Lidocaine-Prilocaine Cream: Uses, Benefits & Application Tips

Key Points About Lidocaine-Prilocaine Cream

Lidocaine-prilocaine cream is a widely used **topical anesthetic** designed to numb the skin, making it particularly helpful before medical procedures or for easing discomfort from minor skin irritations. It works by temporarily blocking nerve signals, providing localized pain relief. Common applications include preparing the skin for needle insertions, venipuncture, and minor dermatological procedures. Always adhere to your healthcare provider’s instructions and consult them before making any changes to your treatment plan.

Medication Names: Lidocaine-Prilocaine Cream

US Brand Name: EMLA (lidocaine-prilocaine)

Medications often have both brand and generic names. The generic name refers to the active ingredients in the medication, which are listed in parentheses.

Pharmacologic Categories of Lidocaine-Prilocaine Cream

1. Topical anesthetics
2. Local anesthetics

Recommended Dosing for Lidocaine-Prilocaine Cream

Lidocaine-prilocaine cream is used to manage various skin conditions and to prepare for certain procedures. Below are the general dosing guidelines for adults. Always consult your healthcare provider before making any adjustments to your dosage. For tailored advice, consider scheduling a telemedicine appointment with one of our providers.

1. Burns (minor): Apply a thick layer to the affected area. Leave it on for 1–2 hours, then gently remove.
2. Eczema: Apply a thin layer to the affected area once daily for up to 7 days.
3. Psoriasis: Apply a thin layer to the affected area once daily for up to 7 days.
4. Dermatitis: Apply a thin layer to the irritated area once daily for up to 7 days.
5. Insect bites: Apply a thin layer to the bite once daily for up to 7 days.
6. Minor skin irritations: Apply a thin layer to the affected area once daily for up to 7 days.
7. Needle insertion pain: Apply a thick layer to the area where the needle will be inserted. Leave it on for 1 hour before the procedure.
8. Superficial skin procedures (e.g., tattooing): Apply a thick layer to the area. Leave it on for 1–2 hours before the procedure.
9. Venipuncture: Apply a thick layer to the area where the needle will be inserted. Leave it on for 1 hour before the procedure.

Dosage Forms and Strengths of Lidocaine-Prilocaine Cream

The cream is available in the following formulation:

1. Topical cream: 2.5% lidocaine and 2.5% prilocaine

How to Use Lidocaine-Prilocaine Cream

To achieve the best results, follow these application instructions:

1. Apply the cream to clean, dry skin.
2. Use the amount specified by your healthcare provider.
3. If instructed, cover the treated area with a dressing or plastic wrap after application.
4. Avoid rubbing the cream into the skin.
5. Wash your hands thoroughly after applying the cream, unless you are treating your hands.
6. Keep the cream away from your eyes, mouth, and open wounds.

Potential Side Effects of Lidocaine-Prilocaine Cream

As with any medication, lidocaine-prilocaine cream may cause side effects. Most are mild and resolve on their own, but some may require medical attention. If you experience severe or concerning symptoms, contact your healthcare provider immediately or schedule a telemedicine appointment for further evaluation.

1. Common side effects: Redness, swelling, or mild irritation at the application site. These effects are typically short-lived.
2. Less common side effects: Skin discoloration or a burning sensation. Seek medical advice if these symptoms persist or worsen.
3. Rare but serious side effects: Allergic reactions, such as rash, itching, or difficulty breathing. If you experience these symptoms, seek emergency medical attention immediately.

Contraindications for Lidocaine-Prilocaine Cream

A contraindication refers to a specific condition or circumstance in which using a medication could pose a risk to the patient. For lidocaine-prilocaine cream, a commonly used topical anesthetic, there are several important contraindications to consider. These conditions make the cream unsafe or unsuitable, so it’s crucial to discuss them with your healthcare provider before use.

Allergy to lidocaine, prilocaine, or other local anesthetics: If you have a known allergy to any of the ingredients in the cream or to similar medications, using lidocaine-prilocaine cream could result in serious allergic reactions. Symptoms may include rash, swelling, or difficulty breathing, which require immediate medical attention.

Methemoglobinemia: This rare blood disorder leads to an abnormal increase in methemoglobin, a form of hemoglobin that reduces the blood’s ability to carry oxygen. Lidocaine-prilocaine cream can heighten the risk of this condition, particularly in infants or individuals with a history of methemoglobinemia.

Severe liver disease: The liver plays a vital role in breaking down lidocaine and prilocaine. In individuals with severe liver disease, the body may struggle to metabolize these medications effectively, potentially causing toxic levels to accumulate in the bloodstream.

Open wounds or severe skin injury: Avoid applying the cream to open wounds or significantly damaged skin. Doing so can increase absorption into the bloodstream, raising the likelihood of adverse effects.

