Lidocaine/prilocaine (On the skin)

Introduction

Lidocaine (LYE-doe-kane), Prilocaine (PRIL-oh-kane)

Relieves pain. It is used on the skin or in the genital area to cause numbness or loss of feeling before certain medical procedures. This medicine is a topical anesthetic.

Brand Name(s)

Emla, EMLA

When This Medicine Should Not Be Used

How to Use This Medicine

Cream, Thin Sheet

• A nurse or other trained health professional will give you this medicine. The medicine is usually applied right before the medical procedure in a hospital or clinic.
• You may be taught how to apply this medicine to yourself or your child at home before the medical procedure.
• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. Do not use it for any other condition without first checking with your doctor. This medicine may cause unwanted effects if too much is used, because more of it is absorbed through the skin.
• This medicine is for use on the skin only. Do not get it in your eyes, nose, or mouth. Do not use it on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Wash your hands with soap and water before and after using this medicine.
• Apply a thick layer of medicine to the area where numbness is needed. Do not spread the medicine on the skin.
• Cover the medicine with a special bandage called an occlusive dressing. This will keep the medicine in place. Your doctor will give you the bandage or tell you what to use.
• Seal the edges of the bandage to keep the medicine from leaking. Do not lift the bandage or disturb it. Keeping the medicine tightly covered helps it work properly.
• For babies or young children, a second covering may be used to prevent them from touching the medicine.
• Carefully watch your baby or child while the medicine is in place. Do not let them loosen or remove the bandage, touch the medicine, or put it in the mouth, eyes, nose, or ears.
• Keep the bandage in place until you or your child arrive at the hospital or clinic.
• Your doctor will remove the bandage and wipe the medicine off the skin before the medical procedure.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using acetaminophen, acetanilid, aniline dyes, benzocaine (Americaine®), chloroquine (Aralen®), dapsone, or naphthalene. Tell your doctor if you are also using nitrofurantoin (Furandantin®), nitroglycerin (Nitrostat®), nitroprusside (Nitropress®), pamaquine, para-aminosalicylic acid, phenacetin, phenobarbital (Luminal®), phenytoin (Dilantin®), primaquine, quinine, or a sulfonamide antibiotic (such as trimethoprim/sulfamethoxazole, Bactrim®).
• Tell your doctor if you are also using a medicine to treat an abnormal heart rhythm such as amiodarone (Cordarone®), bretylium (Bretylol®), dofetilide (Tikosyn®), flecainide (Tambocor®), mexiletine (Mexitil®), propafenone (Rythmol®), quinidine (Cardioquin®, Quinaglute®, Quinidex®), sotalol (Betapace®), or tocainide (Tonocard®).

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you or your child have liver disease, heart disease, heart rhythm problems, methemoglobinemia (blood disease), or glucose-6-phosphate dehydrogenase (G6PD) deficiency (blood disease).
• Do not use this medicine on a baby younger than 3 months of age unless your child's doctor tells you to. Young babies may have more unwanted effects if too much is used and absorbed through the skin. If you use this medicine on a baby younger than 3 months of age, blood tests may be needed to check for unwanted effects.
• Do not use this medicine for a skin problem that has not been checked by your doctor.
• During the time that the skin feels numb, serious injury can occur. Be especially careful to avoid injury until the numbness wears off and you or your child have normal feeling in the area. Do not scratch or rub the area, and do not allow very hot or very cold objects to touch it.
• Using too much of this medicine or using it on a large area of your skin can cause serious unwanted effects. Remove the cream and contact your doctor right away if you or your child have any of these symptoms: lightheadedness, dizziness, vision problems, an irregular or slow heartbeat, difficulty with breathing, or convulsions.
• This medicine may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you or your child have a rash; itching; hoarseness; trouble with breathing; trouble with swallowing; or any swelling of the hands, face, or mouth after you receive the medicine.
• This medicine may cause a rare, but serious blood problem called methemoglobinemia. Remove the cream and call your doctor right away if you or your child develop a blue or bluish purple color on the lips, fingernails, or skin, or have headaches, dizziness, fainting, sleepiness, or trouble with breathing.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Confusion, dizziness, sleepiness, or lightheadedness.
• Loss of color in your face or lips.
• Skin turns a blue color around your mouth, fingers, or toes.
• Tremors or convulsions (seizures).

If you notice these less serious side effects, talk with your doctor:

• Mild burning, itching, or rash.
• Pale or red skin where the medicine was applied.
• Swelling of the skin where the medicine was applied.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088