Lidocaine 5% Cream 30gm
Overview
What is this medicine?
How to Use This Medicine
To use this medication safely and effectively, follow your doctor's instructions and the information provided with your medication. Before and after applying the medication, wash your hands thoroughly. Clean the affected area before use and make sure it is completely dry. Apply the medication as directed by your doctor or according to the package labeling.
Storing and Disposing of Your Medication
Store your medication at room temperature, avoiding freezing. Keep all medications in a secure location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
Missing a Dose
If you use this medication regularly, take a missed dose as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not apply two doses at the same time or take extra doses. If you use this medication as needed, do not use it more frequently than directed by your doctor.
Lifestyle & Tips
- Wash your hands thoroughly before and after applying the cream.
- Apply only a thin layer to the affected area as directed by your doctor or package instructions.
- Do not apply to large areas of the body, broken skin, or for prolonged periods unless specifically instructed by a healthcare professional, as this can increase the risk of systemic absorption and side effects.
- Avoid contact with eyes, nose, mouth, or other mucous membranes. If contact occurs, rinse thoroughly with water.
- Do not use with occlusive dressings (e.g., plastic wrap) unless advised by a doctor, as this can increase absorption.
- Keep out of reach of children and pets. Accidental ingestion can be dangerous.
Available Forms & Alternatives
Available Strengths:
- Lidocaine 4% Top Soln 50ml
- Lidocaine 2% Visc Oral Solution
- Lidocaine 1% Inj, 10ml
- Lidocaine 2% Inj, 2ml
- Lidocaine 4% Injection, 5ml
- Lidocaine 1% Inj, 5ml
- Lidocaine 1% Inj, 20ml
- Lidocaine 2% Inj, 20ml
- Lidocaine 1% Inj, 2ml
- Lidocaine 1% Inj, 50ml
- Lidocaine 2% Inj, 5ml
- Lidocaine 2% Inj, 10ml
- Lidocaine 1% Inj, 30ml
- Lidocaine 2% Inj, 50ml
- Lidocaine 2% Inj, 5ml
- Lidocaine 10mg/ml Inj, 5ml
- Lidocaine 3% Cream 28.35gm
- Lidocaine 3% Cream 85gm
- Lidocaine 2% Topical Jelly 5ml
- Lidocaine 2% Topical Jelly 10ml
- Lidocaine 2% Topical Jelly 20ml
- Lidocaine 20mg/ml Inj, 5ml
- Lidocaine 2% Jelly Gel (uro-Jet)5ml
- Lidocaine 0.5% Inj, 50ml
- Lidocaine 5% Patch
- Lidocaine 5% Topical Ointment 30gm
- Lidocaine 5% Topical Oint 35.44gm
- Lidocaine 5% Topical Ointment 50gm
- Lidocaine 1.5% Inj, 1 Ampule
- Lidocaine 5% Top/oral Oint 50gm
- Lidocaine 4% Cream 15gm
- Lidocaine 4% Cream 30gm
- Lidocaine 4% Cream 5gm
- Lidocaine 3% Cream 85gm
- Lidocaine Pain Relief 4% Patch
- Lidocaine 5% Top/oral Oint (sprmt)
- Lidocaine 5% Anorectal Cream
- Lidocaine 4% Cream 15gm
- Lidocaine 5% Topical Ointment 30gm
- Lidocaine 5% Anorectal Cream 15gm
- Lidocaine Pain Relief 4% Patch
- Lidocaine 5% Cream 30gm
- Lidocaine 2% Inj 25ml
- Lidocaine 5% Ointment 50gm
- Lidocaine 4% Cream 15gm
- Lidocaine 4% Topical Pain Patch
- Lidocaine 3%/hc 0.5% Cream 28.3gm
- Lidocaine 2% Topical Jelly 30ml
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
Side Effects
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:
Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of acidosis (too much acid in the blood), such as:
+ Confusion
+ Rapid breathing or heartbeat
+ Abnormal heartbeat
+ Severe stomach pain, nausea, or vomiting
+ Excessive sleepiness
+ Shortness of breath
+ Feeling extremely tired or weak
Signs of methemoglobinemia, a rare but potentially life-threatening condition, such as:
+ Blue or gray discoloration of the lips, nails, or skin
+ Abnormal heartbeat
+ Seizures
+ Severe dizziness or fainting
+ Severe headache
+ Excessive sleepiness
+ Feeling extremely tired or weak
+ Shortness of breath
Breathing difficulties, such as slow, shallow, or troubled breathing
Severe numbness or tingling
Feeling lightheaded, sleepy, confused, or experiencing blurred vision
Seizures
Changes in vision
Feeling anxious or agitated
Dizziness or fainting
Ringing in the ears
Nausea or vomiting
Feeling excessively hot or cold
Shakiness or tremors
Twitching
Slow heartbeat
Chest pain
Rectal bleeding or pain
Other Possible Side Effects
As with any medication, you may experience side effects. While many people have no side effects or only mild 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:
Irritation at the site of application
Swelling
Redness
Skin discoloration
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns, 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:
- Signs of allergic reaction: rash, itching, hives, swelling (especially of the face, tongue, or throat), severe dizziness, trouble breathing.
