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Benzalkonium Chloride and Benzocaine

Pronunciation

(benz al KOE nee um KLOR ide & BEN zoe kane)

Index Terms

  • Benzocaine and Benzalkonium Chloride

Pharmacologic Category

  • Topical Skin Product

Pharmacology

Benzalkonium chloride is an antiseptic and disinfectant; benzocaine is an ester local anesthetic that blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction

Use: Labeled Indications

Topical treatment of cold sores

Contraindications

Hypersensitivity to benzalkonium chloride, benzocaine, other ester-type local anesthetics, or any component of the formulation; ophthalmic use; use over a large area of body or >3 times daily; longer than 1 week unless directed by healthcare provider

Dosing: Adult

Cold sore: Topical: Apply single dose to cold sore with applicator

Dosing: Pediatric

Cold sore: Topical: Children >2 years and Adolescents: Refer to adult dosing.

Dosing: Renal Impairment

No dosage adjustment provided in manufacturer's labeling(has not been studied).

Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer's labeling(has not been studied).

Administration

Topical: Prior to administration, clean lotions, ointments, or cosmetics from the lip using only warm water and a washcloth. Saturate the applicator with solution and apply to the cold sore. Allow a few moments for the lip to numb, then massage the solution (using the applicator) into the cold sore by rubbing firmly without damaging the skin. Avoid brushing with toothpaste or drinking fruit juices or soft drinks for at least one hour after application.

Storage

Store at room temperature. Flammable; keep away from heat and flame.

Drug Interactions

Dapsone (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Monitor therapy

Nitric Oxide: May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when nitric oxide is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine. Monitor therapy

Prilocaine: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine in infants receiving such agents. Monitor therapy

Sodium Nitrite: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Monitor therapy

Tetracaine (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Monitor therapy

Adverse Reactions

Frequency not defined.

Dermatologic: Stinging of the skin (short-term)

Local: Local irritation

Warnings/Precautions

Other warnings/precautions:

• Appropriate use: For topical use only. If symptoms persist for 7-10 days after treatment then reassess.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience stinging. Have patient report immediately to prescriber severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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