Ethyl Chloride Fine Stream Spray
It is used to ease pain from muscle and sports injuries.It is used to numb an area of the skin before a procedure.
Drug Class
Topical Anesthetic; Vapocoolant
Pharmacologic Class
Halogenated Hydrocarbon; Local Anesthetic
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Ethyl chloride is a spray that quickly cools and numbs the skin. It's used to temporarily relieve pain from minor injuries, injections, or before small skin procedures. It works by making the skin very cold, which numbs the nerves.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all accompanying information carefully. It is essential to use this medication as directed to ensure safe and effective treatment.
Application Instructions
Apply this medication only to your skin, as directed by your doctor. Do not ingest it.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause irritation or burning.
To use, hold the container upright and spray the medication onto the affected area only.
If your skin becomes irritated, do not apply the medication more than once. You may apply white petroleum to other areas of your skin to protect it, if necessary.
Important Safety Precautions
This medication is flammable, so do not use it near an open flame or while smoking.
Storage and Disposal
Store this medication at room temperature.
Missed Dose Instructions
* Since this medication is used as needed, do not use it more frequently than directed by your doctor. If you have any questions or concerns, consult with your doctor for guidance.
To use this medication correctly, follow your doctor's instructions and read all accompanying information carefully. It is essential to use this medication as directed to ensure safe and effective treatment.
Application Instructions
Apply this medication only to your skin, as directed by your doctor. Do not ingest it.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause irritation or burning.
To use, hold the container upright and spray the medication onto the affected area only.
If your skin becomes irritated, do not apply the medication more than once. You may apply white petroleum to other areas of your skin to protect it, if necessary.
Important Safety Precautions
This medication is flammable, so do not use it near an open flame or while smoking.
Storage and Disposal
Store this medication at room temperature.
Missed Dose Instructions
* Since this medication is used as needed, do not use it more frequently than directed by your doctor. If you have any questions or concerns, consult with your doctor for guidance.
Lifestyle & Tips
- Do not spray near open flames, sparks, or heat sources as it is highly flammable.
- Use in a well-ventilated area to avoid inhaling large amounts of the vapor.
- Keep out of reach of children.
- Avoid spraying on open wounds, mucous membranes (eyes, nose, mouth), or broken skin.
- Do not use for prolonged periods or on large areas of the body.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply topically to the skin from a distance of 12-18 inches (30-45 cm) for 5-10 seconds or until the skin blanches. Do not spray for more than 10 seconds.
Condition-Specific Dosing:
minor_surgical_procedures:
Spray for 3-7 seconds.
muscle_spasm_pain:
Spray for 5-10 seconds, followed by stretching.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution due to risk of frostbite)
Infant:
Apply cautiously for 3-5 seconds, observing for skin blanching. Risk of frostbite is higher.
Child:
Apply cautiously for 3-7 seconds, observing for skin blanching. Risk of frostbite is higher.
Adolescent:
Apply topically as for adults, 5-10 seconds or until skin blanches.
Dose Adjustments
Renal Impairment:
Mild:
Not applicable (topical administration, minimal systemic absorption)
Moderate:
Not applicable
Severe:
Not applicable
Dialysis:
Not applicable
Hepatic Impairment:
Mild:
Not applicable (topical administration, minimal systemic absorption)
Moderate:
Not applicable
Severe:
Not applicable
Pharmacology
Mechanism of Action
Ethyl chloride produces local anesthesia by rapid evaporation from the skin, which causes intense cooling and numbing of the nerve endings in the superficial layers of the skin. This rapid cooling desensitizes the nerve endings, providing temporary pain relief.
Pharmacokinetics
Absorption:
Bioavailability:
Negligible systemic absorption from intact skin
Tmax:
Not applicable (instantaneous topical effect)
FoodEffect:
Not applicable
Distribution:
Vd:
Not applicable (minimal systemic absorption)
ProteinBinding:
Not applicable
CnssPenetration:
Limited (only with significant inhalation, not typical topical use)
Elimination:
HalfLife:
Not applicable (primarily evaporates)
Clearance:
Not applicable
ExcretionRoute:
Primarily evaporation from skin surface; minimal pulmonary excretion if inhaled
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Instantaneous (within seconds of application)
PeakEffect:
Instantaneous
DurationOfAction:
Very short (seconds to a few minutes, depending on application)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of kidney problems, such as:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Severe irritation at the site where the medication was applied
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor:
* Changes in skin color
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of kidney problems, such as:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Severe irritation at the site where the medication was applied
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor:
* Changes in skin color
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Excessive skin redness or irritation
- Blistering or peeling of the skin
- Severe pain or burning sensation
- Numbness that persists for a long time
- Signs of frostbite (skin turning white, waxy, or hard; loss of sensation in the sprayed area)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to ensure safe use and minimize potential interactions.
