Lidocaine (Lignocaine) + Prilocaine is a combination of local anaesthetic medicines used to temporarily numb the skin or mucous membranes before minor medical procedures. It works by blocking nerve signals in the area of application, helping reduce pain and discomfort during procedures such as needle insertion, skin biopsies, minor dermatological treatments, and certain dental or genital procedures. It is commonly used in clinical settings to provide effective short-term local anaesthesia and is available in topical formulations such as creams, patches, sprays, and gels under medical supervision.

Lidocaine (Lignocaine) + Prilocaine is a topical local anaesthetic that combines Lidocaine and Prilocaine, both of which belong to the amide class of anaesthetics. It is used in adults and children to produce temporary numbness on intact skin or certain mucosal areas before minor medical, surgical, or dermatological procedures.

This combination works through complementary actions to provide effective local anaesthesia. Both Lidocaine and Prilocaine stabilise neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of nerve impulses. By blocking sodium channels along the nerve fibres, the medicine prevents the sensation of pain from reaching the brain. This action helps regulate local sensitivity, leading to improved comfort during procedures like needle sticks, skin biopsies, or the cleaning of leg ulcers.

The medicine is widely used as part of procedural care to support pain-free minor interventions and reduce the risk of procedure-related distress. It is generally associated with a low risk of systemic absorption when applied to small areas of intact skin. Because the depth of anaesthesia depends on the application time, the medication must be applied under an occlusive dressing for a specific duration to achieve the desired effect.

Because the active ingredients can be absorbed into the bloodstream, application to very large areas or broken skin should be avoided unless specifically directed. Healthcare professionals monitor the application site for local reactions such as pallor or redness. Rarely, a serious blood condition called methemoglobinemia may occur, particularly in infants or patients with certain enzyme deficiencies. This medicine should be used under medical supervision to ensure safe and effective local pain management.

Lidocaine (Lignocaine) + Prilocaine may be indicated by your doctor for:

Local Anaesthesia

For the temporary numbing of intact skin prior to needle insertion, blood sampling, or vaccinations.

Minor Dermatological Procedures

To manage pain during superficial skin treatments, such as wart removal, laser therapy, skin biopsies, or small surgical incisions.

Leg Ulcer Management

To provide pain relief during the cleaning and removal of dead tissue (debridement) from leg ulcers.

Mucosal Anaesthesia

For the numbing of genital or other mucous membranes before minor clinical procedures.

Lidocaine (Lignocaine) + Prilocaine may provide benefits such as:

• Provides effective pain relief for various needle-related and minor surgical procedures.

• Reduces anxiety and discomfort, particularly in children and patients with needle phobias.

• Offers a non-invasive alternative to injectable anaesthesia for superficial skin treatments.

• Features a deep-penetrating formula that reaches the nerve endings through intact skin.

• Allows for a painless cleaning process for chronic wounds like leg ulcers.

• Provides a predictable duration of numbness when applied correctly under occlusion.

• Supports a wide range of applications, from dermatology to dentistry and urology.

Lidocaine (Lignocaine) + Prilocaine is generally well-tolerated, but local skin reactions at the site of application are common and usually temporary.

Common side effects of Lidocaine (Lignocaine) + Prilocaine may include

• Pale skin (pallor) or redness (erythema) at the application site

• Mild swelling or puffiness (oedema)

• Initial burning or itching sensation

• Change in skin temperature (warmth or coolness)

Uncommon side effects of Lidocaine (Lignocaine) + Prilocaine may include

• Small red or purple spots on the skin (purpura or petechiae)

• Skin irritation or rash

Serious side effects that may require immediate medical attention include

• Methemoglobinemia: A rare condition causing blue or grey skin, lips, or fingernails, shortness of breath, and fatigue.

• Severe Allergic Reaction: Hives, swelling of the face or throat, or difficulty breathing.

• Systemic Toxicity: Dizziness, blurred vision, tremors, or ringing in the ears.

