuticals. It is approved for therapeutic indications via injectable (others) or intradermal injection.

Drug Profile

Brand Names3268, lignocaine, Anesiva, ALGRX 3268
CompanyMarathon Pharmaceuticals
Drug ClassSmall Molecule
Molecular TargetSCN9A
RouteInjectable (Others), Intradermal Injection
StatusApproved
Sources: ClinicalTrials.gov, Marathon Pharmaceuticals

Mechanism of Action

Molecular Targets

lidocaine hydrochloride acts on 1 molecular target:

SCN9Asodium voltage-gated channel alpha subunit 9 (SFNP, GEFSP7)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

lidocaine hydrochloride is developed for 2 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersAnaesthesia✓ Approved
Nervous system disordersSensory loss✓ Approved

Related Research Articles

PubMedThe Journal of arthroplasty2026-07-17

Short-Acting Spinal Anesthetics for Total Joint Arthroplasty: A Systematic Review and Network Meta-Analysis.

Siddiqi Ahmed A, Yousuf Khalid M KM, Conrad David D, Meneghini R Michael RM et al.

As total hip arthroplasty (THA) and total knee arthroplasty (TKA) increasingly shift toward outpatient and short-stay care, recovery milestones such as ambulation and bladder function have become critical determinants of discharge readiness. Although spinal anesthesia is widely used in total joint arthroplasty (TJA), the relative recovery profiles of commonly used intrathecal agents remain incompletely defined. A systematic review and network meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were searched through October 2025 for randomized and comparative studies evaluating spinal anesthetics in primary THA or TKA. Random-effects pairwise meta-analyses were performed using restricted maximum likelihood estimation with Hartung-Knapp adjustment. A frequentist network meta-analysis integrated direct and indirect comparisons among bupivacaine, mepivacaine, chloroprocaine, lidocaine, and lidocaine-based mixtures. Risk of bias was assessed using Risk of Bias 2 (RoB 2) and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I), and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). There were 16 studies encompassing 1,914 patients that met inclusion criteria. In THA, short-acting spinal anesthetics were associated with a reduction in lengths of stay compared with bupivacaine (mean difference -293.8 minutes; 95% CI [confidence interval] -614.77 to 27.15; P = 0.07). In TKA, a smaller but consistent reduction in length of stay was observed (mean difference -81.6 minutes; 95% CI -167.02 to 3.79; P = 0.06). Rates of postoperative urinary retention were lower with mepivacaine and lidocaine in both THA and TKA cohorts (mepivacaine odds ratio 0.20; 95% CI 0.09 to 0.44; P < 0.001; lidocaine odds ratio 0.51; 95% CI 0.34 to 0.77; P = 0.001). No significant differences were observed in postoperative nausea and vomiting or readmission in either procedure. Transient neurologic symptoms were more frequent with lidocaine, but not with mepivacaine or chloroprocaine. Network meta-analysis demonstrated consistent ranking of anesthetic agents across outcomes, with mepivacaine showing the most favorable overall recovery profile. Short-acting spinal anesthetics were associated with improved recovery efficiency and lower rates of postoperative urinary retention compared with bupivacaine. These findings support consideration of anesthetic duration as an important contributor to early recovery following THA and TKA within contemporary rapid-recovery pathways. Level II, systematic review and network meta-analysis.

PMID 42462883
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PubMedAesthetic plastic surgery2026-07-17

Transverse Cervical Nerve for Landmark-Guided Cervical Cutaneous Analgesia.

Yi Kyu-Ho KH, Lee Suyeon S, Jitaree Benrita B

Neck injections can be painful despite topical anesthesia. Blocking the transverse cervical nerve (TCN) may improve comfort, but clinicians need practical surface landmarks and attention to the external jugular vein (EJV). In an anatomical mapping series (46 heminecks), the TCN emergence point along the posterior border of the sternocleidomastoid muscle (SCM) was recorded as a percentage of the earlobe-to-lateral clavicular SCM insertion distance (0-100%). In a pilot split-neck study (n=9), the left neck received landmark-guided TCN block with lidocaine at the mapped point (~10 mm depth) before bilateral injections; the right neck received lidocaine 5% cream, applied according to the clinic's routine protocol for 30 minutes prior to injection RESULTS: The TCN emerged at a mean of 53% along the reference line. Complete cutaneous anesthesia occurred in 9/9 participants (95% CI, 66.4-100%). All participants reported lower VAS pain on the blocked side (sign test, p=0.0039). One bruise occurred (1/9; 11.1%; 95% CI, 0.3-48.2%). A proportional SCM landmark (~53%) provides a simple guide for landmark-based TCN block to reduce discomfort during neck injections. EJV awareness and aspiration are essential for safety. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID 42463534
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PubMedBMC anesthesiology2026-07-17

Effect of stellate ganglion block on perioperative psychological symptoms and recovery after total hip arthroplasty for osteonecrosis of the femoral head in non-elderly patients: a randomized controlled trial.

