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Overview: Lidocaine/tetracaine is primarily used to numb the skin and help prevent pain before a minor skin procedure. It works by temporarily blocking nerve signals that cause you to feel pain. The most common side effects are temporary discoloration, redness, and swelling where it is applied. Serious side effects are rare, but include a serious blood disorder called methemoglobinemia.

Uses

What is lidocaine/tetracaine used for?

Lidocaine/tetracaine is commonly used as a local anesthetic to numb the skin and help prevent pain before minor skin procedures. 

Lidocaine/tetracaine may also be used for other conditions as determined by your health care provider.

How does lidocaine/tetracaine work (mechanism of action)?

Lidocaine/tetracaine works by temporarily blocking nerve signals that cause you to feel pain. 

How is lidocaine/tetracaine supplied (dosage forms)?

Brands and other names

  • Pliaglis

Dosage forms and strengths

  • 7%/7% topical cream

How should I store lidocaine/tetracaine?

Lidocaine/tetracaine should be stored in the refrigerator, between 36 F to 46 F (2 C to 8 C). Do not freeze. It can be stored at room temperature for up to three months. Lidocaine/tetracaine should be thrown away after three months at room temperature.

Side Effects

What are the most common side effects of lidocaine/tetracaine?

The most common side effects of lidocaine/tetracaine are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Redness or swelling of the skin
  • Change in skin color

There may be other side effects of lidocaine/tetracaine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of lidocaine/tetracaine?

While less common, the most serious side effects of lidocaine/tetracaine are described below, along with what to do if they happen.

Methemoglobinemia. Lidocaine/tetracaine can cause a serious blood disorder called methemoglobinemia. Hemoglobin is a protein that normally carries oxygen in your blood. Methemoglobinemia is when you have too much of a form of hemoglobin called methemoglobin. If you have methemoglobinemia, it is harder for your body to get oxygen to your tissues. Certain people, such as young children and those taking certain medicines, may be at higher risk of methemoglobinemia. Get help right away if you have any of the following symptoms.

  • Changes in the color of your skin, including pale, gray, or blue colored skin
  • Headache
  • Fast heartbeat
  • Shortness of breath
  • Feeling lightheaded
  • Tiredness or weakness

Severe Allergic Reactions. Lidocaine/tetracaine may cause allergic reactions, which can be serious. Stop using lidocaine/tetracaine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use lidocaine/tetracaine?

Allergies to Ingredients. People who are allergic to any of the following should not use lidocaine/tetracaine.

  • Pliaglis
  • Synera
  • Lidocaine
  • Tetracaine
  • Any other medicine known as an amide or ester anesthetic
  • Any other medicine known as a para-aminobenzoic acid (PABA)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific lidocaine/tetracaine products they stock.

What should I know about lidocaine/tetracaine before using it?

Do not use lidocaine/tetracaine unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share lidocaine/tetracaine with other people, even if they have the same condition as you. It may harm them.

If you are applying lidocaine/tetracaine at home, make sure you know how to properly use the medicine. You should understand when to apply it and how much to apply. Do not apply more than your health care provider recommends. Use the dosing card included with the medicine to measure the amount of lidocaine/tetracaine you need. Do not rub the medicine into your skin or cover it with a bandage or dressing. Ask your health care provider if you have any questions. 

Lidocaine/tetracaine should only be applied to unbroken skin. Do not apply to skin that is irritated, scratched, broken, or has a rash. 

Do not allow lidocaine/tetracaine to come in contact with your eyes, lips, or mouth. If the medicine gets in your eye, wash your eye with water or saline right away and protect the eye until the numbing effect has worn off.

Wash your hands well after applying lidocaine/tetracaine.

Lidocaine/tetracaine forms a film on the skin after being applied. Your health care provider will tell you how long to leave the film on before removing it. Do not leave the film on your skin for more than two hours. If you feel a burning or irritating sensation where the medicine is applied, wash it off with soap and water right away. Contact your health care provider if the burning or irritation does not go away.

When it is time to remove the medicine, carefully peel the film off from your skin, starting from the edges. Wipe any remaining film off with a tissue or paper towel. Once removed, throw the film and any used tissue or paper towel away and wash your hands again. 

This medicine can fully numb the skin. Be careful not to scratch, rub, or expose any numb areas to very hot or cold temperatures to prevent accidental damage or injury.

Do not apply lidocaine/tetracaine to the procedure site after the procedure is completed. 

Keep lidocaine/tetracaine out of the reach of children. Once the medicine is no longer needed, throw it away in a place where children cannot reach it. 

What should I tell my health care provider before using lidocaine/tetracaine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if lidocaine/tetracaine is right for you.

In particular, make sure that you discuss any of the following.

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems, such as an abnormal heart rate or rhythm
  • Kidney problems
  • Liver problems
  • History of a blood disorder, such as methemoglobinemia
  • A genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency 
  • A genetic condition called pseudocholinesterase deficiency 

Other Medicines and Supplements. Lidocaine/tetracaine may interact with other medicines and supplements. Before using lidocaine/tetracaine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how lidocaine/tetracaine could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. Lidocaine/tetracaine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use lidocaine/tetracaine while breastfeeding. Do not apply lidocaine/tetracaine to the nipple or area around the nipple if you are breastfeeding. 

Interactions

Does lidocaine/tetracaine interact with foods or drinks?

There are no known interactions between lidocaine/tetracaine and foods or drinks.

It is unknown if drinking alcohol will affect lidocaine/tetracaine.

Does lidocaine/tetracaine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using lidocaine/tetracaine.

  • A nitrate, such as Isordil, Nitro-Dur, NitroMist, or Nitrostat, which is a medicine used to prevent chest pain caused by a type of heart disease
  • Any other local anesthetic, such as lidocaine, benzocaine, or prilocaine
  • A medicine used to treat cancer
  • A medicine used for bacterial infection
  • A medicine used to treat or prevent malaria 
  • A medicine used to manage seizures
  • Acetaminophen (Tylenol), which is a medicine used for pain or fever
  • Metoclopramide (Reglan and others), which is a medicine for certain stomach problems
  • Sulfasalazine (Azulfidine), which is a medicine used for certain inflammatory conditions, such as ulcerative colitis or rheumatoid arthritis
  • A medicine used for an irregular heart rhythm

This may not be a complete list of medicines that can interact with lidocaine/tetracaine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much lidocaine/tetracaine?

If you or someone else has used too much lidocaine/tetracaine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of lidocaine/tetracaine?

This medicine is typically used prior to a medical procedure. If you forget to apply lidocaine/tetracaine, talk to the health care provider who will be performing the procedure.