Generic Name: lidocaine and prilocaine topical (LY doh kayn and PRIL oh kayn TOP ik al)
Brand Names: Emla

What is Emla?

Emla is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Emla is used to numb the skin, or surfaces of the penis or vagina, in preparation for a medical procedure or to lessen the pain of inserting a medical instrument such as a tube or speculum.

Emla may also be used for other purposes not listed in this medication guide.

Important information

An overdose of numbing medications such as Emla can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal).

Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

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Your body may absorb more Emla if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas.

Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of Emla , or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Do not use Emla if you have had an allergic reaction to a numbing medicine in the past.

Before Emla is applied, tell your doctor if you have liver disease, a history of allergic reaction to lidocaine or prilocaine, or a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

Emla is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

Before using Emla?

An overdose of Emla can cause fatal side effects if too much lidocaine or prilocaine is absorbed through your skin and into your blood. Overdose is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

Do not use Emla if you have a blood cell disorder called methemoglobinemia.

Before Emla is applied, tell your doctor if you have:

  • liver disease;

  • a history of allergic reaction to lidocaine or prilocaine; or

  • a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Emla.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

See also: Pregnancy and breastfeeding warnings (in more detail)

Emla can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use Emla?

Use Emla exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of medicine needed to numb the skin or relieve pain. Do not use large amounts of Emla, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

This medication comes with instructions for safe and effective application. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

You should be lying down when Emla cream is applied.

Your medicine may have been supplied with bandages to cover the cream when it is applied to a small area on your skin. If using a bandage dressing, first apply a thick layer of the cream to the skin, taking care not to spread the cream out. Place the bandage over the cream and smooth down the edges until it is completely sealed around the cream.

Emla is usually applied 1 to 2 hours before the start of a procedure that requires the treated area to be numb. Follow your doctor's instructions about the length of time the cream should be left on the skin.

Store Emla at room temperature away from moisture and heat. Do not allow the cream to freeze.

What happens if I miss a dose?

Since Emla is used as needed, it is not likely that you will be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of Emla applied to the skin can cause life-threatening side effects such as uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

What should I avoid?

Emla is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

Emla side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Emla and call your doctor at once if you have any of these serious side effects:

  • severe burning, stinging, or sensitivity where the medicine is applied;

  • swelling or redness;

  • sudden dizziness or sleepiness after medicine is applied;

  • bruising or purple appearance of the skin; or

  • unusual sensations of temperature.

Less serious Emla side effects may include:

  • mild burning where the medicine is applied;

  • skin redness; or

  • changes in skin color where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Emla?

Before this medication is applied, tell your doctor if you are using any of the following drugs:

  • heart rhythm medication such as mexiletine (Mexitil);

  • acetaminophen (Tylenol);

  • chloroquine (Aralen);

  • dapsone;

  • nitrates or nitrites such as Imdur, Isordil, Monoket;

  • nitrofurantoin (Furadantin, Macrodantin, Macro-Bid);

  • phenobarbital (Luminal, Solfoton);

  • primaquine;

  • quinine; or

  • a sulfa drug (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others).

This list is not complete and there may be other drugs that can interact with Emla. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Emla.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 2.04. Revision Date: 11/19/2009 1:55:24 PM.

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