Prilocaine/Lignocaine

Drug Class:	Commonly Known As:	Category:
Prilocaine Hydrochloride + Felypressin	Prilocaine/Lignocaine

Prilocaine/Lignocaine - What is it for

This medication contains two topical anaesthetics, lignocaine and prilocaine. When applied to the skin, it causes temporary numbing of the skin (short term loss of sensation to the skin area)

It is used before procedures or injections to relieve the feeling of pain caused by the procedures or injections.

Prilocaine/Lignocaine - Side Effects, Precautions, and Contraindications

What side effects can Prilocaine/Lignocaine cause?

Common side effects include:

Whitening or redness of the skin
Puffiness of the skin
Burning or itching on the site of application

These side effects may disappear during treatment. If any of the following effects persist or are severe, consult your doctor. Rare but serious side effects include:

Allergic reactions which include

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

Small red dots (petechiae) at the application site, especially in children with skin problems (e.g., atopic dermatitis or eczema).
Methaemoglobinemia

Bluish or greyish color of the lips, nails, skin
Abnormal heartbeat
Seizures
Severe dizziness, passing out
Severe headache
Shortness of breath
Feeling weak or tired

Slow heartbeat
Change in balance or speech
Ringing in ears
Anxiety, restless, excitable, low mood
Feeling lightheaded, confused, or having blurred vision

Before taking Prilocaine/Lignocaine , what precautions must I follow?

Inform your healthcare professional if you have:

Allergy to prilocaine, lignocaine/lidocaine, local anaesthetics, or any of the other ingredients of this medication
Dermatitis or any other skin problems
Severe liver conditions
Severe heart rhythm conditions
Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Methaemoglobinaemia (a blood disorder that causes the skin, especially around lips and nails, to turn brownish or greyish)
Infection, skin rash or broken skin at, or near the area where you want to apply EMLA cream
Plans to become pregnant, are pregnant or breastfeeding

The skin on which EMLA cream is applied may stay numb for up to several hours after the cream is removed. For this reason, you should be careful to avoid accidental injury to the treated area, such as scratching, rubbing or exposure to extreme temperatures, until complete sensation returns.
Avoid getting EMLA cream in your eyes, nose, or mouth. If you get EMLA in your eyes, rinse them with plenty of water. If the medication is swallowed, call a doctor immediately.
Do not apply to ruptured eardrum, anus, or children’s genital areas.
Children should be closely observed during and after use of EMLA cream, as they are at greater risk than adults for serious side effects, such as methaemoglobinemia.

What food or medicine must I avoid when I take Prilocaine/Lignocaine ?

Inform your doctor if you are taking

Other medications, especially

Antiarrhythmic drugs for heart problems e.g., amiodarone
Other local anaesthetics
Cimetidine
Beta-blockers
Other drugs which may trigger methaemoglobin formation e.g., sulfonamides, nitrofurantoin, chloroquine, dapsone, phenytoin, phenobarbital

Are taking supplements, traditional medications and herbal remedies

Prilocaine/Lignocaine - Dosage and How to Use

How should Prilocaine/Lignocaine be used?

Squeeze out the prescribed quantity of the cream on the area of the skin where the procedure or injection is to be done. Do not rub EMLA cream into the skin.
Take one of the occlusive dressings provided, and remove the cut-out piece in the middle
Peel the paper liner from the framed dressing.
Cover the EMLA cream with this dressing so that you get a thick layer of cream between your skin and the dressing. Do not spread out the cream. Press down on the sides of the dressing carefully to avoid leakages. It is important to cover EMLA cream with an air-tight dressing to ensure that the cream enters the skin properly and numbs the skin
Remove the frame of the dressing. Write down the time the cream was applied, directly on the dressing.
Wash your hands immediately after using EMLA.
Remove the dressing and wipe off the cream after the recommended duration of application in the table below or as advised by your doctor.

Type of procedures/ injections	Patient group	Duration of application
Minor procedures e.g., putting in needle, removal of molluscum bumps, or other minor skin operations	Infants 0- 12 months old	1 hour
	Children 1- 12 years old	1 hour; maximum 5 hours
	Children with atopic dermatitis or eczema	30 minutes
	12years of age>	1 hour; maximum 5 hours
Procedures that require deeper skin anaesthesia e.g., split-skin grafting	Adults	2 hours; maximum 5 hours
Use on genital skin before injection of local anaesthetics	Adults	15 minutes on male 60 minutes on female
Use on genital mucosa before injection of local anaesthetics	Adults	5-10 minutes Dressing is not used
Cleaning of leg ulcers	Adults	30 minutes to 1 hour

Your doctor may use EMLA cream for specialized procedures. Follow your doctor's instructions for use.

What should I do if I miss a dose?

EMLA is usually only applied once prior to each procedure. It must be in contact with the skin for a period of time for it to work. If you applied this medication later than directed, tell your health care professional before starting the procedure.