lidocaine and prilocaine (EMLA)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: lidocaine and prilocaine

BRAND NAME: Emla

DRUG CLASS AND MECHANISM: Lidocaine and prilocaine is a topical anesthetic cream. Lidocaine and prilocaine enter through the skin and block pain receptors in nerve endings. Lidocaine and prilocaine reduce conduction of nerve impulses by interrupting the transfer of sodium ions across the membranes of nerve cells. This results in a local anesthetic action. The FDA approved lidocaine/prilocaine in December 1992.

PRESCRIBED FOR: Lidocaine and prilocaine cream is commonly used as a local anesthetic on normal intact skin and genital mucous areas, before minor procedures.

SIDE EFFECTS: Side effects of lidocaine and prilocaine are:

  • application site redness,
  • pain,
  • burning,
  • paleness,
  • edema, and
  • altered temperature sensation.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Lidocaine and prilocaine is a combination cream, containing 2.5% of each component. Lidocaine and prilocaine is available in 5 gram and 30 gram tubes.

STORAGE: Cream should be stored at room temperature 20 C to 25 C (68 F to 77 F). The tube must be closed tightly at all times when not in use.

DOSING:

Adults
  • Minor skin procedures: Apply 2.5 grams of cream over 20 to 25 cm2of skin surface for at least 1 hour.
  • Major skin procedures: Apply 2 grams of cream per 10 cm2of skin and allow to remain in contact with the skin for at least 2 hours.
  • Genital mucous membrane (female): Apply a thick layer (5 to 10 grams) of cream for 5 to 10 minutes.
  • Male genital skin: Apply a thick layer of cream (1 g/10 cm2) to the skin surface for 15 minutes. Local anesthetic infiltration should be performed immediately after removal of cream.
Children
  • Birth to 3 month or weight less than 5 kg: Maximum of 1 gram of cream to be applied to the maximum area of 10 cm2 for the maximum application time of 1 hour.
  • Three to 12 months or weight more than 5 kg: Maximum of 2 gram of cream to be applied to the maximum area of 20 cm2 for the maximum application time of 4 hour.
  • One to 6 years or weight more than 10 kg: Maximum of 10 gram of cream to be applied to the maximum area of 100 cm2 for the maximum application time of 4 hour.
  • Seven to 12 years or weight more than 20 kg: Maximum of 20 gram of cream to be applied to the maximum area of 200 cm2 for the maximum application time of 4 hour.
Medically Reviewed by a Doctor on 1/29/2015

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