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Benzocaine (Topical) (Monograph)

Brand names: Americaine, Anacaine, Chiggerex, Chiggertox, Dermoplast, ... show all 9 brands
Drug class: Antipruritics and Local Anesthetics
VA class: NT300
CAS number: 94-09-7

Medically reviewed by Drugs.com on Nov 30, 2023. Written by ASHP.

Introduction

Local anesthetic.

Uses for Benzocaine (Topical)

Dermatologic Conditions

Self-medication for temporary relief of pain and itching associated with minor burns, sunburn, minor cuts or scrapes, insect bites, or minor skin irritations.

Usually used in fixed-combination with an antibacterial (e.g., benzethonium chloride), antipruritic (e.g., menthol), or skin protectant (e.g., calamine).

Hemorrhoids

Self-medication for temporary relief of pain and itching associated with hemorrhoids.

Premature Ejaculation

Self-medication, as a male genital desensitizer, to aid in slowing the onset of ejaculation.

Anesthetic Lubricant

Has been used as a water-soluble lubricant (no longer commercially available in US) for topical anesthesia on intratracheal catheters and pharyngeal and nasal airways to obtund pharyngeal and tracheal reflexes and on nasogastric and endoscopic tubes, urinary catheters, laryngoscopes, proctoscopes, sigmoidoscopes, and vaginal specula; however, methemoglobinemia has occurred when applied to mucous membranes.

Benzocaine (Topical) Dosage and Administration

Administration

Topical Administration

Apply topically to the skin as an aerosol spray, cream, lotion, ointment, or solution.

Avoid contact with the eye(s) and do not apply to deep or puncture wounds or to serious burns.

Aerosol Spray

Shake well prior to use.

Hold spray canister approximately 6–12 inches away from the affected area.

To avoid contact with eyes when applying to face, first spray the drug into the palm of hand and then apply.

Dosage

Pediatric Patients

Dermatologic Conditions
Topical

Children ≥2 years of age (self-medication): Apply 5–20% aerosol spray, cream, lotion, ointment, or solution 3 or 4 times daily or as directed by a clinician.

Hemorrhoids
Topical

Children ≥12 years of age (self-medication): Apply 20% ointment to cleansed, affected area up to 6 times daily.

Adults

Dermatologic Conditions
Topical

Self-medication for the temporary relief of pain and itching associated with various skin conditions, apply 5–20% aerosol spray, cream, lotion, ointment, or solutions 3 or 4 times daily or as directed by a clinician.

Hemorrhoids
Topical

Self-medication for the temporary relief of pain and itching associated with hemorrhoids, apply 20% ointment to cleansed, affected area up to 6 times daily.

Premature Ejaculation
Topical

Self-medication to aid in slowing the onset of ejaculation, apply a small amount of a preparation containing 3–7.5% benzocaine in a water-soluble base to the head and shaft of the penis before intercourse.

After intercourse, wash off any remaining benzocaine to minimize the chance of an allergic reaction occurring.

Cautions for Benzocaine (Topical)

Contraindications

Warnings/Precautions

Warnings

Administration

For external use only.

Avoid contact with the eyes.

Not intended for prolonged use (e.g., >1 week).

When used for self-medication, discontinue the drug and consult a clinician if the condition worsens or symptoms persist for >7 days or clear and occur again within a few days, if infection or bleeding occurs, or if rash or irritation occurs.

When used for genital desensitization, recognize that premature ejaculation may be due to a condition requiring medical attention.

Sensitivity Reactions

Possible sensitization.

If a rash or irritation develops during therapy, discontinue the drug and consult a clinician.

When used for self-medication as a male genital desensitizer, advise the male to use the drug with caution if his sexual partner is sensitive to local anesthetics, sunscreens, sulfa drugs, or hair dyes. Discontinue therapy if rash or irritation (e.g., burning, itching) occurs; consult clinician if symptoms persists.

General Precautions

Methemoglobinemia

Possible methemoglobinemia; closely adhere to dosing recommendations.

Serious Adverse Effects associated with Local Anesthetics

Risk of serious adverse effects (e.g., seizures, coma, irregular heart beat, respiratory depression) with use of topical local anesthetics; generally reported following application of extemporaneously prepared topical preparations containing high concentrations of anesthetics.

Potential for life-threatening adverse effects (e.g., irregular heart beat, seizures, breathing difficulties, coma, death) when topical local anesthetics are applied to a large area of skin, when the area of application is covered with an occlusive dressing, if a large amount of topical anesthetic is applied, if the anesthetic is applied to irritated or broken skin, or if the skin temperature increases (from exercise or use of a heating pad).

Lidocaine 4% gel has been investigated to reduce discomfort during mammography. Whether such use could result in serious reactions has not been determined. Patients should speak with their clinician if they are considering using a topical anesthetic before obtaining a mammogram.

When a topical anesthetic is needed for a procedure, use of an FDA-approved preparation has been recommended. Use a preparation containing the lowest concentration of anesthetic likely to be effective; apply a small amount of the preparation to the affected area for the shortest period necessary for the desired effect, and do not apply to broken or irritated skin.

Specific Populations

Pregnancy

Category C.

Lactation

Not known whether benzocaine is distributed into milk; use with caution.

Pediatric Use

Safety and efficacy of topical aerosol spray, cream, lotion, ointment, or solution not established in children <2 years of age; use only under the direction of a clinician.

Common Adverse Effects

Generally nontoxic when applied topically, but sensitization can occur. Contact dermatitis and/or hypersensitivity can result in burning, stinging, pruritus, tenderness, erythema, rash, urticaria, and edema.

Male genital desensitization preparations usually do not adversely affect female orgasm in the sexual partner, but sensitization can occur. (See Sensitivity Reactions under Cautions.)

Stability

Storage

Topical

Aerosol

<40°C, preferably between 15–30°C.

Do not puncture, use, or store aerosol containers near heat or an open flame, expose to temperatures >49°C, or place into a fire or incinerator for disposal.

Creams

Tight, light-resistant containers at <40°C, preferably between 15–30°C. Avoid prolonged exposure to temperatures >30°C.

Ointments

Tight, light-resistant containers at <40°C, preferably between 15–30°C. Avoid prolonged exposure to temperatures >30°C.

Solutions

<40°C, preferably 15–30°C. Do not freeze.

Actions

Advice to Patients

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Benzocaine

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Aerosol

5%

Foille Medicated First Aid

Blistex

20%

Americaine First Aid Spray

Insight

Dermoplast

MedTech

Solarcaine

Schering-Plough

Cream

5%*

Benzocaine Cream

Ivarest

Blistex

Lotion

0.5%

Solarcaine

Schering-Plough

Ointment

2%

Chiggerex

Scherer

5%

Foille Medicated First Aid

Blistex

10%

Anacaine

Gordon

20%

Americaine Hemorrhoidal Ointment

Insight

Solution

2.1%

Chiggertox

Scherer

20%

Outgro

MedTech

AHFS DI Essentials™. © Copyright 2024, Selected Revisions December 10, 2015. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

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