Name Lidocaine + Prilocaine
Classes Dermatological/Topical Agent
Anesthetic
Local Anesthetic
Diseases Anesthesia
Skin Surgery

Lidocaine + Prilocaine

Lidocaine + Prilocaine is a combination amide and ester local anesthetic. Lidocaine + Prilocaine diffuses into nerve cells, where they bind to sodium channels, preventing them from opening and blocking sodium ion influx. Nerve cells that are unable to allow sodium into their cells are unable to depolarize and conduct nerve impulses. 

Lidocaine + Prilocaine is indicated for use on intact skin to provide local dermal analgesia for superficial venous access and superficial dermatological procedures such as excision, electrodessication and shave biopsy of skin lesions. 

  • Lidocaine + Tetracaine is available as a transdermal patch.
  • Lidocaine + Tetracaine should only be applied to intact skin.
  • Apply Lidocaine + Tetracaine for 20 to 30 minutes prior to venipuncture or intravenous cannulation and for 30 minutes prior to superficial dermatological procedures.

The most common adverse reactions were localized and included-

  • erythema
  • blanching
  • edema
  • Application of Lidocaine + Prilocaine for longer duration than recommended or the simultaneous or sequential application of multiple Lidocaine + Prilocaine patches could result in serious adverse effects. 
  • Store and dispose of Lidocaine + Prilocaine out of the reach of children and pets due to the large amount of lidocaine and Prilocaine (at least 90% of the initial amount) present in used patches.
  • Use with caution in patients who may be more sensitive to the systemic effects of lidocaine and Prilocaine, including the acutely ill or those with severe hepatic disease or pseudocholinesterase deficiency. 
  • Allergic or anaphylactoid reactions associated with lidocaine or Prilocaine can occur.
  • Avoid contact with the eyes.
  • Not recommended for use on mucous membranes or on areas with a compromised skin barrier. 
  • The Lidocaine + Prilocaine patch must be removed before a patient undergoes magnetic resonance imaging.

Contraindication

Patients with a known history of sensitivity to lidocaine, prilocine or local anesthetics of the amide or ester type.