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Lidocaine Hydrochloride side effects: what 59,879 FDA adverse event reports show

Lidocaine Hydrochloride · 1,199 reaction terms · 264,184 drug–reaction co-reports · data 2026-09-14
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Drug class

Amide Local Anesthetic, Antiarrhythmic

FDA label (Established Pharmacologic Class) · compare the class

Who reports

59,879 reports · 74% serious · 6,089 with death outcome · 63% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Lidocaine Ointment 5% is indicated for production of anesthesia of accessible mucous membranes of the oropharynx. It is also useful as an anesthetic lubricant for intubation and for the temporary relief of pain associated with minor burns, including sunburn, abrasions of the skin, and insect bites.

FDA label, Indications and Usage

What it is

DESCRIPTION Lidocaine Ointment 5% contains a local anesthetic agent and is administered topically. See INDICATIONS AND USAGE for specific uses. Lidocaine Ointment 5% contains lidocaine, which .

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Likely indication confounding 1Reporting / coding artifact 9Not in label — unassessed 28
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,159 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Inspiratory capacity decreased99197.0
153.9–252.2ROR 197.4 · calibrated p 8e-10 ✓
122.8 EB05 103.8 · IC025 +5.9
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.9 (3.9–6.1)
Not in label — unassessedserious n=99 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Sleep disorder therapy62175.0
128.9–237.5ROR 175.2 · calibrated p 3e-9 ✓
112.4 EB05 90.8 · IC025 +5.5
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.2 (3.9–6.8)
Reporting / coding artifactserious n=62 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Device wireless communication issue64120.4
90.6–160.0ROR 120.5 · calibrated p 5e-8 ✓
87.2 EB05 70.7 · IC025 +5.3
3/3 methods agree
vs other Amide Local Anesthetics: only this drug
Reporting / coding artifact♀ 100% (drug 63%) · 100% consumernot reported in cached trials
Appendicolith94115.2
91.2–145.5ROR 115.4 · calibrated p 6e-8 ✓
85.1 EB05 71.6 · IC025 +5.6
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.3 (4.2–6.7)
Not in label — unassessedserious n=94 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Analgesic therapy6492.2
70.0–121.5ROR 92.3 · calibrated p 3e-7 ✓
71.4 EB05 57.9 · IC025 +5.1
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.3 (4.0–7.0)
Reporting / coding artifactserious n=64 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Infusion site discharge35491.4
81.3–102.7ROR 91.9 · calibrated p 2e-7 ✓
72.1 EB05 66.1 · IC025 +5.9
3/3 methods agree
vs other Amide Local Anesthetics: PRR 6.8 (6.0–7.7)
Not in label — unassessedserious n=225 · ♀ 83% (drug 63%) · 90% consumernot reported in cached trials
Maternal exposure during delivery19185.6
73.1–100.3ROR 85.9 · calibrated p 4e-7 ✓
68.3 EB05 60.6 · IC025 +5.6
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.0 (3.4–4.7)
Reporting / coding artifactserious n=179 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Drug therapy6284.0
63.7–110.9ROR 84.1 · calibrated p 6e-7 ✓
66.4 EB05 53.7 · IC025 +5.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.2 (3.9–6.8)
Reporting / coding artifactserious n=62 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Device maintenance issue10277.2
62.3–95.7ROR 77.3 · calibrated p 1e-6 ✓
62.5 EB05 53.0 · IC025 +5.3
3/3 methods agree
vs other Amide Local Anesthetics: only this drug
Reporting / coding artifact100% consumernot reported in cached trials
Toxic anterior segment syndrome19576.3
65.3–89.1ROR 76.5 · calibrated p 9e-7 ✓
62.3 EB05 55.3 · IC025 +5.5
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.2 (4.4–6.1)
Not in label — unassessedserious n=190not reported in cached trials