Fan Xiaomin X, Huang Ziqi Z, Li Xia X, Li Jing J et al.

The incidence of osteonecrosis of the femoral head (ONFH) in non-elderly patients is increasing. Psychological distress, including anxiety and depression related to both the disease itself and total hip arthroplasty (THA), may adversely affect postoperative outcomes. This study aimed to evaluate the effects of stellate ganglion block (SGB) on perioperative psychological symptoms and postoperative recovery in patients undergoing THA for ONFH. A total of 94 patients undergoing THA were enrolled in this study and randomly divided into the stellate ganglion block group (SGB group) and the control group (CON group). Patients in the SGB group received ultrasound-guided unilateral stellate ganglion block before surgery with an injection of 4 mL of 0.8% lidocaine; patients in the CON group underwent the same procedure, with an equal volume of normal saline replacing lidocaine. On postoperative days 1 and 4, the degree of anxiety and depression, pain intensity, sleep quality, recovery status, and occurrence of complications were evaluated in all patients. Compared with the CON group, patients receiving SGB treatment showed favorable trends in GAD-7 scores and improved postoperative recovery quality, as reflected by the primary mixed-effects analysis (P < 0.05) and significantly higher QoR-15 scores. However, additional ANCOVA adjusting for baseline GAD-7 scores did not confirm a significant between-group difference in GAD-7 outcomes. The observed GAD-7 effect was therefore not robust to baseline adjustment. Although HADS scores tended to be lower in the SGB group, the difference did not reach statistical significance. SGB did not significantly affect pain intensity (VAS score) or the incidence of adverse events, including hypotension, dizziness, nausea and vomiting, and nightmares (all P > 0.05). Among non-elderly patients undergoing THA, SGB was associated with some favorable trends in perioperative psychological symptoms and postoperative recovery quality. However, the evidence was inconsistent across different psychological assessment scales and sensitive to baseline adjustment. Therefore, these findings should be considered hypothesis-generating rather than conclusive. This study was registered in the Chinese Clinical Trial Registry. (ChiCTR2400089542) on 2024/09/10.

PMID 42464128
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PubMedJournal of virology2026-07-17

Cyclo-C stabilizes PEX13 to inhibit porcine epidemic diarrhea virus replication by blocking pexophagy-mediated disruption of antiviral innate immunity.

Lou Jinxiu J, Guo Zhiwei Z, Chen Kang K, Tian Yuanmingyue Y et al.

The persistent threat of porcine epidemic diarrhea virus (PEDV) to the global swine industry is compounded by high neonatal piglet mortality and the absence of effective antiviral therapies. Host-directed strategies that reinforce immunity offer a promising avenue to counter viral immune evasion. Through screening of an FDA-approved compound library, we identify the small-molecule cyclocytidine hydrochloride (Cyclo-C) as a potent inhibitor of PEDV replication that acts by stabilizing the peroxisomal biogenesis factor PEX13, a previously unrecognized host restriction factor. The antiviral activity of Cyclo-C is strictly PEX13-dependent, as it is completely abrogated in PEX13 knockout cells. Mechanistically, Cyclo-C disrupts the interaction between PEX13 and the viral nonstructural protein 8 (NSP8), thereby preventing NSP8-mediated PEX13 degradation and the subsequent induction of PI3K/AKT/mTOR-driven pexophagy. Preservation of peroxisomal integrity stabilizes the peroxisome-localized pool of MAVS, leading to a robust enhancement of type III interferon (IFN-III) responses that suppress viral replication. Critically, this mechanism translates in vivo, where Cyclo-C treatment of PEDV-challenged piglets significantly reduces mortality, lowers viral loads, and protects intestinal villus architecture. Our findings establish Cyclo-C as a first-in-class host-directed therapeutic candidate and validate the concept that pharmacological preservation of peroxisome-mediated innate immunity represents an effective antiviral strategy against enteric coronaviruses. The high genetic variability of porcine epidemic diarrhea virus (PEDV) limits current vaccine efficacy, and no antiviral therapeutics exist. Host-directed therapies targeting cellular pathways that viruses exploit for immune evasion offer an alternative approach. Here, we identify the FDA-approved compound Cyclo-C as a potent inhibitor of PEDV replication. Cyclo-C acts by stabilizing PEX13, a host protein that the virus degrades to evade immunity. By blocking viral protein NSP8 from binding PEX13, Cyclo-C prevents virus-induced pexophagy, thereby preserving peroxisomal integrity. This preserves peroxisome-localized MAVS and enhances type III interferon responses. In infected neonatal piglets, Cyclo-C reduced mortality and viral loads while protecting intestinal integrity. This study provides proof of concept that targeting peroxisomal immune regulation is a viable antiviral strategy and identifies Cyclo-C as a promising candidate for treating PEDV infection.

