Lidocaine + Prilocaine


Concise Prescribing Info
Indications/Uses
Local anesth.
Dosage/Direction for Use
Adult : Topical As eutectic mixture containing lidocaine base 2.5% and prilocaine base 2.5%: For minor procedures: Apply 2.5 g over 20-25 cm2 of skin surface for at least 1 hr. For major dermal procedures involving a larger skin area: Apply 2 g per 10 cm2 of skin and allow to remain in contact with the skin for at least 2 hr. As adjunct to local infiltration anesth in genital mucous membranes: Apply 1 g per 10 cm2 of the skin surface for 15 mins. For superficial minor surgery of genital mucous membranes in adult females: Apply 5-10 g for 5-10 mins.
Dosage Details
Topical/Cutaneous
Local anaesthesia
Adult: As eutectic mixture containing lidocaine base 2.5% and prilocaine base 2.5%: For minor procedures (e.g. IV cannulation or venipuncture): Apply 2.5 g over 20-25 cm2 of skin surface for at least 1 hr. For major dermal procedures involving a larger skin area: Apply 2 g per 10 cm2 of skin and allow to remain in contact with the skin for at least 2 hr. As adjunct to local infiltration anesth in genital mucous membranes: Apply 1 g per 10 cm2 of the skin surface for 15 minutes; local anaesthetic infiltration procedure should be performed immediately after removal of cream. For superficial minor surgery of genital mucous membranes in adult females: Apply 5-10 g for 5-10 minutes.
Child: Dose depends on age and wt of the child. 0-3 mth or <5 kg: Max of 1 g over no >10 cm2 of skin; leave on for no >1 hr. 3-12 mth and >5 kg: Max of 2 g over no >20 cm2 of skin; leave on for no >4 hr. 1-6 yr and >10 kg: Max of 10 g over no >100 cm2 of skin; leave on for no >4 hr. 7-12 yr and >20 kg: Max of 20 g over no >200 cm2 of skin; leave on for no >4 hr. For children >3 mth: Max total dose should be based on the patient's wt rather than the age.
Elderly: Dose reduction may be required.
Contraindications
Neonates with gestational age <37 wk. Infants <12 mth of age who are receiving treatment with methaemoglobin-inducing agents or children who are receiving medications associated with drug-induced methaemoglobinemia. Children with congenital or idiopathic methaemoglobinemia. Application on mucous membranes, broken or inflamed skin.
Special Precautions
Caution when used over large areas and leaving on for >2 hr. Severe hepatic impairment. Caution when used in patients who are receiving class I and III antiarrhythmics. Dose reduction may be necessary in acutely ill, debilitated patients and elderly. Avoid using on open wounds or near the eyes. Pregnancy and lactation.
Adverse Reactions
Hyperpigmentation, erythema, itching, rash, burning, urticaria, stinging, oedema.
Overdosage
Toxic levels of lidocaine (>5 µg/ml) and/or prilocaine (>6 µg/ml) may decrease cardiac output, total peripheral resistance and mean arterial pressure. These changes are due to direct depressant effects of these local anaesthetic agents on the CVS.
Drug Interactions
Increased risk of toxicity when used with drugs that are known to cause methaemoglobinaemia. Concurrent use with class III antiarrhythmics may lead to additive cardiac effects. Toxic effects may be additive when used with class I antiarrhythmics.
Action
Description: Lidocaine and prilocaine are local anaesthetic agents of the amide type. Both work by stabilising the neuronal membranes and inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby giving rise to the anaesthetic action.
Onset: About 1 hr.
Pharmacokinetics:
Absorption: Lidocaine and prilocaine: Amount absorbed through the skin depends on the duration and area of application. Absorption through inflamed skin and under occlusive dressing is higher.
Distribution: Steady state volume of distribution: 1.1-2.1 L/kg (lidocaine) and 0.7-4.4 L/kg (prilocaine). Lidocaine: About 70% bound to plasma proteins. Prilocaine: 55% bound to plasma proteins.
Metabolism: Lidocaine: Metabolised rapidly by the liver. Prilocaine: Metabolied in the liver and kidneys by amidases to various metabolites.
Storage
Store at 15-30°C.
Disclaimer: This information is independently developed by MIMS based on Lidocaine + Prilocaine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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