* Any existing health problems, as this medication may interact with other medical conditions or drugs.
To guarantee your safety, carefully review all your medications and health issues with your doctor and pharmacist. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to ensure safe use and minimize potential interactions.
* Any existing health problems, as this medication may interact with other medical conditions or drugs.
To guarantee your safety, carefully review all your medications and health issues with your doctor and pharmacist. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
When applying this drug, avoid placing it on cuts, scrapes, or damaged skin, as this can cause adverse effects.
Ingestion of this medication can be harmful. If you accidentally swallow this drug, immediately contact a doctor or a poison control center for assistance.
Avoid inhaling this drug, as breathing it in can cause serious harm or even death.
If you are pregnant, planning to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks of using this medication, both for you and your baby.
When applying this drug, avoid placing it on cuts, scrapes, or damaged skin, as this can cause adverse effects.
Ingestion of this medication can be harmful. If you accidentally swallow this drug, immediately contact a doctor or a poison control center for assistance.
Avoid inhaling this drug, as breathing it in can cause serious harm or even death.
If you are pregnant, planning to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks of using this medication, both for you and your baby.
Overdose Information
Overdose Symptoms:
- If inhaled in large quantities (e.g., intentional abuse): dizziness, lightheadedness, confusion, nausea, vomiting, loss of consciousness, irregular heartbeat (arrhythmias), respiratory depression, seizures, sudden death (due to cardiac sensitization).
What to Do:
If accidental ingestion or significant inhalation occurs, move to fresh air immediately. Seek emergency medical attention. For skin frostbite, warm the area gently with lukewarm water (do not rub or use direct heat) and seek medical attention. Call 1-800-222-1222 for Poison Control.
Drug Interactions
Monitoring
Baseline Monitoring
Skin integrity
Rationale: Ensure skin is intact and free of open wounds or irritation before application.
Timing: Prior to each application
Routine Monitoring
Skin blanching
Frequency: During application
Target: Visible blanching of the skin
Action Threshold: Stop spraying immediately once blanching occurs or after 5-10 seconds to prevent frostbite.
Signs of frostbite (excessive redness, blistering, pain, numbness)
Frequency: Immediately after application and for several minutes thereafter
Target: Absence of these signs
Action Threshold: Discontinue use and seek medical attention if signs of frostbite develop.
Symptom Monitoring
- Skin irritation (redness, itching, burning)
- Blistering
- Pain or numbness beyond the intended anesthetic effect
- Signs of frostbite (white or waxy skin, hardness, lack of sensation)
Special Patient Groups
Pregnancy
Generally considered safe for topical use during pregnancy due to minimal systemic absorption. However, avoid prolonged or excessive use, and ensure adequate ventilation to prevent maternal inhalation.
Trimester-Specific Risks:
First Trimester:
Low risk with proper topical use.
Second Trimester:
Low risk with proper topical use.
Third Trimester:
Low risk with proper topical use.
Lactation
Likely safe for use during lactation due to minimal systemic absorption. Avoid applying to areas where the infant might come into direct contact with the sprayed skin or inhale the vapors.
Infant Risk:
Low risk
Pediatric Use
Use with extreme caution in infants and young children due to thinner skin and higher risk of frostbite. Limit spray duration to the minimum effective time (e.g., 3-5 seconds) and observe closely for skin blanching. Avoid use on very young infants unless specifically directed by a healthcare professional.
Geriatric Use
No specific dose adjustments needed. However, elderly patients may have thinner skin, increasing the risk of frostbite. Apply cautiously and observe skin response closely.
Clinical Information
Clinical Pearls
- Highly flammable: Keep away from ignition sources, including electrocautery, lasers, and open flames.
- Risk of frostbite: Do not spray for more than 5-10 seconds or until skin blanches. Maintain recommended spray distance (12-18 inches).
- Avoid inhalation: Use in a well-ventilated area. Inhalation of high concentrations can cause CNS depression and cardiac arrhythmias.
- Not for open wounds: Do not apply to broken skin, mucous membranes, or eyes.
- Rapid onset, short duration: Ideal for quick, superficial pain relief or pre-injection numbing.
- Physical therapy adjunct: Often used to relieve muscle spasm and facilitate stretching in 'spray and stretch' techniques.
Alternative Therapies
- Ice packs/cold compresses
- Topical lidocaine spray/cream
- Benzocaine spray
- Cryotherapy (e.g., liquid nitrogen for warts, but different mechanism/intensity)
- Vapocoolant sprays containing other agents (e.g., tetrafluoroethane, pentafluoropropane)
Cost & Coverage
Average Cost:
$10 - $30 per 100g/3.5oz spray can
Generic Available:
Yes
Insurance Coverage:
Often covered by insurance for medical procedures; may be out-of-pocket for OTC use.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.