Generic
Lidocaine + Prilocaine topical
3 brands available in the market
At a glance
Lidocaine + Prilocaine topical is a local anesthetic cream used to numb the skin and mucous membranes. It is used to prevent pain before procedures such as injections, suturing, blood draws, and minor surgeries.
Description
Lidocaine and prilocaine are local anaesthetic agents of the amide type. Both work by stabilising the neuronal membranes and inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby giving rise to the anaesthetic action. The cream is applied to intact skin and covered with an occlusive dressing. Absorption from wound surfaces and mucous membranes is relatively high, especially in the bronchial tree.
Indications
- Local analgesia - on normal intact skin (IV cannulation, venipuncture)
- Surface anesthesia on genital mucous membranes - before minor surgery
- Pretreatment for infiltration anesthesia
Therapeutic class
Local & Surface Anesthesia
Pharmacological class
Amide Local Anesthetic
Pharmacology
Lidocaine and prilocaine stabilize neuronal membranes and inhibit Na+ ion movements to block pain signals from nerves to the brain.
Mechanism of action
Blocks pain signals from nerves to the brain, numbing the area.
Dosage
Adult Dose (Topical):
- Minor dermal procedures (IV cannulation, venipuncture): 2.5 g/20-25 cm², at least 1 hour
- Major dermal procedures (e.g., skin graft): 2 g/10 cm², at least 2 hours
- Male genital skin (pretreatment): Thick layer, 15 minutes
- Female genital mucous membranes: 5-10 g, 5-10 minutes
Pediatric Dose:
- 0-3 months or <5 kg: Max 1 g, Time 1 hour
- 3-12 months and >5 kg: Max 2 g, Time 4 hours
- 1-6 years and >10 kg: Max 10 g, Time 4 hours
- 7-12 years and >20 kg: Max 20 g, Time 4 hours
Administration
- For external use only
- Apply to intact skin
- Cover with occlusive dressing
- Do not apply to broken, inflamed, or infected skin
- Avoid contact with eyes, mouth, nose, or mucous membranes
- Wash hands after application
Missed dose
Not generally applicable; consult doctor if needed.
Side effects
Common Side Effects:
- Application site reactions (burning, irritation, itching, redness)
- Skin rash
- Nervousness, dizziness, blurred vision, tremors
- Rare: convulsions, unconsciousness, respiratory arrest, hypotension, bradycardia
Precautions & warnings
- Neonates with gestational age <37 weeks - do not use
- Infants <12 months receiving methaemoglobin-inducing agents - do not use
- Do not apply to mucous membranes, broken or inflamed skin
- Caution in epilepsy, impaired cardiac condition, bradycardia, impaired hepatic function, and severe shock
- Oropharyngeal use may interfere with swallowing and increase aspiration risk (especially in children)
Contraindications
- Hypersensitivity to amide type local anesthetics or any other component of the product
- Neonates with gestational age <37 weeks
- Congenital or idiopathic methaemoglobinemia
Drug interactions
- Increased risk of toxicity with methaemoglobin-inducing drugs
- Additive cardiac effects with class III antiarrhythmics
- Additive toxic effects with class I antiarrhythmics
Food interactions
No food interactions found.
Use in pregnancy
Use in Pregnancy: Lidocaine + Prilocaine topical is generally considered safe during pregnancy. Animal studies have shown low or no adverse effects to the developing baby. Wide use has shown no apparent ill consequences.
Use in lactation
Use in Lactation: Lidocaine + Prilocaine topical enters breast milk in small quantities, but generally poses no risk to the child at therapeutic doses. Caution is advised and consult your doctor.
Pediatric use
Pediatric doses are established (age and weight-based); specific precautions for neonates.
Geriatric use
Safe for elderly; no special precautions needed.
Renal / hepatic impairment
No specific precautions applicable (topical use).
Overdose effects
Overdose: lidocaine (>5 µg/ml) and/or prilocaine (>6 µg/ml) may decrease cardiac output, peripheral resistance, and mean arterial pressure.
Storage conditions
Store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Lidocaine + Prilocaine Topical