Infusion site haemorrhage45356.8
51.4–62.7ROR 57.2 · calibrated p 6e-6 ✓
48.8 EB05 45.1 · IC025 +5.4
3/3 methods agree
vs other Amide Local Anesthetics: PRR 7.9 (7.0–8.8)
Not in label — unassessedserious n=244 · 85% consumernot reported in cached trials
Methaemoglobinaemia29852.0
46.1–58.7ROR 52.3 · calibrated p 1e-5 ✓
45.2 EB05 41.0 · IC025 +5.2
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.5 (4.8–6.2)
Not in label — unassessedserious n=287 · 100% cliniciannot reported in cached trials
Infusion site mass12948.0
39.9–57.7ROR 48.1 · calibrated p 2e-5 ✓
42.0 EB05 36.3 · IC025 +4.9
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.3 (4.3–6.4)
Not in label — unassessedserious n=86 · ♀ 87% (drug 63%) · 78% consumernot reported in cached trials
Infusion site irritation15048.0
40.4–56.9ROR 48.1 · calibrated p 2e-5 ✓
42.0 EB05 36.7 · IC025 +4.9
3/3 methods agree
vs other Amide Local Anesthetics: PRR 10.9 (8.9–13.3)
Not in label — unassessedserious n=63 · 100% consumernot reported in cached trials
Infusion site nodule10445.6
37.2–56.0ROR 45.7 · calibrated p 3e-5 ✓
40.1 EB05 34.1 · IC025 +4.8
3/3 methods agree
vs other Amide Local Anesthetics: PRR 8.6 (6.8–10.9)
Not in label — unassessed100% consumernot reported in cached trials
Infusion site warmth13744.9
37.6–53.7ROR 45.0 · calibrated p 3e-5 ✓
39.7 EB05 34.4 · IC025 +4.8
3/3 methods agree
vs other Amide Local Anesthetics: PRR 10.2 (8.3–12.5)
Not in label — unassessedserious n=63 · 100% consumernot reported in cached trials
Infusion site pruritus34944.0
39.4–49.2ROR 44.3 · calibrated p 3e-5 ✓
39.1 EB05 35.8 · IC025 +5.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.7 (5.1–6.5)
Not in label — unassessedserious n=207 · ♀ 85% (drug 63%) · 77% consumernot reported in cached trials
Infusion site swelling67543.0
39.7–46.6ROR 43.5 · calibrated p 3e-5 ✓
38.3 EB05 36.0 · IC025 +5.1
3/3 methods agree
vs other Amide Local Anesthetics: PRR 7.6 (7.0–8.4)
Not in label — unassessedserious n=328 · 81% consumernot reported in cached trials
Body tinea6041.6
31.8–54.3ROR 41.6 · calibrated p 6e-5 ✓
36.8 EB05 29.6 · IC025 +4.4
3/3 methods agree
vs other Amide Local Anesthetics: only this drug
Not in label — unassessedserious n=60 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Infusion site discolouration9141.3
33.2–51.3ROR 41.3 · calibrated p 5e-5 ✓
36.7 EB05 30.8 · IC025 +4.6
3/3 methods agree
vs other Amide Local Anesthetics: PRR 13.8 (10.5–18.0)
Not in label — unassessed♀ 100% (drug 63%) · 100% consumernot reported in cached trials
Infusion site bruising22040.3
35.1–46.3ROR 40.5 · calibrated p 5e-5 ✓
36.1 EB05 32.3 · IC025 +4.8
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.1 (4.4–5.9)
Not in label — unassessedserious n=153 · 74% consumernot reported in cached trials
Infusion site induration14539.7
33.4–47.1ROR 39.8 · calibrated p 6e-5 ✓
35.5 EB05 30.9 · IC025 +4.7
3/3 methods agree
vs other Amide Local Anesthetics: PRR 20.2 (16.0–25.6)
Not in label — unassessedserious n=48 · 100% consumernot reported in cached trials
Infusion site pain1,26538.4
36.3–40.7ROR 39.2 · calibrated p 6e-5 ✓
34.6 EB05 33.1 · IC025 +5.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 7.4 (7.0–7.9)
Likely indication confounding
term in indications
age-adj. PRR 24.4 · serious n=546 · 84% consumernot reported in cached trials
Infusion site erythema81037.8
35.2–40.7ROR 38.3 · calibrated p 7e-5 ✓
34.2 EB05 32.2 · IC025 +5.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 9.4 (8.7–10.2)
Not in label — unassessedserious n=359 · 83% consumernot reported in cached trials
Infusion site discomfort9736.6
29.7–45.1ROR 36.7 · calibrated p 1e-4 ✓
33.0 EB05 27.8 · IC025 +4.5
3/3 methods agree
vs other Amide Local Anesthetics: PRR 7.0 (5.5–8.9)
Not in label — unassessedserious n=57 · 100% consumernot reported in cached trials
Infusion site inflammation6436.6
