Ethyl Chloride Mist 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 mist spray is a topical anesthetic that works by rapidly cooling the skin, causing temporary numbness and pain relief. It's used for minor procedures like injections, or to relieve pain from muscle spasms or minor injuries.
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.
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 them.
Important Safety Precautions
This medication is flammable, so avoid using it near open flames 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 recommended 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.
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 them.
Important Safety Precautions
This medication is flammable, so avoid using it near open flames 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 recommended by your doctor. If you have any questions or concerns, consult with your doctor for guidance.
Lifestyle & Tips
- Use in a well-ventilated area to avoid inhalation.
- Keep away from open flames, sparks, and hot surfaces as it is highly flammable.
- Do not spray near eyes, mouth, or mucous membranes.
- Avoid prolonged spraying on one area to prevent frostbite.
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) for 3-7 seconds or until skin blanches. Repeat as needed for short-term pain relief or prior to minor procedures.
Condition-Specific Dosing:
minor_surgical_procedures:
Spray for 3-7 seconds or until skin blanches, immediately prior to incision or injection.
muscle_spasms:
Spray in sweeping motions over the affected area from origin to insertion of the muscle, while stretching the muscle.
Pediatric Dosing
Neonatal:
Not established, use with extreme caution due to thin skin and risk of frostbite.
Infant:
Apply sparingly from a distance of 3-7 inches (8-18 cm) for 3-5 seconds or until skin blanches. Monitor closely for frostbite.
Child:
Apply sparingly from a distance of 3-7 inches (8-18 cm) for 3-7 seconds or until skin blanches. Monitor closely for frostbite.
Adolescent:
Apply topically to the skin from a distance of 3-7 inches (8-18 cm) for 3-7 seconds or until skin blanches. Repeat as needed.
Dose Adjustments
Renal Impairment:
Mild:
Not applicable due to topical administration and minimal systemic absorption.
Moderate:
Not applicable due to topical administration and minimal systemic absorption.
Severe:
Not applicable due to topical administration and minimal systemic absorption.
Dialysis:
Not applicable due to topical administration and minimal systemic absorption.
Hepatic Impairment:
Mild:
Not applicable due to topical administration and minimal systemic absorption.
Moderate:
Not applicable due to topical administration and minimal systemic absorption.
Severe:
Not applicable due to topical administration and minimal systemic absorption.
Pharmacology
Mechanism of Action
Ethyl chloride is a vapocoolant that produces topical anesthesia by rapid evaporation from the skin surface. This rapid evaporation causes intense cooling of the skin and underlying superficial nerve endings, leading to temporary numbness and pain relief. The cooling effect also causes vasoconstriction.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption
Tmax:
Not applicable (topical effect is immediate)
FoodEffect:
Not applicable
Distribution:
Vd:
Not applicable (minimal systemic distribution)
ProteinBinding:
Not applicable (minimal systemic distribution)
CnssPenetration:
Limited (only with significant inhalation exposure)
Elimination:
HalfLife:
Not applicable (topical effect is transient)
Clearance:
Not applicable (minimal systemic clearance)
ExcretionRoute:
Primarily evaporates from skin surface; minimal systemic excretion
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Immediate (seconds)
PeakEffect:
Immediate
DurationOfAction:
Short (seconds to a few minutes)
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 medical attention immediately:
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 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 medical attention immediately:
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 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:
- Persistent skin blanching (white appearance)
- Blistering or skin discoloration (blue/gray)
- Severe pain or numbness after application
- Signs of frostbite (e.g., waxy, hard skin)
- Dizziness, lightheadedness, or confusion (if inhaled)
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 avoid potential interactions between this medication and other substances.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is vital to verify that this medication is compatible with all your medications and health conditions. Never start, stop, or adjust the dosage 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 is crucial to avoid potential interactions between this medication and other substances.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is vital to verify that this medication is compatible with all your medications and health conditions. Never start, stop, or adjust the dosage 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 placing it on cuts, scrapes, or damaged skin, as this may cause adverse effects.
