Prilocaine/Lignocaine

Uses

Precaution

Side Effects

Handling

Uses

What is Prilocaine/Lignocaine for?

This medication contains two topical anaesthetics, lignocaine and prilocaine. When applied to the skin, it causes temporary numbing of the skin (short term loss of sensation to the skin area)

It is used before procedures or injections to relieve the feeling of pain caused by the procedures or injections.

How should I take or use Prilocaine/Lignocaine?

Squeeze out the prescribed quantity of the cream on the area of the skin where the procedure or injection is to be done. Do not rub EMLA cream into the skin.
Take one of the occlusive dressings provided, and remove the cut-out piece in the middle
Peel the paper liner from the framed dressing.
Cover the EMLA cream with this dressing so that you get a thick layer of cream between your skin and the dressing. Do not spread out the cream. Press down on the sides of the dressing carefully to avoid leakages. It is important to cover EMLA cream with an air-tight dressing to ensure that the cream enters the skin properly and numbs the skin
Remove the frame of the dressing. Write down the time the cream was applied, directly on the dressing.
Wash your hands immediately after using EMLA.
Remove the dressing and wipe off the cream after the recommended duration of application in the table below or as advised by your doctor.

Type of procedures/ injections	Patient group	Duration of application
Minor procedures e.g., putting in needle, removal of molluscum bumps, or other minor skin operations	Infants 0- 12 months old	1 hour
	Children 1- 12 years old	1 hour; maximum 5 hours
	Children with atopic dermatitis or eczema	30 minutes
	12years of age>	1 hour; maximum 5 hours
Procedures that require deeper skin anaesthesia e.g., split-skin grafting	Adults	2 hours; maximum 5 hours
Use on genital skin before injection of local anaesthetics	Adults	15 minutes on male 60 minutes on female
Use on genital mucosa before injection of local anaesthetics	Adults	5-10 minutes Dressing is not used
Cleaning of leg ulcers	Adults	30 minutes to 1 hour

Your doctor may use EMLA cream for specialized procedures. Follow your doctor's instructions for use.

What should I do if I forget to take or use Prilocaine/Lignocaine?

EMLA is usually only applied once prior to each procedure. It must be in contact with the skin for a period of time for it to work. If you applied this medication later than directed, tell your health care professional before starting the procedure.

Precaution

What precautions should I take when taking or using Prilocaine/Lignocaine?

Inform your healthcare professional if you have:

Allergy to prilocaine, lignocaine/lidocaine, local anaesthetics, or any of the other ingredients of this medication
Dermatitis or any other skin problems
Severe liver conditions
Severe heart rhythm conditions
Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Methaemoglobinaemia (a blood disorder that causes the skin, especially around lips and nails, to turn brownish or greyish)
Infection, skin rash or broken skin at, or near the area where you want to apply EMLA cream
Plans to become pregnant, are pregnant or breastfeeding

The skin on which EMLA cream is applied may stay numb for up to several hours after the cream is removed. For this reason, you should be careful to avoid accidental injury to the treated area, such as scratching, rubbing or exposure to extreme temperatures, until complete sensation returns.
Avoid getting EMLA cream in your eyes, nose, or mouth. If you get EMLA in your eyes, rinse them with plenty of water. If the medication is swallowed, call a doctor immediately.
Do not apply to ruptured eardrum, anus, or children’s genital areas.
Children should be closely observed during and after use of EMLA cream, as they are at greater risk than adults for serious side effects, such as methaemoglobinemia.

What food or medication should I avoid when I take or use Prilocaine/Lignocaine?

Inform your doctor if you are taking

Other medications, especially

Antiarrhythmic drugs for heart problems e.g., amiodarone
Other local anaesthetics
Cimetidine
Beta-blockers
Other drugs which may trigger methaemoglobin formation e.g., sulfonamides, nitrofurantoin, chloroquine, dapsone, phenytoin, phenobarbital

Are taking supplements, traditional medications and herbal remedies

Side Effects

What are some common side effects of Prilocaine/Lignocaine?

Common side effects include:

Whitening or redness of the skin
Puffiness of the skin
Burning or itching on the site of application

These side effects may disappear during treatment. If any of the following effects persist or are severe, consult your doctor. Rare but serious side effects include:

Allergic reactions which include
- Swollen face/eyes/lips/tongue
- Difficulty in breathing
- Itchy skin rashes over your whole body
Small red dots (petechiae) at the application site, especially in children with skin problems (e.g., atopic dermatitis or eczema).
Methaemoglobinemia
- Bluish or greyish color of the lips, nails, skin
- Abnormal heartbeat
- Seizures
- Severe dizziness, passing out
- Severe headache
- Shortness of breath
- Feeling weak or tired
Slow heartbeat
Change in balance or speech
Ringing in ears
Anxiety, restless, excitable, low mood
Feeling lightheaded, confused, or having blurred vision

Handling

How should I store Prilocaine/Lignocaine?

Keep away from children
Keep in a cool, dry place, away from direct sunlight
Store in the refrigerator. Do not freeze.

How do I throw away Prilocaine/Lignocaine safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.