Lidocaine/prilocaine
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Combination of | |
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Lidocaine | Local anesthetic |
Prilocaine | Local anesthetic |
Clinical data | |
Trade names | Emla, Fortacin, Senstend, others |
AHFS/Drugs.com | Micromedex Detailed Consumer Information |
License data |
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Routes of administration | Topical |
ATC code |
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Legal status | |
Legal status | |
Identifiers | |
CAS Number | |
PubChem CID | |
ChemSpider | |
KEGG | |
CompTox Dashboard (EPA) | |
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Lidocaine/prilocaine is a eutectic mixture of equal quantities (by weight) of lidocaine and prilocaine. A 5% emulsion preparation, containing 2.5% each of lidocaine/prilocaine, is marketed by APP Pharmaceuticals under the trade name EMLA (an abbreviation for Eutectic Mixture of Local Anesthetics).[5] As a spray, it is marketed under the name Tempe (topical eutectic-like mixture for premature ejaculation) (PSD502) that can be used by men to help with premature ejaculation. The spray is manufactured by Plethora Solutions and branded as Fortacin in the UK and Recordati in the EU.[6]
Eutectic mixture
Separately, lidocaine and prilocaine are solid bases. When mixed in equal quantities by weight, however, they form a eutectic mixture – that is the
Clinical use
Indications
The lidocaine/prilocaine combination is indicated for
A topical spray consisting of an aerosol formulation of lidocaine and prilocaine was evaluated under the name PSD502 for use in treating
Dosage forms
Lidocaine/prilocaine eutectic mixture is marketed as a 5% oil-in-water emulsion incorporated in a cream base (EMLA cream) or a cellulose disk (EMLA patch). The cream is applied under an occlusive dressing, while the patch incorporates an occlusive dressing to facilitate absorption of lidocaine and prilocaine into the area where anaesthesia is required. Local dermal anaesthesia is achieved after approximately 60 minutes, whereupon the occlusive dressing (or patch) is removed. The duration of anaesthesia is approximately two hours following removal of the occlusive dressing.
E. Fougera & Co., makers of the generic cream widely used in the United States as Lidocaine and Prilocaine Cream, 2.5%/2.5%, recommends different timing for application of the cream as well as length of anesthesia. They state the cream must be applied at least one hour before the start of a routine procedure and for two hours before the start of a painful procedure. Additionally, they state that the duration of effective skin anesthesia will be at least one hour after removal of the occlusive dressing.[10]
Circumcision
Lidocaine/prilocaine eutectic mixture has been used during circumcision in newborn boys and has been considered efficacious and safe to lessen pain from circumcision.[11]
The European Medicines Agency concludes in its latest (2014) statement on Emla: "Safety and efficacy for the use of EMLA on genital skin and genital mucosa have not been established in children younger than 12 years. Available paediatric data do not demonstrate adequate efficacy for circumcision."[12]
The Patient Information Leaflet of EMLA in the UK states: "EMLA Cream should not be applied to the genital skin (e.g. penis) and genital mucosa (e.g. in the vagina) of children (below 12 years of age) owing to insufficient data on absorption of active substances."[13]
Tempe
The spray is a combination of local
Compendial status
See also
- Dosage form
- Eutectic point
- Lidocaine
- Prilocaine
References
- ^ "Emla Cream 5% (for 5 g and pre-medication packs) - Summary of Product Characteristics (SmPC)". (emc). 4 May 2017. Retrieved 27 September 2020.
- ^ "Fortacin - Summary of Product Characteristics (SmPC)". (emc). 14 November 2018. Retrieved 27 September 2020.
- ^ "Nulbia 5% cream - Summary of Product Characteristics (SmPC)". (emc). 18 December 2017. Retrieved 27 September 2020.
- ^ "List of nationally authorised medicinal products" (PDF). ema.europa.eu. 1 December 2022. Retrieved 13 June 2023.
- ^ Pesaturo KA, Matthews M (2009). "Topical Anesthesia Use in Children: Eutectic Mixture of Local Anesthetics". US Pharm. 34 (3): HS-4. Retrieved 7 January 2014.
- S2CID 205540753.
- ^ "EMLA Official FDA information, side effects and uses". Drugs.com. Retrieved 7 January 2014.
- PMID 15009338.
- ^ "PSD502 TEMPE Spray". Promescent.com. Retrieved 4 July 2014.
- ^ Lidocaine and Prilocaine Cream, 2.5%/2.5%, package insert. E. Fougera & Co. package insert. Melville, New York, 9/2007.
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- ^ "INN of the active substance(s): lidocaine/prilocaine" (PDF). Committee for Medicinal Products for Human Use (CHMP). European Medicines Agency.
- ^ "Package leaflet: Information for the user EMLA Cream 5%" (PDF). AstraZeneca. 2017.
- ^ "TEMPE Spray Delays Ejaculation". bio-medicine.org. Archived from the original on 27 September 2013. Retrieved 25 September 2013.
- ^ "Viagra Inventor Develops 'Tempe Spray' To Help Men Deal With Premature Ejaculation: Is It Safe?". medicaldaily.com. 24 September 2013. Retrieved 25 September 2013.
- ^ The United States Pharmacopeial Convention. "Revision Bulletin: Lidocaine and Prilocaine Cream–Revision to Related Compounds Test". Archived from the original on 5 July 2010. Retrieved 10 July 2009.
External links
- "Lidocaine mixture with Prilocaine". Drug Information Portal. U.S. National Library of Medicine.