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Overview: Lidocaine/prilocaine is primarily used for pain relief or to numb part of your body before a minor surgical procedure. It works by temporarily blocking nerve signals that cause you to feel pain. The most common side effects are temporary discoloration, redness, swelling, or a burning sensation where it is applied. Serious side effects are rare, but include a serious blood disorder called methemoglobinemia.

Uses

What is lidocaine/prilocaine used for?

Lidocaine/prilocaine is commonly applied to the skin for pain relief. It is also used as a local anesthetic to numb part of your body before minor surgical procedures. 

Lidocaine/prilocaine may also be used for other conditions as determined by your healthcare provider.

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

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

How is lidocaine/prilocaine supplied (dosage forms)?

Brands and other names

  • Emla

Dosage forms and strengths

  • 2.5%/2.5% topical cream 

How should I store lidocaine/prilocaine?

Lidocaine/prilocaine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

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

The most common side effects of lidocaine/prilocaine are temporary discoloration, redness, swelling, or a burning sensation where it is applied. Tell your healthcare provider if you have any of these side effects that bother you.

There may be other side effects of lidocaine/prilocaine that are not listed here. Contact your healthcare 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/prilocaine?

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

Methemoglobinemia. Lidocaine/prilocaine 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/prilocaine may cause allergic reactions, which can be serious. Stop using lidocaine/prilocaine 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/prilocaine?

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

  • Emla
  • Lidocaine
  • Prilocaine
  • Any other medicine known as an amide anesthetic 
  • Any of the ingredients in the specific product dispensed

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

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

Do not use lidocaine/prilocaine unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

This medicine is often given at a hospital or clinic by a healthcare provider just before a procedure. 

If you are applying lidocaine/prilocaine 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 healthcare provider recommends. Use the dosing card included with the medicine to measure the amount of lidocaine/prilocaine you need. Ask your healthcare provider if you have any questions. 

Wash your hands well after using lidocaine/prilocaine. 

Do not apply lidocaine/prilocaine to open wounds or inside your ears. 

Do not allow lidocaine/prilocaine to come in contact with your eyes. 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.

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 share lidocaine/prilocaine with other people, even if they have the same condition as you. It may harm them.

Keep lidocaine/prilocaine out of the reach of children. If you are applying lidocaine/prilocaine to a young child, watch them closely to be sure that they do not ingest it or get it into their eyes by accident. Ask your healthcare provider for advice.

What should I tell my healthcare provider before using lidocaine/prilocaine?

Tell your healthcare 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/prilocaine is right for you.

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

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

  • Heart problems, such as an abnormal heart rate or rhythm
  • History of a blood disorder, such as methemoglobinemia
  • Kidney problems
  • Liver problems
  • An allergy or sensitivity to any medicine known as a para-aminobenzoic acid (PABA)
  • A genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency

Other Medicines and Supplements. Lidocaine/prilocaine may interact with other medicines and supplements. Before using lidocaine/prilocaine, tell your healthcare 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/prilocaine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take lidocaine/prilocaine while you are pregnant or trying to get pregnant.

Breastfeeding. Lidocaine/prilocaine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use lidocaine/prilocaine while breastfeeding.

Interactions

Does lidocaine/prilocaine interact with foods or drinks?

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

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

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

Always tell your healthcare 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/prilocaine.

  • 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/prilocaine. Always check with your healthcare 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/prilocaine?

If you or someone else has used too much lidocaine/prilocaine, 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/prilocaine?

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

 

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