Lidocaïne/Prilocaïne Teva (Lidocaine, Prilocaine)

Lidocaine/prilocaine is a topical local anesthetic used to numb intact skin or mucous membranes.

• Minor surgical procedures: provides surface anesthesia for small incisions, excisions or suturing.
• Diagnostic procedures: numbs the area for skin biopsies, dermatoscopic examinations or laser therapy.
• Dental procedures: offers superficial mucosal anesthesia for procedures such as scaling or minor extractions.

• Lidocaine and prilocaine act by reversibly binding to neuronal voltage‑gated sodium channels, stabilising the inactive state of the channel and preventing depolarisation. This blocks the initiation and propagation of nerve impulses, resulting in loss of sensation in the applied area without affecting surrounding tissues.

Topical application of lidocaine/prilocaine can cause local and systemic reactions.

Common Side Effects

• Transient erythema: mild redness at the application site.
• Burning or stinging sensation: brief discomfort during or after application.
• Pruritus: mild itching of the treated area.

Serious or Rare Side Effects

• Allergic contact dermatitis: rash, swelling or vesicles indicating hypersensitivity.
• Systemic toxicity: dizziness, tinnitus, seizures or cardiac arrhythmias if absorbed in large amounts.
• Methemoglobinemia: rare reduction in oxygen‑carrying capacity, more associated with prilocaine.

When using lidocaine/prilocaine topical formulation, consider the following precautions.

• Allergy assessment: verify no known hypersensitivity to amide‑type local anesthetics.
• Intact skin only: avoid application on broken, inflamed or infected skin.
• Surface area limitation: do not exceed the recommended total area to prevent systemic absorption.
• Pediatric use: monitor closely in children, especially when large areas are treated.
• Concomitant anesthetics: avoid using other topical anesthetics simultaneously.
• Store at room temperature: keep in the original packaging, protect from moisture and light.

Lidocaine/prilocaine may interact with other medicines; monitor accordingly.

Major Interactions (Avoid)

• Concurrent sodium channel blockers (e.g., class I antiarrhythmics): increased risk of systemic toxicity.
• Combined use with other systemic local anesthetics: may raise plasma concentrations and toxicity.

Moderate Interactions (Monitor Closely)

• CYP2D6 inhibitors (e.g., fluoxetine, quinidine): may slow prilocaine metabolism.
• Drugs that lower seizure threshold (e.g., tramadol, bupropion): heightened risk of CNS effects.
• Methemoglobin‑forming agents (e.g., dapsone, sulfonamides): additive risk of methemoglobinemia.