Dosing & Uses
Dosage Forms & Strengths
Minor dermal procedure
- Normal intact skin for local analgesia: Apply 2.5 g of cream over 20-25 cm of skin surface or 1 anesthetic disc (1 g over 10 cm) for at least 1 hour
Major dermal procedure
- Apply 2 g of the cream per 10 cm of skin surface and allow to remain in contact with skin for at least 2 hours
Genital mucous membrane
- Superficial minor surgery and as pretreatment for infiltration anesthesia
- Male genital skin: apply thick layer of cream (1 g/10 cm) to skin surface for 15 minutes
- Perform local anesthetic infiltration immediately after removal of the cream
- Female genital mucous membranes: apply a thick layer (5 to 10 g) of cream for 5 to 10 minutes
Dosage Forms & Strengths
Intact skin only
0-3 months or <5 kg: Apply 1 g per 10 cm for a maximum of 1 hour
3-12 months and >5 kg : Apply 2 g per 20 cm for a maximum of 4 hours
1-6 years and >10 kg : Apply 10 g per 100 cm for a maximum of 4 hours
7-12 years and >20 kg : Apply 20 g per 200 cm for a maximum of 4 hours
If >3 months and does not meet the minimum weight requirement, the maximum total dose should be restricted to that which corresponds to the patient's weight
<7 years: less overall benefit than older children or adults
Do not use in neonates with a gestational age of 37 weeks or less
Do not use in infants under 12 months of age who are receiving treatment with methemoglobin-inducing agents (eg, acetaminophen, nitrates, phenytoin, sulfonamides)
Burning sensation (17%)
Alterations in temperature sensations (7%)
Frequency Not Defined
CNS excitement or depression
Sensations of hot, cold, or numbness
Cardiovascular collapse leading to arrest
Discrete purpuric or petechial reactions at the site of application
Blistering of foreskin in neonates about to undergo circumcision
Blurred or double vision
Allergic and anaphylactoid reactions (characterized by urticaria, angioedema, bronchospasm, and shock)
Hypersensitivity to local anesthetics of the amide type or any component of the product
Application to larger areas or for longer than recommended could result in sufficient absorption causing serious adverse reactions
Pregnancy & Lactation
Pregnancy Category: B
Lactation: Unknown whether distributed in breast milk, caution advised
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Stabilizes neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action
For topical use only; not for ophthalmic or otic use
Dermal analgesia can be expected to increase for up to 3 hours under occlusive dressing and persist for 1 to 2 hours after removal of the cream
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Adding plans allows you to:
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.