28.3–47.4ROR 36.6 · calibrated p 1e-4 ✓
32.9 EB05 26.7 · IC025 +4.3
3/3 methods agree
vs other Amide Local Anesthetics: only this drug
Not in label — unassessed100% consumernot reported in cached trials
Device infusion issue22835.8
31.3–41.1ROR 36.0 · calibrated p 1e-4 ✓
32.5 EB05 29.1 · IC025 +4.7
3/3 methods agree
vs other Amide Local Anesthetics: PRR 8.3 (7.1–9.6)
Reporting / coding artifactserious n=124 · 89% consumernot reported in cached trials
Cauda equina syndrome6934.2
26.7–43.8ROR 34.3 · calibrated p 2e-4 ✓
31.0 EB05 25.3 · IC025 +4.3
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.3 (4.0–6.9)
Not in label — unassessedserious n=69 · 100% cliniciannot reported in cached trials
Infusion site rash12033.7
28.0–40.7ROR 33.8 · calibrated p 2e-4 ✓
30.7 EB05 26.3 · IC025 +4.5
3/3 methods agree
vs other Amide Local Anesthetics: PRR 6.0 (4.9–7.4)
Not in label — unassessedserious n=71 · 74% consumernot reported in cached trials
Foetal exposure during delivery5530.5
23.1–40.2ROR 30.5 · calibrated p 3e-4 ✓
27.9 EB05 22.2 · IC025 +4.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 6.7 (4.9–9.1)
Reporting / coding artifactserious n=54 · 100% cliniciannot reported in cached trials
Procedural hypotension6729.6
23.1–38.0ROR 29.6 · calibrated p 3e-4 ✓
27.2 EB05 22.1 · IC025 +4.1
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.1 (3.9–6.7)
Not in label — unassessedserious n=66 · 100% cliniciannot reported in cached trials
Infusion site infection17629.4
25.2–34.3ROR 29.5 · calibrated p 3e-4 ✓
27.1 EB05 23.9 · IC025 +4.4
3/3 methods agree
vs other Amide Local Anesthetics: PRR 73.1 (52.6–101.7)
Not in label — unassessedserious n=84 · 100% consumernot reported in cached trials
Anaesthetic complication20529.0
25.2–33.4ROR 29.1 · calibrated p 3e-4 ✓
26.8 EB05 23.8 · IC025 +4.4
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.1 (4.3–5.9)
Reporting / coding artifactserious n=174 · 100% cliniciannot reported in cached trials
Anaesthetic complication neurological6225.5
19.7–33.0ROR 25.5 · calibrated p 7e-4 ✓
23.6 EB05 19.1 · IC025 +3.9
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.0 (3.8–6.6)
Not in label — unassessedserious n=60 · 100% cliniciannot reported in cached trials
Infusion site reaction19324.8
21.5–28.7ROR 24.9 · calibrated p 7e-4 ✓
23.2 EB05 20.6 · IC025 +4.2
3/3 methods agree
vs other Amide Local Anesthetics: PRR 9.0 (7.6–10.7)
Not in label — unassessedserious n=95 · 81% consumernot reported in cached trials
Chronic kidney disease-mineral and bone disorder6321.7
16.8–28.0ROR 21.7 · calibrated p 0.002 ✓
20.4 EB05 16.5 · IC025 +3.7
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.6 (3.5–6.0)
Not in label — unassessedserious n=63not reported in cached trials
Kounis syndrome13121.5
18.0–25.6ROR 21.5 · calibrated p 0.002 ✓
20.2 EB05 17.5 · IC025 +4.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 5.3 (4.3–6.4)
Not in label — unassessedserious n=131 · 100% cliniciannot reported in cached trials
Mastoiditis5219.7
14.9–26.1ROR 19.7 · calibrated p 0.003 ✓
18.6 EB05 14.7 · IC025 +3.5
3/3 methods agree
vs other Amide Local Anesthetics: only this drug
Not in label — unassessedserious n=52 · ♀ 100% (drug 63%)not reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Anaphylaxis / angioedema2,0555.85.6–6.1signal
Seizure1,5532.82.6–2.9signal
Arrhythmia / qt1,4582.62.5–2.8signal
Serious infection5,2602.42.3–2.5signal
Hyponatraemia4772.11.9–2.3raised
Kidney injury2,5111.91.9–2.0raised
Opportunistic infection7381.91.8–2.0raised
Fall / fracture2,0011.81.8–1.9raised
Neutropenia / agranulocytosis1,2761.81.7–1.9raised
Anaemia1,4381.71.6–1.8raised
Tendon disorder1771.61.4–1.9raised
Severe cutaneous reaction3291.51.4–1.7raised
Venous thromboembolism9481.51.4–1.6raised
Thrombocytopenia9011.41.3–1.5raised
Heart failure6941.41.3–1.5raised
Osteonecrosis2191.31.2–1.5raised

