Ethyl Chloride Med 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
Local Anesthetic (via rapid evaporation/cooling)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Ethyl chloride spray is a medicine that quickly cools and numbs your skin. It's used to lessen pain from things like needle sticks, minor cuts, or muscle spasms. It works by making the skin very cold, which temporarily blocks pain signals.
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 the affected area of your skin. Do not ingest it or apply it to your mouth, nose, or eyes, as it may cause irritation or burning.
When using the spray, hold the container upright and avoid turning it upside down.
Spray the medication directly onto the affected area only. If your skin becomes irritated, do not use the medication more than once. You can apply white petroleum to other areas of your skin to protect them.
Be cautious when using this medication, as it is flammable. Keep it away from open flames and do not use it while smoking.
Storage and Disposal
Store this medication at room temperature.
Missed Dose
This medication is used as needed. If you miss a dose, do not use it more frequently than prescribed by your doctor. Follow their instructions for use to avoid overuse or potential side effects.
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 the affected area of your skin. Do not ingest it or apply it to your mouth, nose, or eyes, as it may cause irritation or burning.
When using the spray, hold the container upright and avoid turning it upside down.
Spray the medication directly onto the affected area only. If your skin becomes irritated, do not use the medication more than once. You can apply white petroleum to other areas of your skin to protect them.
Be cautious when using this medication, as it is flammable. Keep it away from open flames and do not use it while smoking.
Storage and Disposal
Store this medication at room temperature.
Missed Dose
This medication is used as needed. If you miss a dose, do not use it more frequently than prescribed by your doctor. Follow their instructions for use to avoid overuse or potential side effects.
Lifestyle & Tips
- Do not spray near open flames, sparks, or heat sources as it is highly flammable.
- Avoid spraying into eyes, nose, mouth, or on mucous membranes.
- Do not apply to broken skin, open wounds, or areas with poor circulation.
- Use in a well-ventilated area to avoid inhaling large amounts of the vapor.
- Keep the spray at the recommended distance from the skin (usually 3-7 inches) to prevent excessive cooling and frostbite.
- Do not spray for longer than recommended (typically 4-10 seconds) to avoid skin damage.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply topically to the skin from a distance of 3-7 inches (8-18 cm) until the skin blanches or a light frost appears. Application typically lasts 4-10 seconds, depending on the area and desired effect.
Dose Range:
4 - 10 mg
Condition-Specific Dosing:
pre-injection:
Apply for 4-10 seconds before venipuncture or minor surgical procedures.
muscle_spasm:
Spray in a sweeping motion over the affected muscle area, stretching the muscle during application.
Pediatric Dosing
Neonatal:
Not established (use with extreme caution, shorter application time due to very thin skin)
Infant:
Apply for a very brief duration (e.g., 2-4 seconds) from a greater distance, observing skin closely for blanching. Avoid prolonged application due to risk of frostbite.
Child:
Apply for a brief duration (e.g., 3-5 seconds) from a greater distance, observing skin closely for blanching. Avoid prolonged application.
Adolescent:
Similar to adult dosing, but with caution regarding application duration and skin sensitivity.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No adjustment needed (minimal systemic absorption)
Hepatic Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Pharmacology
Mechanism of Action
Ethyl chloride is a volatile liquid that, upon topical application, rapidly evaporates. This rapid evaporation causes intense cooling of the skin and underlying superficial tissues. The cooling effect numbs the nerve endings in the skin, producing a transient local anesthetic effect and reducing pain sensation.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption when applied topically to intact skin.
Tmax:
Not applicable (topical effect is immediate)
FoodEffect:
Not applicable
Distribution:
Vd:
Not significant systemically
ProteinBinding:
Not significant systemically
CnssPenetration:
Limited (minimal systemic absorption)
Elimination:
HalfLife:
Not significant systemically
Clearance:
Not significant systemically
ExcretionRoute:
Primarily evaporates from skin surface; minimal systemic excretion.
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Seconds (immediate upon application)
PeakEffect:
Seconds (during application)
DurationOfAction:
Short (typically 1-5 minutes after application ceases)
Confidence:
High
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
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 immediate medical attention:
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, contact your doctor for advice:
* Changes in skin color
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult 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 immediate medical attention:
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, contact your doctor for advice:
* Changes in skin color
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult 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:
- Skin turning excessively white or waxy
- Blistering of the skin
- Severe pain or burning sensation after application
- Numbness that lasts for a long time or spreads beyond the treated area
- Signs of frostbite (e.g., skin becoming hard, cold, and insensitive)
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 information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting 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 information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
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 putting it on cuts, scrapes, or damaged skin, as this can cause adverse effects.