- Signs of systemic toxicity: unusual tiredness or drowsiness, confusion, dizziness, lightheadedness, ringing in the ears (tinnitus), blurred vision, numbness or tingling around the mouth, unusual taste, muscle twitching, tremors, seizures, slow or irregular heartbeat, low blood pressure, difficulty breathing.
- Severe irritation or worsening of symptoms at the application site.
Before Using This Medicine
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 allergic reaction and its symptoms.
The presence of an infection at the site where this medication will be applied.
Any broken skin or open wounds at the application site.
Swollen skin, numbness, or loss of sensation at the application site, as this may affect the medication's absorption or increase the risk of adverse reactions.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication in combination with your other medications and health conditions.
Remember, do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor to ensure your safety.
Precautions & Cautions
A rare but serious blood condition called methemoglobinemia has been associated with drugs similar to this one. Your risk may be increased if you have a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), heart problems, or lung problems. Additionally, the risk may be higher when taking certain other medications or in infants under 6 months of age. If you have a history of methemoglobinemia, be sure to discuss this with your doctor.
Before using any other medications or skin products, including soaps, consult with your doctor. Do not use this medication for a longer period than prescribed by your doctor. While your skin is numb, avoid scratching or rubbing the area, and do not expose it to extreme temperatures.
Apply this medication only to intact skin, unless your doctor specifically instructs you to use it on cuts, scrapes, or damaged skin. Avoid using heat sources such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, or heated waterbeds. Also, avoid taking long, hot baths or sunbathing, as these can cause your body temperature to rise, leading to excessive absorption of the medication.
If this medication is accidentally swallowed, immediately contact a doctor or a poison control center. Note that different brands of this medication may be approved for use in children of various ages, so consult with your doctor before administering it to a child. When using this medication in children, exercise caution, as they may be at a higher risk for certain side effects.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. Pregnant or breastfeeding women should discuss the potential benefits and risks of using this medication with their doctor.
Overdose Information
Overdose Symptoms:
- Severe dizziness or lightheadedness
- Confusion
- Drowsiness
- Ringing in the ears (tinnitus)
- Blurred or double vision
- Numbness or tingling around the mouth
- Muscle twitching or tremors
- Seizures
- Slow or irregular heartbeat (bradycardia)
- Low blood pressure (hypotension)
- Difficulty breathing
- Coma
What to Do:
If you suspect an overdose, seek immediate medical attention. Call 911 or your local Poison Control Center (e.g., 1-800-222-1222 in the US) right away.
Drug Interactions
Contraindicated Interactions
- Known hypersensitivity to amide-type local anesthetics or any component of the formulation.
- Patients with Adams-Stokes syndrome, Wolff-Parkinson-White syndrome, or severe degrees of heart block (unless a pacemaker is in place).