Drug-to-Drug Interactions with Lidocaine-Prilocaine Cream

It’s important to inform your healthcare provider about all medications you are currently taking, as some drugs may interact with lidocaine-prilocaine cream, increasing the risk of side effects. Below are examples of medications that may interact with this local anesthetic:

1. Amiodarone (Pacerone): Commonly prescribed for heart rhythm disorders, this medication can amplify the risk of heart-related side effects when used alongside lidocaine-prilocaine cream.
2. Beta-blockers (e.g., propranolol, brand name Inderal): These drugs can slow the breakdown of lidocaine in the body, potentially leading to higher levels of the medication in the bloodstream.
3. Cimetidine (Tagamet): Often used to treat acid reflux, cimetidine may also interfere with the metabolism of lidocaine, increasing the likelihood of side effects.
4. Other local anesthetics: Using lidocaine-prilocaine cream in combination with other local anesthetics, such as bupivacaine (Marcaine) or ropivacaine (Naropin), can elevate the risk of toxicity.

Using Lidocaine-Prilocaine Cream During Pregnancy

Is it safe to use lidocaine-prilocaine cream during pregnancy? The answer is: it depends. This topical anesthetic is classified as a Category B medication by the FDA. This means that while animal studies have not shown harm to the fetus, there are no well-controlled studies in pregnant women. It’s essential to weigh the potential benefits and risks with your healthcare provider. If you are pregnant, consider consulting one of our telemedicine providers to determine whether this medication is appropriate for you.

Using Lidocaine-Prilocaine Cream While Breastfeeding

Is it safe to use lidocaine-prilocaine cream while breastfeeding? In most cases, yes, but caution is recommended. Lidocaine and prilocaine are excreted in breast milk in very small amounts, making it unlikely to harm a nursing infant when the cream is used as directed. However, avoid applying the cream to areas that could come into contact with the baby’s skin, such as the breasts. Always consult your healthcare provider before using any medication while breastfeeding to ensure safety for both you and your baby.

Estimated Cost of Lidocaine-Prilocaine Cream

The cost of a 30-day supply of lidocaine-prilocaine cream without insurance can vary significantly. With a GoodRx coupon, prices typically range from $15 to $40 for a 30-gram tube. However, costs may differ depending on the pharmacy and your location. To save money, it’s a good idea to compare prices and take advantage of available discounts or coupons.

Possible Alternatives to Lidocaine-Prilocaine Cream

Depending on your condition, alternative treatments or lifestyle adjustments may help manage symptoms effectively. Always consult your healthcare provider before making any changes to your treatment plan. Below are some common alternatives for conditions often treated with lidocaine-prilocaine cream:

Burns

For minor burns, applying cool compresses, aloe vera gel, or over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) can help alleviate pain and reduce inflammation.

Eczema

Managing eczema often involves using moisturizers, topical corticosteroids, and avoiding triggers such as harsh soaps, allergens, or irritants. These steps can help soothe flare-ups and prevent future episodes.

Psoriasis

Topical treatments, including corticosteroids, vitamin D analogs, or coal tar, are commonly used to manage psoriasis. For more severe cases, light therapy or systemic medications may be necessary under the guidance of a healthcare provider.

Dermatitis

To manage dermatitis, avoiding irritants, applying emollients, and using anti-inflammatory creams can provide relief. In some cases, oral antihistamines may also help reduce itching and discomfort.

Insect Bites

Itching and swelling from insect bites can often be relieved with over-the-counter hydrocortisone cream, oral antihistamines, or cold compresses. These remedies can help soothe the affected area and reduce irritation.

Minor Skin Irritations

For minor skin irritations, cleaning the area thoroughly and applying soothing lotions or creams—such as those containing aloe vera or calamine—can promote healing and reduce discomfort.

Needle Insertion Pain

To ease pain during needle procedures like vaccinations or blood draws, numbing creams such as lidocaine-prilocaine or ice packs can be effective. Discuss these options with your healthcare provider to determine the best approach for you.

Superficial Skin Procedures

For minor cosmetic procedures, numbing creams or local anesthetics can help minimize discomfort. Consult your healthcare provider to identify the most appropriate option for your specific needs.

Venipuncture

During blood draws or IV insertions, numbing creams or distraction techniques can make the process more comfortable. These methods are particularly helpful for individuals who experience anxiety or sensitivity during such procedures.

Tattooing

Numbing creams like lidocaine-prilocaine can reduce pain during tattooing sessions. However, it’s important to consult both your tattoo artist and healthcare provider to ensure the cream is safe and effective for your situation.

Recent Updates on Lidocaine-Prilocaine Cream Research

Recent studies have highlighted the effectiveness of lidocaine-prilocaine cream in pediatric populations, particularly for reducing pain during needle procedures such as vaccinations and blood draws. When applied correctly, this topical anesthetic has proven to be a valuable tool for children who may experience anxiety or fear related to needles.

Additionally, ongoing research is exploring the use of lidocaine-prilocaine cream in combination with other pain-relief methods for more complex procedures, such as laser treatments and minor surgeries. These advancements demonstrate the cream’s versatility and potential in both medical and cosmetic applications.

As with any medication, staying informed about the latest research is crucial. If you have questions or concerns, discuss them with your healthcare provider to ensure you’re receiving the most appropriate treatment for your needs. If you’re considering lidocaine-prilocaine cream for pain relief, our telemedicine providers are available to guide you in making an informed decision.

James Kingsley

Learn More