A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Emla Side Effects, and Drug Interactions - Lidocaine and Prilocaine
Emla Side Effects, and Drug Interactions - Lidocaine and Prilocaine
SIDE EFFECTS
Localized Reactions: During or immediately after treatment
with EMLA, the skin at
the site of treatment may
develop erythema or
edema or may be the locus
of abnormal sensation.
Rare cases of hyperpigmentation
following the use of EMLA
Cream have been reported. The relationship to EMLA
Cream or the underlying procedure
has not been established. In
clinical studies involving
over 1,300 EMLA Cream-treated
subjects, one or more such
local reactions were noted
in 56% of patients, and were generally mild and transient, resolving
spontaneously within 1 or 2 hours. There were no
serious reactions which were ascribed to EMLA Cream.
In patients treated with EMLA
Cream, local effects observed in the trials included: paleness (pallor
or blanching) 37%, redness (erythema) 30%, alterations in temperature
sensations 7%, edema 6%, itching 2% and rash,
less than 1%.
Allergic Reactions: Allergic and anaphylactoid reactions
associated with lidocaine
or prilocaine can occur. They are characterized by urticaria,
angioedema, bronchospasm,
and shock. If they occur they should be managed by conventional
means. The detection of sensitivity
by skin testing is of doubtful
value.
Systemic (Dose Related) Reactions: Systemic adverse reactions
following appropriate
use of EMLA are unlikely
due to the small dose absorbed
(see CLINICAL PHARMACOLOGY:
Pharmacokinetics). Systemic adverse effects of lidocaine
and/or prilocaine are similar in nature to those observed with other
amide local anesthetic
agents including CNS excitation
and/or depression
(light-headedness, nervousness, apprehension, euphoria,
confusion, dizziness,
drowsiness, tinnitus, blurred or double
vision, vomiting, sensations
of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness,
respiratory depression and arrest). Excitatory CNS
reactions may be brief or not occur at all, in which case
the first manifestation
may be drowsiness
merging into unconsciousness. Cardiovascular manifestations may
include bradycardia, hypotension and cardiovascular
collapse leading to
arrest.
DRUG INTERACTIONS
EMLA should be used with caution in patients receiving Class I
antiarrhythmic
drugs (such as tocainide
and mexiletine) since the toxic
effects are additive and potentially synergistic.
Prilocaine may contribute to the formation of methemoglobin
in patients treated with other drugs known to cause this condition
(see WARNINGS:
Methemoglobinemia).
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