In the event that this drug is swallowed, it can be harmful. If ingestion occurs, immediately contact a doctor or a poison control center for assistance.
To minimize risks, do not inhale this drug, as breathing it in can cause serious harm or even death.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss your situation with your doctor. Your healthcare provider will help you weigh the benefits and risks of using this medication to ensure the best possible outcome for both you and your baby.
When applying this drug, avoid placing it on cuts, scrapes, or damaged skin, as this may cause adverse effects.
In the event that this drug is swallowed, it can be harmful. If ingestion occurs, immediately contact a doctor or a poison control center for assistance.
To minimize risks, do not inhale this drug, as breathing it in can cause serious harm or even death.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss your situation with your doctor. Your healthcare provider will help you weigh the benefits and risks of using this medication to ensure the best possible outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Topical: Frostbite, skin blistering, tissue damage.
- Inhalation (abuse/misuse): Central nervous system depression (dizziness, confusion, loss of consciousness), cardiac arrhythmias, respiratory depression, sudden sniffing death.
What to Do:
For topical overdose (frostbite): Warm the affected area gently, do not rub. Seek immediate medical attention. For inhalation overdose: Move to fresh air, seek immediate medical attention. Call 911 or Poison Control (1-800-222-1222).
Drug Interactions
Monitoring
Routine Monitoring
Skin integrity
Frequency: During and immediately after application
Target: No signs of frostbite or irritation
Action Threshold: Discontinue use if skin blanching persists, blistering, or signs of frostbite appear.
Symptom Monitoring
- Skin blanching (desired effect)
- Pain relief (desired effect)
- Redness or irritation at application site
- Blistering or signs of frostbite (undesired effect)
- Dizziness or lightheadedness (if inhaled)
Special Patient Groups
Pregnancy
Category C. Minimal systemic absorption is expected with topical use, suggesting low risk. However, animal studies are lacking, and human data are limited. Use only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
First Trimester:
Low risk due to minimal systemic absorption, but caution advised.
Second Trimester:
Low risk due to minimal systemic absorption, but caution advised.
Third Trimester:
Low risk due to minimal systemic absorption, but caution advised.
Lactation
L3 (Moderately Safe). Minimal systemic absorption makes it unlikely to be excreted in breast milk in significant amounts. However, caution is advised. Avoid applying to areas where the infant may come into direct contact or ingest the product.
Infant Risk:
Low risk of adverse effects to the infant due to minimal maternal systemic absorption.
Pediatric Use
Can be used in pediatric patients, but extreme caution is necessary, especially in infants and young children, due to thinner skin and increased susceptibility to frostbite. Apply from a greater distance and for shorter durations. Monitor closely for adverse skin reactions.
Geriatric Use
No specific dose adjustments are typically needed. However, geriatric patients may have thinner skin, making them more susceptible to frostbite. Apply with caution and monitor skin closely.
Clinical Information
Clinical Pearls
- Highly flammable: Ensure no ignition sources are present during application.
- Use in a well-ventilated area to minimize inhalation exposure.
- Always hold the can upright during spraying to ensure proper mist delivery.
- Do not spray on broken skin, open wounds, or mucous membranes.
- The goal is skin blanching, not prolonged freezing. Stop spraying immediately once blanching occurs to prevent frostbite.
- Can be used for temporary relief of pain from injections, minor surgical procedures, or muscle spasms.
- Not intended for prolonged or deep anesthesia.
Alternative Therapies
- Fluoromethane spray (another vapocoolant)
- Topical lidocaine cream/patch
- Benzocaine spray
- Ice packs/cold compresses
- Cryospray (liquid nitrogen, for dermatological procedures)
Cost & Coverage
Average Cost:
$15 - $50 per 100g/103mL spray can
Generic Available:
Yes
Insurance Coverage:
Often available over-the-counter (OTC) or covered under medical supplies/durable medical equipment (DME) by some insurance plans.
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 your 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, including the amount taken and the time it happened, to ensure you receive the best possible care.