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Lidocaine as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)4,3541.2
1.1–1.2ROR 1.2 · calibrated p 0.420
1.2 EB05 1.1 · IC025 +0.2
vs other Amide Local Anesthetics: PRR 4.2 (4.1–4.3)
Reporting / coding artifactage-adj. PRR 1.4 · serious PRR 1.6not reported in cached trials
Nausea3,7501.7
1.6–1.7ROR 1.7 · calibrated p 0.776
1.7 EB05 1.6 · IC025 +0.7
vs other Amide Local Anesthetics: PRR 4.9 (4.7–5.0)
Not in label — unassessedage-adj. PRR 1.5 · serious PRR 1.9not reported in cached trials
Pain3,6892.1
2.0–2.2ROR 2.2 · calibrated p 0.963
2.1 EB05 2.0 · IC025 +1.0
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.3 (4.2–4.5)
Likely indication confounding
term in indications
age-adj. PRR 2.2 · serious PRR 2.0not reported in cached trials
Fatigue (tiredness)3,5631.6
1.6–1.7ROR 1.6 · calibrated p 0.736
1.6 EB05 1.6 · IC025 +0.6
vs other Amide Local Anesthetics: PRR 4.7 (4.6–4.9)
Not in label — unassessedage-adj. PRR 1.4 · serious PRR 1.7not reported in cached trials
Headache3,3481.9
1.8–1.9ROR 1.9 · calibrated p 0.904
1.9 EB05 1.8 · IC025 +0.8
vs other Amide Local Anesthetics: PRR 4.8 (4.6–4.9)
Not in label — unassessedage-adj. PRR 1.5 · serious PRR 2.0not reported in cached trials
Off label use (used outside approved label)3,2051.3
1.3–1.3ROR 1.3 · calibrated p 0.515
1.3 EB05 1.3 · IC025 +0.3
vs other Amide Local Anesthetics: PRR 3.3 (3.2–3.5)
Reporting / coding artifactage-adj. PRR 1.3 · serious PRR 1.4not reported in cached trials
Dyspnoea (shortness of breath)2,7871.7
1.7–1.8ROR 1.8 · calibrated p 0.808
1.7 EB05 1.7 · IC025 +0.7
vs other Amide Local Anesthetics: PRR 5.1 (4.9–5.3)
Not in label — unassessedage-adj. PRR 1.6 · serious PRR 1.6not reported in cached trials
Diarrhoea (diarrhea)2,5221.4
1.3–1.4ROR 1.4 · calibrated p 0.569
1.4 EB05 1.3 · IC025 +0.4
vs other Amide Local Anesthetics: PRR 5.1 (4.9–5.3)
Not in label — unassessedage-adj. PRR 1.2 · serious PRR 1.3not reported in cached trials
Pneumonia (lung infection)2,3112.5
2.4–2.6ROR 2.6 · calibrated p 0.782
2.5 EB05 2.4 · IC025 +1.3
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.8 (4.6–5.0)
Not in label — unassessedage-adj. PRR 2.2 · serious PRR 2.0NCT01401647: 100/993 (10.1%) on Lidocaine
Vomiting2,2611.7
1.6–1.8ROR 1.7 · calibrated p 0.780
1.7 EB05 1.6 · IC025 +0.7
vs other Amide Local Anesthetics: PRR 4.8 (4.6–5.1)
Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.6not reported in cached trials
Dizziness2,1611.5
1.5–1.6ROR 1.5 · calibrated p 0.668
1.5 EB05 1.5 · IC025 +0.5
vs other Amide Local Anesthetics: PRR 5.0 (4.8–5.2)
Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.6not reported in cached trials
Hypotension (low blood pressure)2,0063.5
3.4–3.7ROR 3.6 · calibrated p 0.457
3.5 EB05 3.4 · IC025 +1.7
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.8 (4.6–5.0)
Labeled adverse reaction
exact term
age-adj. PRR 3.3 · serious PRR 3.0NCT01401647: 114/993 (11.5%) on Lidocaine
Sinusitis2,0036.9
6.6–7.2ROR 7.1 · calibrated p 0.093
6.8 EB05 6.6 · IC025 +2.7
3/3 methods agree
vs other Amide Local Anesthetics: PRR 4.2 (4.0–4.4)
Not in label — unassessedage-adj. PRR 5.0 · serious PRR 7.1not reported in cached trials
Pyrexia (fever)1,9652.0
1.9–2.1ROR 2.0 · calibrated p 0.958
2.0 EB05 1.9 · IC025 +0.9
vs other Amide Local Anesthetics: PRR 5.2 (5.0–5.5)
Not in label — unassessedage-adj. PRR 1.8 · serious PRR 1.6not reported in cached trials
Fall1,8992.0
1.9–2.1ROR 2.0 · calibrated p 0.964
2.0 EB05 1.9 · IC025 +0.9
vs other Amide Local Anesthetics: PRR 4.5 (4.2–4.7)
Not in label — unassessedage-adj. PRR 1.8 · serious PRR 1.7not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Oxycodone Hydrochloride ↔ Drug Dependence.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Lidocaine?

In FDA FAERS, the most frequently co-reported reaction terms for Lidocaine are nausea, pain, fatigue, headache, dyspnoea, diarrhoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Lidocaine have an FDA boxed warning?

No. The FDA label retrieved for Lidocaine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Lidocaine causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.