Trade Names:EMLA- Cream 2.5% lidocaine and 2.5% prilocaine- Anesthetic Disc 1 g EMLA emulsion (2.5% lidocaine, 2.5% prilocaine). Contact surface approximately 10 cm 2EMLA Patch (Canada)
Stabilizes neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action.
As a topical anesthetic for use on normal intact skin for local analgesia or genital mucous membranes for superficial minor surgery and as pretreatment for infiltration anesthesia.
Sensitivity to local anesthetics of the amide type or any component of the product.
Topical Apply 2.5 g of cream over 20 to 25 cm 2 of skin surface or 1 anesthetic disc (1 g over 10 cm 2 ) for at least 1 h.Major Dermal ProceduresAdults
Topical Apply 2 g of the cream per 10 cm 2 of skin surface and allow to remain in contact with skin for at least 2 h.Male Genital SkinAdults
Topical As adjunct prior to local anesthetic infiltration, apply a thick layer of cream (1 g/10 cm 2 ) to the skin surface for 15 min. Perform local anesthetic infiltration immediately after removal of the cream.Female Genital Mucous MembranesAdults
Topical Apply a thick layer (5 to 10 g) of cream for 5 to 10 min.Pediatrics (Intact skin)Children (0 to 3 mo or less than 5 kg)
Topical Apply 1 g per 10 cm 2 for a max of 1 h.Children (3 mo up to 12 mo and more than 5 kg)
Topical Apply 2 g per 20 cm 2 for a max of 4 h.Children (1 yr to 6 yr and more than 10 kg)
Topical Apply 10 g per 100 cm 2 for a max of 4 h.Children (7 yr to 12 yr and more than 20 kg)
Topical Apply 20 g per 200 cm 2 for a max of 4 h.Note
If a patient is older than 3 mo and does not meet the min weight requirement, the max total dose should be restricted to that which corresponds to the patient's weight.
Store at controlled room temperature (59° to 86°F). Keep tube tightly closed.
Toxic effects may be additive or synergistic.Methemoglobin-inducing agents
May increase risk of methemoglobinemia.
None well documented.
Bradycardia; hypotension, CV collapse leading to arrest.
CNS excitement or depression; lightheadedness; nervousness; apprehension; euphoria; confusion; dizziness; drowsiness; sensations of hot, cold, or numbness; twitching; tremors; convulsions, unconsciousness; respiratory depression and arrest.
Paleness (37%); erythema (30%); burning sensation (17%); edema (10%); alterations in temperature sensations (7%); itching (2%); discrete purpuric or petechial reactions at the site of application; hyperpigmentation (cream); redness; blistering of foreskin in neonates about to undergo circumcision.
Tinnitus; blurred or double vision.
Allergic and anaphylactoid reactions (characterized by urticaria, angioedema, bronchospasm, and shock).
Category B .
Lidocaine and probably prilocaine are excreted in human milk.
Children under 7 yr have shown less overall benefit than older children or adults. Do not use in neonates with a gestational age of 37 wk or less.
Application to larger areas or for longer than recommended could result in sufficient absorption causing serious adverse reactions.
Do not use in patients with congenital or idiopathic methemoglobinemia or in infants under 12 mo of age who are receiving treatment with methemoglobin-inducing agents (eg, acetaminophen, nitrates, phenytoin, sulfonamides).
Confusion, drowsiness, unconsciousness, tremors, convulsions, hypotension, bradycardia, CV collapse, cardiac arrest, tinnitus, diplopia.
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