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Lidocaine + heparin is a **combination drug** administered primarily by intravesical instillation (directly into the bladder) as a compounded, non-commercial pharmaceutical for the treatment of bladder pain, urgency, and frequency, especially in patients with interstitial cystitis/bladder pain syndrome (IC/BPS)[1][3][6]. Lidocaine is a local anesthetic that blocks sodium channel protein type 1 subunit alpha on sensory nerve fibers, producing rapid and reversible local anesthesia to reduce pain, while heparin is a glycosaminoglycan that forms a protective coating on the bladder epithelium, restoring the mucosal permeability barrier disrupted in IC, and may additionally stabilize lidocaine in solution[1][5][6]. This combination has demonstrated greater and more rapid symptom improvement—bladder pain reduction (up to 42%), decreased urgency, and extended relief (up to 12 hours)—than lidocaine alone in randomized control trials for IC patients[3][4][5][6]. Formulations typically include 50,000 units heparin and 200 mg alkalinized lidocaine hydrochloride in 15 mL water, buffered to pH ~7.2 with sodium bicarbonate[5][6].
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