• Eye Irritation: Severe pain or redness if the medication accidentally contacts the eyes.

• Always consult your doctor if you notice any persistent or concerning reactions while using Lidocaine (Lignocaine) + Prilocaine.

Use Lidocaine (Lignocaine) + Prilocaine exactly as directed by your doctor based on the prescribed form.

• Clean and dry the area of skin where the medication will be applied.

• Apply a thick layer of the medicine to the required area as instructed by your healthcare provider.

• For most procedures on intact skin, the treated area must be covered with an airtight (occlusive) dressing.

• Note the time of application; the medicine usually needs to stay on the skin for at least 60 minutes before a procedure.

• Do not apply the medicine to open wounds, broken skin, or areas with a rash unless specifically told to do so for ulcer care.

• Avoid contact with the eyes, ears, and mouth.

• Your healthcare professional will remove the dressing and wipe off the excess medicine immediately before the procedure begins.

Lidocaine (Lignocaine) + Prilocaine works by blocking the conduction of nerve signals in the area where it is applied. Both Lidocaine and Prilocaine are local anaesthetics that penetrate the skin and reach the local nerve endings. Biologically, they bind to sodium channels on the nerve cell membranes. This binding prevents sodium from entering the nerve cells, which is a necessary step for the nerve to send a pain signal to the brain.

Clinically, this results in a temporary loss of sensation in the targeted area. Because the mixture is "eutectic," it stays in a liquid state at room temperature, which allows for a much higher concentration of the active ingredients to be absorbed through the skin's barrier compared to other topical creams. This ensures the numbness is deep enough to cover the pain of needles or minor surgical cuts.

• Apply the medicine at least one hour before your scheduled procedure to ensure the skin is properly numbed.

• Do not leave the cream on for longer than the time recommended by your doctor, usually no more than 4 to 5 hours.

• Ensure the dressing is secure; if the cream leaks out, the numbing effect may not be consistent.

• Once the area is numb, be careful not to injure the skin through scratching or exposure to heat, as you will not feel pain.

• If you are applying this to a child, ensure they do not touch or lick the cream or the dressing.

• Inform your doctor if you have a rare blood disorder like G6PD deficiency, as you may be at higher risk for side effects.

• Store at room temperature in a dry place.

• Do not freeze the medication, as this can destroy the emulsion.

• Keep the container tightly closed when not in use.

• Keep out of the reach of children and pets to prevent accidental ingestion.

• Do not use the medicine after the expiry date printed on the tube or packaging.

• General Diet (NO INTERACTION): There are no known interactions between this topical medicine and specific foods or beverages.

• Class III Anti-arrhythmics (MODERATE): Medicines like amiodarone may have additive effects on the heart if systemic absorption occurs.

• Methemoglobin-inducing Agents (SEVERE): Using alongside drugs like sulfonamides or nitrates can increase the risk of blood complications.

• Other Local Anaesthetics (CAUTION): Risk of toxicity increases if used simultaneously with other numbing agents.

• Methemoglobinemia (SEVERE): Should be used with extreme caution in patients with congenital or idiopathic methemoglobinemia.

• G6PD Deficiency (CAUTION): Patients with this enzyme deficiency are more susceptible to drug-induced blood complications.

• Severe Liver Disease (CAUTION): Patients may be more sensitive to systemic effects if the drug is absorbed in large amounts.

• Atopic Dermatitis (CAUTION): A shorter application time may be needed as the medicine is absorbed more quickly through inflamed skin.

An overdose can occur if the medicine is applied to a very large surface area or left on for too long. Symptoms may include numbness of the tongue, lightheadedness, blurred vision, or blue-tinted skin. If you suspect an overdose or if the medication is swallowed, seek emergency medical assistance immediately.

Since this medicine is typically applied before a procedure, missing a dose usually means the procedure may need to be delayed to allow time for the numbing effect to develop. Consult your clinic if you forget to apply it at the scheduled time before your appointment.