lidocaine and prilocaine (EMLA)
Omudhome Ogbru, PharmD
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:
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.
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.
PRESCRIBED FOR: Lidocaine and prilocaine cream is commonly used as a local anesthetic on normal intact skin and genital mucous areas, before minor procedures.
Lidocaine and prilocaine cream is not recommended in neonates with a gestational less than 37 weeks or infants younger than 12 months who are receiving treatment with methemoglobin-inducing agents.
DRUG INTERACTIONS: Lidocaine and prilocaine should not be used together with anti-arrhythmic drugs such as tocainide (Tonocard) and mexiletine (Mexitil), due to additive effects on heart rate and rhythm.
Prilocaine may contribute to formation of methemoglobin in patients treated with other drugs known to cause methemoglobinemia.
Lidocaine and prilocaine should be used with caution with anti-arrhythmic drugs like amiodarone (Cordarone), sotalol (Betapace), bretylium, and dofetilide (Tikosyn) because of increased risk developing abnormal heart rate and rhythm.
PREGNANCY: There are no adequate studies of lidocaine and prilocaine to determine safe and effective use in pregnant women.
NURSING MOTHERS: Lidocaine and prilocaine may be excreted in breast milk; therefore, caution should be exercised before using them in nursing mothers.
SIDE EFFECTS: Side effects of lidocaine and prilocaine are application site redness, pain, burning, paleness, edema, and altered temperature sensation.
REFERENCE: FDA Prescribing Information.
Medically Reviewed by a Doctor on 6/26/2014
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