Lidocaïne/Prilocaïne Teva (Lidocaine, Prilocaine)

Lidocaine/Prilocaine is a topical local anesthetic that works by reversibly blocking sodium channels in peripheral nerves, providing surface numbness for a variety of minor dermatologic and procedural applications.

• Minor skin procedures: provides localized anesthesia to facilitate biopsies, suturing or minor excisions.
• Venipuncture or cannulation: reduces pain and discomfort during blood draws or intravenous line placement.
• Superficial burns or abrasions: alleviates discomfort from minor thermal or mechanical skin injuries.
• Dermatologic laser or cosmetic procedures: offers temporary anesthesia to improve patient tolerance.

• Lidocaine and prilocaine act by reversibly binding to the intracellular portion of voltage‑gated sodium channels on neuronal membranes. This binding stabilizes the inactive state of the channel, preventing the influx of sodium ions during depolarization. Consequently, the generation and propagation of action potentials are inhibited, resulting in loss of sensation in the applied area without affecting surrounding tissues.

Topical application of lidocaine/prilocaine may be associated with local and systemic adverse reactions, most of which are mild and reversible.

Common Side Effects

• Mild skin irritation: redness or itching at the application site.
• Transient burning sensation: brief warmth during onset.
• Erythema: localized redness without swelling.
• Edema: slight swelling of the treated area.
• Contact dermatitis: allergic skin reaction with rash.
• Dryness or flaking: mild desquamation of the skin.

Serious or Rare Side Effects

• Methemoglobinemia: reduced oxygen‑carrying capacity, presenting with cyanosis.
• Systemic toxicity: dizziness, seizures, or cardiac arrhythmias after excessive absorption.
• Severe allergic reaction: anaphylaxis with airway compromise.

When using lidocaine/prilocaine topical products, clinicians should observe several precautionary measures to minimize risk and ensure optimal efficacy.

• Assess allergy history: verify patient has no known hypersensitivity to amide‑type local anesthetics.
• Limit application area: avoid covering large skin surfaces to prevent systemic absorption.
• Avoid use on compromised skin: do not apply to open wounds, mucous membranes, or infected areas unless directed.
• Monitor cardiovascular status: use cautiously in patients with heart disease or arrhythmias.
• Pregnancy and lactation: consider risk‑benefit ratio and consult prescribing information.
• Store at ambient temperature: keep below 25 °C, protect from moisture and direct sunlight, retain in original packaging.

Lidocaine/prilocaine may interact with other agents that affect cardiac conduction or alter drug metabolism, requiring careful assessment.

Major Interactions (Avoid)

• Class I antiarrhythmics (e.g., quinidine, procainamide): increased risk of cardiac toxicity and conduction disturbances.
• Concurrent use of other local anesthetics: additive systemic toxicity, especially with high total dose.
• Monoamine oxidase inhibitors (MAOIs): potential enhancement of central nervous system effects, including seizures.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask early signs of systemic toxicity such as tachycardia.
• CYP450 inhibitors (e.g., cimetidine, erythromycin): can raise plasma levels of lidocaine, necessitating dose adjustment.
• Alcohol: may potentiate CNS depression when combined with high topical doses.