Strepsils Max Plus (Anaesthetic) Lozenge Mechanism of Action

Pharmacology: Amylmetacresol and dybenal (2,4-dichlorobenzyl alcohol) have antiseptic properties. Lignocaine hydrochloride is a local anaesthetic of the amide type and has a fast onset and an intermediate duration of action.
Pharmacokinetics: Absorption: Lignocaine is readily absorbed from the gastrointestinal tract, from mucous membrane and through damaged skin.
Protein-Binding: Lignocaine is bound to plasma proteins, including α₁-acid glycoprotein (AAG). The extent of binding is variable but is approximately 66%. Plasma protein-binding of lignocaine depends in part on the concentrations of both lignocaine and AAG.
Metabolism: Lignocaine is largely metabolised in the liver and first-pass metabolism is extensive and bioavailability is about 35% after oral administration. Approximately 90% of a given dose is dealkylated to form monoethylglycinexylidide (MEGX) and glycinexylidide (GX).
Excretion: Further metabolism occurs and metabolites are excreted in the urine with <10% of unchanged lignocaine. Lignocaine crosses the placenta and blood-brain barrier: It is excreted in the breast milk.