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All about: lidocaine and prilocaine topical

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Generic Name: lidocaine and prilocaine topical (LY doh kayn and PRIL oh kayn TOP ik al)
Brand Names: Emla, Emla Anesthetic Disc

What is lidocaine and prilocaine topical?

Lidocaine and prilocaine topical is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine and prilocaine topical is used to numb the skin, or surfaces of the penis or vagina, in preparation for a medical procedure or to lessen the pain of inserting a medical instrument such as a tube or speculum.

Lidocaine and prilocaine topical may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about lidocaine and prilocaine?

An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Do not use lidocaine and prilocaine topical if you have had an allergic reaction to a numbing medicine in the past.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have:

  • liver disease;

  • a history of allergic reaction to lidocaine or prilocaine; or

  • a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

What should I discuss with my health care provider before using lidocaine and prilocaine topical?

An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure. Do not use lidocaine and prilocaine topical if you have a blood cell disorder called methemoglobinemia.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have:

  • liver disease;

  • a history of allergic reaction to lidocaine or prilocaine; or

  • a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

If you have any of these conditions, you may not be able to use lidocaine and prilocaine topical, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Lidocaine and prilocaine topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use lidocaine and prilocaine topical?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of medicine needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

This medication comes with instructions for safe and effective application. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

You should be lying down when lidocaine and prilocaine topical cream is applied.

Your medicine may have been supplied with bandages to cover the cream when it is applied to a small area on your skin. If using a bandage dressing, first apply a thick layer of the cream to the skin, taking care not to spread the cream out. Place the bandage over the cream and smooth down the edges until it is completely sealed around the cream.

Lidocaine and prilocaine topical is usually applied 1 to 2 hours before the start of a procedure that requires the treated area to be numb. Follow your doctor's instructions about the length of time the cream should be left on the skin.

Store lidocaine and prilocaine topical at room temperature away from moisture and heat. Do not allow the cream to freeze.

What happens if I miss a dose?

Since lidocaine and prilocaine topical is used as needed, it is not likely that you will be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of lidocaine and prilocaine topical applied to the skin can cause life-threatening side effects such as uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

What should I avoid while taking lidocaine and prilocaine topical?

Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

Lidocaine and prilocaine topical side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using lidocaine and prilocaine topical and call your doctor at once if you have any of these serious side effects:
  • severe burning, stinging, or sensitivity where the medicine is applied;

  • swelling or redness;

  • sudden dizziness or sleepiness after medicine is applied;

  • bruising or purple appearance of the skin; or

  • unusual sensations of temperature.

Continue using lidocaine and prilocaine topical and talk with your doctor if you have any of these less serious side effects:

  • mild burning where the medicine is applied;

  • skin redness; or

  • changes in skin color where the medicine was applied.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect lidocaine and prilocaine topical?

Before this medication is applied, tell your doctor if you are using any of the following drugs:

  • heart rhythm medication such as tocaininde (Tonocard) or mexiletine (Mexitil);

  • acetaminophen (Tylenol);

  • chloroquine (Aralen);

  • dapsone;

  • nitrates or nitrites such as Imdur, Isordil, Monoket;

  • nitrofurantoin (Furadantin, Macrodantin, Macro-Bid);

  • phenobarbital (Luminal, Solfoton);

  • primaquine;

  • quinine; or

  • a sulfa drug such as Azulfidine, Bactrim, Cotrim, Gantanol, Gantrisin, or Septra.

If you are using any of these drugs, you may not be able to use lidocaine and prilocaine topical, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect lidocaine and prilocaine topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has more information about lidocaine and prilocaine topical written for health professionals that you may read.

What does my medication look like?

Lidocaine and prilocaine topical is available over-the-counter (without a prescription) under many different brand names. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.02. Revision Date: 03/14/2007 09:36:51.

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