Topical pain relief:
Indications for Lidocaine/Prilocaine Cream:
Topical anesthetic on normal intact skin for local analgesia or on genital mucous membranes for superficial minor surgery and as pretreatment for infiltration anesthesia.
Minor dermal procedures (eg, IV cannulation, venipuncture): apply 2.5g in a thick layer with occlusion over 20–25cm2 for at least 1hr. Major dermal procedures (eg, skin graft harvesting): apply 2g per 10cm2 in a thick layer with occlusion for at least 2hrs. Pretreatment before local anesthetic infiltration on adult male genital skin: apply 1g per 10cm2 in a thick layer with occlusion for 15mins. Minor procedures on female external genitalia (eg, wart removal, local anesthetic infiltration): apply 5–10g in a thick layer for 5–10mins; may occlude to help keep cream in place.
If age and weight are not proportional, base max dose on weight (see full labeling). <37wks gestational age: not recommended. 0–3mos (<5kg): max 1g/10cm2 applied for up to 1hr. 3–12mos (>5kg): max 2g/20cm2 applied for up to 4hrs. 1–6yrs (>10kg): max 10g/100cm2 applied for up to 4hrs. 7–12yrs (≥20kg): max 20g/200cm2 applied for up to 4hrs.
Not for use near tympanic membrane. Increased risk of methemoglobinemia in G6PD deficiency, congenital/idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants <6mos; monitor and discontinue if occurs. Avoid eyes, open wounds, ingestion, application to large areas, and using for longer than recommended time. Monitor children to prevent accidental ingestion. Severe hepatic disease. Effect on intradermal live vaccines unknown. Acutely ill. Elderly. Debilitated. Pregnancy (Cat.B). Nursing mothers.
<12mos of age: do not use with methemoglobin-inducing drugs (eg, acetaminophen, sulfonamides, nitrates, phenytoin, phenobarbital, other local anesthetics); caution with these in other patients. Toxicity potentiated by Class I (eg, tocainide, mexiletine) and Class III antiarrhythmics (eg, amiodarone, bretylium, sotalol, dofetilide); monitor.
Local effects (eg, paleness, erythema, changes in temperature sensation, edema, itching).
Formerly known under the brand name Emla.