Lidocaine/Prilocaine, Topical

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KEY POINTS

• This medicine is used to numb your skin before injections, minor surgery, or other procedures. Use it exactly as directed. It is very important to use the correct amount of medicine to prevent serious side effects.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: topical anesthetic (pain reliever)

Generic and brand names: lidocaine/prilocaine, topical; EMLA Cream

What is this medicine used for?

This medicine is used to numb your skin before injections, minor surgery, or other procedures.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood disorder such as methemoglobinemia or G6PD
• A heart rhythm problem
• Liver disease

Tell your healthcare provider if you take medicine for an irregular heartbeat.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Use the medicine as directed by your healthcare provider. Do not use more medicine, use it more often, or leave it on longer than instructed. Using too much, too often, or leaving it on too long may cause serious side effects. Check with your healthcare provider before using this medicine in children under age 4 months.

Wash your hands before and after using this medicine.

This medicine comes in the form of a cream. Use the medicine on skin that is not broken, damaged, or irritated. Your healthcare provider may instruct you to cover the medicine with a special dressing or bandage.

Keep this medicine out of your mouth, nose and eyes. It can irritate or injure your eyes. If you get this medicine in your eye, do not rub your eyes. Flush them with plenty of cool water. If you smear it on another part of the skin by accident, just wipe it off.

What if I miss a dose?

If you forget to use this medicine or apply this medicine later than directed, contact your healthcare provider.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are using this medicine.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, confusion, nervousness, ringing in the ears, blurred vision, feeling hot or cold, numbness, muscle twitches, irregular heartbeat, seizures, slow breathing, breathing that stops, coma.

What should I watch out for?

Use this medicine with caution with people who are very ill or elderly, or with infants less than 3 months old. It is very important to use the correct amount of medicine to prevent serious side effects. Talk with your healthcare provider about this.

If you become very dizzy or sleepy, or your skin turns blue or gray around your mouth, fingers, or toes after using this medicine, remove the medicine and contact your healthcare provider right away.

Since this medicine stops all feeling on your skin, be careful not to injure your skin by scratching, rubbing, or exposing it to extreme hot or cold temperatures. The numbing effect of the medicine goes away after a few hours.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Lightheadedness, dizziness, ringing in the ears, vision problems, extreme nervousness, tremor, irregular heart rate, seizures, weakness, confusion, blue or gray skin tone.

Other: Redness, swelling, or mild burning sensation, mild rash.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Acetaminophen and medicines that contain acetaminophen
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, mexiletine, procainamide, propafenone (Rythmol), quinidine, and sotalol (Betapace, Sorine)
• Antibiotics such as ciprofloxacin (Cipro), clarithromycin (Biaxin), dapsone, erythromycin (E.E.S., Ery-Tab, Erythrocin), nitrofurantoin (Furadantin, Macrobid, Macrodantin), ofloxacin, and telithromycin (Ketek)
• Antidepressants such as fluvoxamine (Luvox), nefazodone, and phenelzine (Nardil)
• Antifungal medicines such as itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Cancer medicines such as abiraterone (Zytiga) and idelalisib (Zydelig)
• Conivaptan (Vaprisol)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• Methoxsalen (8-MOP, Oxsoralen Ultra, Uvadex)
• Nitrate medicines such as isosorbide (Dilatrate, Isordil, Monoket) and nitroglycerin (Minitran, Nitro-Dur, Nitrostat)
• Other numbing medicines such as benzocaine, bupivacaine (Exparel, Marcaine, Sensorcaine), lidocaine (Lidoderm, Xylocaine), and tetracaine (Tetravisc)
• Phenazopyridine (Pyridium)
• Phenobarbital
• Phenytoin (Dilantin, Phenytek)
• Sulfa antibiotics such as sulfadiazine, sulfamethoxazole/trimethoprim (Bactrim, Septra), and sulfasalazine (Azulfidine)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.