PMID 42466851
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PubMedLuminescence : the journal of biological and chemical luminescence2026-07-16

Pioneering Novel, Green, White, and Blue Fluorescence-Based Platforms for Sustainable and Concurrent Monitoring of Ciprofloxacin With Celecoxib or Itopride in Biological Matrices.

Barakat Neamat T NT, El-Aziz Heba Abd HA, Eid Manal I MI, Ibrahim Fawzia A FA

Two innovative spectrofluorimetric techniques were developed for the first time to enable simultaneous quantification of ciprofloxacin hydrochloride in binary mixtures with either celecoxib or itopride hydrochloride in biological fluids. The first relied on synchronous spectrofluorimetry at a constant wavelength interval (Δλ = 100 nm), which effectively reduced spectral interference and allowed accurate estimation of celecoxib and ciprofloxacin hydrochloride at their zero-crossing points of 276 and 328 nm, respectively. The second technique leveraged direct spectrofluorimetric measurement of ciprofloxacin hydrochloride and itopride hydrochloride mixture, using excitation at 258 nm that yielded two discrete emission peaks at 351 nm for ITH and 441 nm for CPN. Both methods demonstrated remarkable sensitivity and selectivity, achieving excellent linearity (r = 0.9999) across broad ranges of (0.05-3.0 μg/mL and 0.05-5.0 μg/mL for ciprofloxacin hydrochloride and celecoxib, respectively, and 0.07-4.0 μg/mL for ciprofloxacin hydrochloride and 0.04-9.0 μg/mL for itopride hydrochloride. Comprehensive greenness assessment was performed, which confirmed their low environmental burden. Moreover, whiteness and blueness evaluations highlighted the favorable integration of analytical efficiency with sustainability principles. The proposed strategies combine rapidity, high sensitivity, and environmental safety, providing reliable alternatives for routine quality control of pharmaceutical formulations and accurate determination of CPN mixtures in biological matrices.

PMID 42458825
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PubMedCanadian journal of ophthalmology. Journal canadien d'ophtalmologie2026-07-16

Factors influencing graft survival in full-thickness skin grafts of the periocular region: a systematic review.

Prabhu Neetin N, Gupta Arjav A, Hodgson Kevin K, Oyesode Oyeleye O et al.

Full-thickness skin grafts (FTSG) are a commonly used tool in facial reconstruction. The success of a skin graft is paramount to the structural integrity of a defect repair. We sought to systematically review existing evidence for factors influencing the success of full-thickness skin grafts in the periocular region. A systematic review of published literature from 1965 to December 1, 2025, was conducted following PRISMA guidelines. Publication descriptors, methodological details, and overall results were extracted. Articles were assessed for methodological quality using MINORS, Cochrane ROB 2, or AMSTAR 2 instruments depending on study type. Twenty-six studies were included. Most were retrospective, and 73.1% were from the 3rd level of evidence. Noncomparative, nonrandomized studies were generally rated as higher quality, with the remainder being low to moderate. Nine studies reported graft failure, with an incidence below 10% in nearly all studies. The only comparative study that found a statistically significant decrease in graft survivability was with infiltration of lidocaine with epinephrine into the graft donor site compared with infiltration of lidocaine without epinephrine (p = .05). Overall, studies investigating factors influencing FTSG were of low to moderate quality. Success of FTSG in the periocular region was high regardless of additional interventions. Local anesthetic use with epinephrine was, however, associated with worse outcomes. Our review identified a need for additional high-quality evidence that can be used to indicate whether the donor site affects success for this intervention, as well as additional randomized controlled trials to improve the quality of the literature.

PMID 42457147
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