cocaine hydrochloride

  • 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.

What is cocaine hydrochloride-topical, and how does it work (mechanism of action)?

Cocaine is a naturally occurring chemical found in the leaves of Erythroxylum coca or coca plant, which is native to South America. Coca leaves have been used and abused for hundreds of years. Cocaine is a highly addictive stimulant drug that directly affects the nervous system, including the brain. Effects of cocaine include short-term euphoria, energy, talkativeness, and it may cause dangerous increases in heart rate and blood pressure.

Cocaine acts as a local anesthetic by blocking conduction of nerve impulses. Topical preparations of cocaine hydrochloride are applied to the lining of the mouth, nose, and throat prior to certain surgical procedures as a local anesthetic to numb the area. Numbing the surrounding area(s) allows certain types of surgical procedures without causing pain or discomfort to the patient. Although cocaine works very well to provide local aesthetic effects, the risk for abuse and severe local vasoconstriction (narrowing of the blood vessels) prevents its widespread clinical use. Cocaine is a schedule II controlled substance, which means that it has a high potential for abuse. However, cocaine can be prescribed by a doctor to be used as a local anesthetic in certain cases of eye, ear, or throat surgeries.

What brand names are available for cocaine hydrochloride-topical?

N/A

Is cocaine hydrochloride-topical available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for cocaine hydrochloride-topical?

Yes

What are the side effects of cocaine hydrochloride-topical?

Common side effects of cocaine include:

  • dizziness,
  • nervousness,
  • restlessness,
  • nausea, and
  • unusual feelings of well-being.

Serious side effects may include:

What is the dosage for cocaine hydrochloride-topical?

  • The dose should not exceed 1 mg/kg. Dosing of cocaine is variable and is based on numerous factors including the area to be anesthetized, individual patient tolerance, vascularity of the tissue, and anesthetic technique.
  • The lowest possible dose should be utilized to achieve effective anesthesia.
  • Dose reductions should be utilized in children, the elderly, and debilitated patients.
  • Cocaine hydrochloride can be administered by means of cotton applicators, packs, sprays, or instilled into a cavity.

Which drugs or supplements interact with cocaine hydrochloride-topical?

: Due to the risk for serious cardiac arrhythmias, severely elevated blood pressure, and additional stimulation of the brain, ergot alkaloids (for example, ergotamine), monoamine oxidase inhibitors or MAOIs (for example, iproniazid), and other sympathomimetics should not be combined with cocaine hydrochloride.

Is cocaine hydrochloride-topical safe to take if I'm pregnant or breastfeeding?

Cocaine hydrochloride should only be given to pregnant women if clearly needed. Cocaine is classified as FDA pregnancy risk category C (adverse effects in animals but insufficient human data).

Cocaine is excreted in breast milk and may cause adverse effects in the nursing infant. The American Association of Pediatrics recommends against the use of cocaine during breastfeeding. Due to the potential for serious side effects in the nursing infant, it is recommended that nursing be discontinued during cocaine use.

What else should I know about cocaine hydrochloride-topical?

What preparations of cocaine hydrochloride-topical are available?

Topical solution: 4 % and 10%

How should I keep cocaine hydrochloride-topical stored?

Cocaine hydrochloride should be stored at 20 C to 25 C (68 F to 77 F).

REFERENCES:

FDA Prescribing Information.

National Institute on Drug Abuse: The Science of Drug Abuse & Addiction. Cocaine.

Summary

Cocaine hydrochloride is an anesthetic (local) used by health-care professionals prior to surgical procedures that involve the nasal, laryngeal, or oral cavities. Side effects, drug interactions, warnings and precautions, dosing, storage, pregancy, and breastfeeding safety should be reviewed prior to using this medication.

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Reviewed on 6/1/2015
References
REFERENCES:

FDA Prescribing Information.

National Institute on Drug Abuse: The Science of Drug Abuse & Addiction. Cocaine.

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