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Generic Name: lidocaine and tetracaine topical (LYE doe kane and TET ra kane TOP i kal)
Brand Name: Pliaglis, Synera

Medically reviewed by on Jan 4, 2019 – Written by Cerner Multum

What is Pliaglis?

Lidocaine and tetracaine are local anesthetics (numbing medicines). They work by blocking nerve signals in your body.

Pliaglis (for use on the skin) is a combination medicine used to numb a small area of your skin. This can help prevent pain during certain medical procedures such as a skin biopsy, minor skin surgery, insertion of an intravenous (IV) needle, or other needle-stick procedures.

Pliaglis is also used to numb a skin area during minor cosmetic procedures such as a Botox injection, laser treatment, or tattoo removal.

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

Important Information

An overdose of numbing medicine can cause fatal side effects if too much of the medicine is absorbed through your skin. This can happen if you apply more than the recommended dose, or if you leave a skin patch on too long.

Keep both used and unused skin patches out of the reach of children or pets.

Before taking this medicine

You should not use Pliaglis if you are allergic to:

  • any type of numbing medicine; or

  • sunscreen or other skin products that contain para-aminobenzoic acid (PABA).

Fatal overdoses have occurred when numbing medicines were used without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). Be aware that many cosmetic procedures are performed without a medical doctor present.

To make sure Pliaglis is safe for you, tell your doctor if you have:

  • liver disease;

  • a blood cell disorder called methemeglobinemia;

  • a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency;

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

  • a condition for which you take a heart rhythm medicine; or

  • allergy to any other medicine used for anesthesia.

Pliaglis is not expected to harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether this medicine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Pliaglis?

Follow all directions on your prescription label. Never use this medicine in larger amounts, or for longer than prescribed.

Pliaglis is usually applied 20 to 30 minutes before your procedure (or 60 minutes before tattoo removal).

If you use this medicine at home, read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Pliaglis comes in a cream or a skin patch.

Do not take by mouth. Topical medicine is for use only on the skin. If this medicine gets in your mouth, nose, rectum, or vagina, rinse with water.

The Pliaglis cream should not be used on a child younger than 3 years old. The skin patch is not approved for use by anyone younger than 18 years old.

For a cosmetic procedure, a healthcare professional or other care provider will apply Pliaglis cream to your skin.

As it dries, the cream turns into a film that can be peeled off after the prescribed amount of numbing time. Your care provider will remove the cream and clean your skin before your procedure.

If you use a Pliaglis skin patch, apply it only to clean, dry, healthy skin on the area to be numbed. Press firmly into place. You may begin to feel a warming sensation. Mild warmth from the skin patch is normal, but it should not feel unpleasantly hot.

Wash your hands after applying a skin patch.

After your prescribed amount of numbing time, remove the skin patch, then clean and disinfect the skin as recommended by your doctor.

After removing a skin patch: fold it in half with the sticky side in, and throw it away in a place out of the reach of children or pets.

Store unused skin patches at room temperature away from moisture and heat.

Both used and unused skin patches should be kept out of the reach of children or pets. The amount of medicine in the skin patches could be harmful to a child or pet who accidentally sucks on or swallows a patch. Seek emergency medical attention if this happens.

What happens if I miss a dose?

Since Pliaglis is used as a single dose, it does not have a daily dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of numbing medicine can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood.

Your body may absorb too much of Pliaglis if:

  • you apply more than the recommended dose;

  • you apply the medicine to skin that is cut or irritated; or

  • you leave a skin patch on your skin for too long.

Overdose symptoms may include numbness or tingling in your face, ringing in your ears, drowsiness, nausea, and slurred speech. Serious complications of lidocaine or tetracaine overdose may include seizure (convulsions), slowed breathing, coma, heart failure, or respiratory failure (breathing stops).

What should I avoid while using Pliaglis?

Do not allow this medicine to come into contact with your eyes. If it does, rinse with water.

Avoid using the medicine on skin that is raw or blistered.

Do not use a skin patch if it has been cut or damaged.

Avoid touching the sticky side of a skin patch while applying it.

Pliaglis side effects

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

Tell your caregivers or call your doctor right away if you have:

  • severe burning, stinging, or other irritation where the medicine was applied;

  • sudden dizziness or drowsiness after the medicine is applied;

  • a nervous or restless feeling;

  • headache, confusion, nausea;

  • blurred vision, ringing in your ears; or

  • unusual sensations of temperature.

Common side effects include:

  • skin redness;

  • skin swelling; 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.

What other drugs will affect Pliaglis?

It is not likely that other drugs you take orally or inject will have an effect on topically applied lidocaine and tetracaine. However, some drugs can cause conditions that may make it harmful for you to use Pliaglis. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

  • Your pharmacist has information about Pliaglis.

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

More about Pliaglis (lidocaine / tetracaine topical)

Consumer resources

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Professional resources

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