Generic Name and Formulations:
Lidocaine 2.5%, prilocaine 2.5%; crm.
Topical anesthetic on normal intact skin for local analgesia or on genital mucous membranes for superficial minor surgery and as pretreatment for infiltration anesthesia.
Minor dermal procedures (eg, IV cannulation, venipuncture): apply 2.5g in a thick layer with occlusion over 20–25cm2 for at least 1 hr. Major dermal procedures (eg, skin graft harvesting): apply 2g per 10cm2 in a thick layer with occlusion for at least 2 hrs. Pretreatment before local anesthetic infiltration on adult male genital skin: apply 1g per 10cm2 in a thick layer with occlusion for 15 minutes. Minor procedures on female external genitalia (eg, wart removal, local anesthetic infiltration): apply 5–10g in a thick layer for 5–10 minutes; may occlude to help keep cream in place.
If age and weight are not proportional, base max dose on weight (see literature). <37weeks gestational age: not recommended. 0–3months (<5kg): max 1g/10cm2 applied for up to 1 hr. 3–12months (>5kg): max 2g/20cm2 applied for up to 4 hrs. 1–6yrs (>10kg): max 10g/100cm2 applied for up to 4 hrs. 7–12yrs (≥20kg): max 20g/200cm2 applied for up to 4 hrs.
Not for use near tympanic membrane. Risk of methemoglobinemia if very young or if G6PD deficient. Avoid eyes, mucous membranes, ingestion, application to large areas, and using for longer than recommended time. Monitor children to prevent accidental ingestion. Severe hepatic disease. Effect on intradermal live vaccines unknown. Acutely ill. Elderly. Debilitated. Pregnancy (Cat.B). Nursing mothers.
<12 months of age: do not use with methemoglobin-inducing drugs (eg, acetaminophen, sulfonamides, nitrates, phenytoin, phenobarbital); caution with these in other patients. Toxicity potentiated by Class I antiarrhythmics (eg, tocainide, mexiletine).
Local effects (eg, paleness, erythema, changes in temperature sensation, edema, itching).
Crm 5g—1, 5; 30g—1
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