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Lidocaine / Tetracaine Topical Side Effects

Medically reviewed by Drugs.com. Last updated on Aug 17, 2023.

Applies to lidocaine/tetracaine topical: topical application cream, topical application patch extended release.

Serious side effects

Along with its needed effects, lidocaine/tetracaine topical may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking lidocaine / tetracaine topical:

More common side effects

  • flushing or redness of the skin
  • swelling
  • unusually warm skin

Less common side effects

  • blistering, burning, crusting, dryness, or flaking of the skin
  • change in the color of treated skin
  • itching, scaling, severe redness, soreness, or swelling of the skin
  • rash

Rare side effects

  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chills
  • cough
  • fainting or loss of consciousness
  • fast or irregular breathing
  • fever
  • hives or welts
  • hoarseness
  • lower back or side pain
  • painful or difficult urination
  • swelling of the eyes or eyelids
  • tightness in the chest
  • trouble with breathing

Incidence not known

  • blurred vision
  • chest pain or discomfort
  • cold, clammy, or pale skin
  • confusion
  • difficulty with breathing
  • difficulty with swallowing
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast, slow, or irregular heartbeat
  • feelings of coldness, heat, or numbness
  • irregular, fast or slow, or shallow breathing
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • no breathing
  • noisy breathing
  • pale or blue lips, fingernails, or skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • shakiness in the legs, arms, hands, or feet
  • slow heart rate
  • sweating
  • trembling or shaking of the hands or feet
  • twitching
  • unusual tiredness or weakness

Get emergency help immediately if any of the following symptoms of overdose occur while taking lidocaine / tetracaine topical:

Symptoms of overdose

Other side effects

Some side effects of lidocaine / tetracaine topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare side effects

Incidence not known

  • continuing ringing or buzzing or other unexplained noise in the ears
  • depression
  • double vision
  • drowsiness
  • false or unusual sense of well-being
  • fear
  • hearing loss
  • nervousness

Managing side effects (general information)

For healthcare professionals

Applies to lidocaine / tetracaine topical: topical cream, topical film.

Local adverse events

Local side effects have included erythema , blanching, edema, or abnormal sensation at the site of treatment. The most common of the local reactions were erythema (71%), blanching (12%), and edema (12%). These reactions were generally mild, and resolved spontaneously soon after treatment.[Ref]

Hypersensitivity

Hypersensitivity side effects have included allergic or anaphylactoid reactions to the active or inactive ingredients. They may be characterized by urticaria, angioedema, bronchospasm, and shock.[Ref]

Nervous system

Nervous system side effects are unlikely with appropriate use of lidocaine-tetracaine topical. Potential side effect include CNS excitation and/or depression (light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold, or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest). Excitatory CNS reactions may be brief or not occur at all, in which case the first manifestation may be drowsiness developing into unconsciousness. Signs of CNS toxicity may start at plasma concentrations of lidocaine as low as 1000 ng/mL. The plasma concentrations at which tetracaine toxicity may occur are less well characterized; however, systemic toxicity with tetracaine is thought to occur with much lower plasma concentrations compared with lidocaine. The toxicity of co-administered local anesthetics is thought to be at least additive.[Ref]

Cardiovascular

Cardiovascular side effects are unlikely with appropriate use of lidocaine-tetracaine topical. Potential side effects include bradycardia, hypotension and cardiovascular collapse leading to arrest.[Ref]

References

1. (2005) "Product Information. Synera (lidocaine-tetracaine topical)." Ferndale Laboratories Inc

Further information

Lidocaine/tetracaine topical side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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