If you accidentally swallow this medication, it can be harmful. Immediately contact a doctor or a poison control center for assistance.
Inhaling this drug can be dangerous and potentially life-threatening. Avoid breathing in this medication at all times.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication to ensure the best outcome for both you and your baby.
When applying this drug, avoid putting it on cuts, scrapes, or damaged skin, as this can cause adverse effects.
If you accidentally swallow this medication, it can be harmful. Immediately contact a doctor or a poison control center for assistance.
Inhaling this drug can be dangerous and potentially life-threatening. Avoid breathing in this medication at all times.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication to ensure the best outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Topical: Frostbite, skin blistering, tissue damage.
- Inhalation (accidental or intentional abuse): Dizziness, lightheadedness, confusion, nausea, vomiting, loss of consciousness, respiratory depression, cardiac arrhythmias, sudden sniffing death.
What to Do:
For topical overdose (frostbite): Warm the affected area gently with lukewarm water (not hot). Do not rub. Seek immediate medical attention. For inhalation overdose: Move to fresh air. If breathing is difficult or stops, administer artificial respiration. Seek immediate medical attention. Call 911 or Poison Control (1-800-222-1222).
Drug Interactions
Monitoring
Baseline Monitoring
Skin integrity
Rationale: To ensure skin is intact and free from open wounds or irritation before application, which could increase systemic absorption or cause further damage.
Timing: Prior to first application
Routine Monitoring
Skin appearance (blanching/frost)
Frequency: During each application
Target: Light blanching or appearance of light frost
Action Threshold: Discontinue application immediately if excessive blanching, blistering, or signs of frostbite occur.
Patient comfort/pain level
Frequency: During and immediately after application
Target: Reduced pain/discomfort
Action Threshold: If pain increases or severe discomfort is reported, discontinue use and assess skin.
Symptom Monitoring
- Skin redness
- Blistering
- Excessive pain or burning sensation
- Numbness extending beyond the treated area
- Signs of frostbite (e.g., waxy, pale skin, hardness, lack of sensation)
Special Patient Groups
Pregnancy
Category C. While systemic absorption is minimal with topical use, animal reproduction studies have not been conducted. Use only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
First Trimester:
Risk unknown; minimal systemic absorption suggests low risk, but caution advised.
Second Trimester:
Risk unknown; minimal systemic absorption suggests low risk, but caution advised.
Third Trimester:
Risk unknown; minimal systemic absorption suggests low risk, but caution advised.
Lactation
L3 (Moderately Safe). It is unknown if ethyl chloride is excreted in human milk. Due to minimal systemic absorption, infant exposure is expected to be very low. Use with caution; consider applying after feeding or avoiding application to areas where the infant might come into direct contact.
Infant Risk:
Low risk due to minimal systemic absorption, but direct skin contact with treated area should be avoided.
Pediatric Use
Use with extreme caution, especially in infants and young children, due to thinner skin and increased susceptibility to frostbite. Apply for shorter durations and from a greater distance than in adults. Monitor skin closely for signs of excessive cooling or damage.
Geriatric Use
Use with caution due to potentially thinner skin, reduced circulation, and increased susceptibility to skin damage or frostbite. Monitor skin closely during application.
Clinical Information
Clinical Pearls
- Ethyl chloride is highly flammable; ensure no ignition sources are present during use.
- The anesthetic effect is very rapid but short-lived, making it ideal for quick procedures like venipuncture or minor injections.
- Always spray in a sweeping motion, not a direct stream, to prevent localized over-cooling and frostbite.
- Ensure the patient's eyes and mucous membranes are protected during facial applications.
- Can be used for 'spray and stretch' techniques in myofascial pain syndromes.
Alternative Therapies
- Ice packs/cold compresses
- Topical lidocaine cream/patch
- Benzocaine spray
- Cryotherapy devices (e.g., liquid nitrogen for warts, but different mechanism/intensity)
Cost & Coverage
Average Cost:
$15 - $50 per 100-120 mL spray can
Generic Available:
Yes
Insurance Coverage:
Often considered an over-the-counter (OTC) product; typically not covered by insurance unless specifically prescribed and deemed medically necessary.
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 happened.