Major Interactions
- Class I Antiarrhythmics (e.g., mexiletine, tocainide, procainamide): Additive cardiac effects, increased risk of CNS and cardiovascular toxicity.
- Other Local Anesthetics: Additive systemic toxicity if significant absorption occurs.
Moderate Interactions
- Beta-blockers (e.g., propranolol, metoprolol): May reduce hepatic blood flow, potentially decreasing lidocaine clearance and increasing systemic levels.
- Cimetidine: Inhibits CYP450 enzymes, potentially increasing lidocaine plasma concentrations.
- Succinylcholine: May prolong neuromuscular blockade.
- Phenytoin: May increase lidocaine levels and enhance cardiac depression.
Minor Interactions
- Not typically significant for topical use with limited systemic absorption.
Monitoring
Baseline Monitoring
Rationale: To assess the risk of systemic absorption and potential toxicity.
Timing: Prior to initial application.
Rationale: To identify pre-existing conditions that may increase risk of systemic toxicity.
Timing: Prior to initial application.
Routine Monitoring
Frequency: During and after application, especially with extensive use or in at-risk populations.
Target: Absence of symptoms.
Action Threshold: Any signs of dizziness, confusion, tinnitus, blurred vision, muscle twitching, tremors, seizures, bradycardia, hypotension, or arrhythmias require immediate medical attention.
Frequency: Daily, or with each application.
Target: Absence of severe irritation.
Action Threshold: Discontinue use if severe irritation or allergic reaction occurs.
Symptom Monitoring
- Dizziness
- Lightheadedness
- Confusion
- Drowsiness
- Tinnitus (ringing in ears)
- Blurred vision
- Numbness or tingling around the mouth
- Muscle twitching
- Tremors
- Seizures
- Bradycardia (slow heart rate)
- Hypotension (low blood pressure)
- Arrhythmias (irregular heart beat)
- Difficulty breathing
- Skin irritation (redness, rash, itching, swelling at application site)
- Allergic reactions (hives, swelling of face/tongue/throat, severe dizziness, trouble breathing)
Special Patient Groups
Pregnancy
Lidocaine is Pregnancy Category B. Topical use during pregnancy is generally considered safe when used as directed due to limited systemic absorption. However, consult a healthcare professional before use.
Trimester-Specific Risks:
Lactation
Lidocaine is considered compatible with breastfeeding when used topically as directed. Minimal amounts are excreted into breast milk, and adverse effects on the infant are unlikely.
Pediatric Use
Use with extreme caution, especially in infants and young children, due to their higher risk of systemic absorption and toxicity (e.g., methemoglobinemia in very young infants, though less common with lidocaine alone). Dosing must be carefully controlled by weight and surface area. Not recommended for routine use without strict medical supervision.
Geriatric Use
Use with caution in elderly or debilitated patients, as they may be more sensitive to the systemic effects of lidocaine. Consider starting with lower doses or applying to smaller areas. Monitor closely for signs of systemic toxicity, especially if underlying cardiac, hepatic, or renal impairment is present.
Clinical Information
Clinical Pearls
- Lidocaine 5% cream provides temporary symptomatic relief and does not treat the underlying cause of pain or itching.
- Patients should be educated on the signs and symptoms of systemic lidocaine toxicity and instructed to seek immediate medical attention if they occur.
- Avoid applying to large body surface areas, broken or inflamed skin, or under occlusive dressings, as this significantly increases systemic absorption and the risk of toxicity.
- Not for ophthalmic use. Avoid contact with eyes.
- Hypersensitivity reactions, though rare, can occur. Patients with a history of allergy to amide-type local anesthetics should avoid use.
- The cream should be applied as a thin layer; rubbing it in vigorously is generally not necessary and may increase absorption.
Alternative Therapies
- Other topical anesthetics (e.g., pramoxine, benzocaine)
- Topical corticosteroids (for inflammation and itching, e.g., hydrocortisone cream)
- Astringents (e.g., witch hazel pads for hemorrhoids)
- Oral analgesics (e.g., acetaminophen, NSAIDs for pain relief)
- Sitz baths (for anal discomfort)