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Lidocaine/tetracaine (On the skin)

Lidocaine (LYE-doe-kane), Tetracaine (TE-tra-kane)

Numbs a small area of the skin to reduce pain before drawing blood or placing an intravenous (IV) line or when the skin has to be cut during a medical procedure.

Brand Name(s):

Pliaglis, Synera

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to lidocaine, tetracaine, or similar medicines, or para-aminobenzoic acid.

How to Use This Medicine:

Cream, Patch

  • A nurse or other trained health professional will give you this medicine.
  • You may also be taught how to give your medicine at home. Make sure you understand all instructions before you apply the patch. Do not use more medicine or use it more often than your doctor tells you to.
  • The patch is applied to your skin about 20 to 30 minutes before your procedure. Do not cover the vent holes in the top of the skin patch while you are wearing it. Tell your doctor if you still have feeling in the skin after 30 minutes have passed.
  • This medicine is for use only on the skin. Do not get this medicine into your eyes. If it does get into your eyes, rinse with water or saline solution right away.
  • Wash your hands with soap and water before and after applying a patch.
  • Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
  • Do not apply this medicine to open wounds, burns, broken, irritated, or inflamed skin, or to a large area of the skin, unless directed by your doctor.
  • Do not cut the patch or tear it apart in any way. This could cause medicine to leak out of the patch and burn your skin.
  • Do not keep a patch on longer than what your doctor ordered or apply multiple patches at the same time and application site as the first patch.
  • Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it. You will also need to throw away old patches after the expiration date has passed.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Some medicines can affect how lidocaine/tetracaine works. Tell your doctor if you are using any of the following:
    • Acetaminophen, chloroquine, metoclopramide, primaquine, quinine, sulfasalazine
    • Cancer medicine (including cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase)
    • Medicine for heart rhythm problems (including mexiletine, tocainide)
    • Medicine to treat an infection (including dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamide)
    • Medicine to treat seizures (including phenobarbital, phenytoin, sodium valproate)
    • Nitrate or nitrite medicine (including nitric oxide, nitroglycerin, nitroprusside, nitrous oxide)
    • Other anesthetic medicines

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, heart problems, lung or breathing problems, a blood disorder, or a genetic disease (including pseudocholinesterase deficiency, G6PD deficiency).
  • This medicine may cause methemoglobinemia (blood disorder).
  • Your treated skin areas may still be numb for several hours after using the skin patch. Be careful not to accidentally injure the skin by scratching or rubbing it while it is still numb. Avoid exposing the skin to very hot or cold temperatures until your feeling returns.
  • Make sure any doctor who treats you knows that you are using this medicine. You must stop using this medicine before you have an MRI (magnetic resonance imaging) scan. You may also need to stop using this medicine before having a breast exam or other medical procedure.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Burning where the patch is applied
  • Confusion, blurred vision
  • Fast, pounding, or irregular heartbeat
  • Lightheadedness, dizziness, or fainting
  • Pale, gray, or blue lips, nails, or skin, dark urine, headache, unusual tiredness or weakness
  • Seizures
  • Shallow or difficulty breathing

If you notice these less serious side effects, talk with your doctor:

  • Eye irritation, sore eyes
  • Redness, itching, or swelling, where the patch is applied

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 3/19/2020

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