ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Benzocaine: Drug information

Benzocaine: Drug information
(For additional information see "Benzocaine: Patient drug information" and see "Benzocaine: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Aftertest Topical Pain Relief [OTC] [DSC];
  • Allevacaine [OTC];
  • Anacaine [DSC];
  • Anbesol Cold Sore Therapy [OTC];
  • Anbesol Maximum Strength [OTC];
  • Anbesol [OTC] [DSC];
  • Baby Anbesol [OTC];
  • Benz-O-Sthetic [OTC] [DSC];
  • CankerMelts [OTC];
  • Cepacol INSTAMAX [OTC] [DSC];
  • Cepacol [OTC] [DSC];
  • Dent-O-Kain/20 [OTC] [DSC];
  • Foille [OTC] [DSC];
  • GoodSense Oral Pain Relief [OTC];
  • HurriCaine One [OTC];
  • Hurricaine [OTC];
  • Hurricane Snap-n-Go [OTC];
  • HurriPak Starter Kit [OTC];
  • Instant Oral Pain Relief Max [OTC];
  • Ivy-Rid [OTC];
  • Kank-A Mouth Pain [OTC] [DSC];
  • LolliCaine [OTC];
  • Ora-film [OTC];
  • Topex Topical Anesthetic [DSC];
  • Zilactin Baby [OTC]
Pharmacologic Category
  • Analgesic, Topical;
  • Local Anesthetic
Dosing: Adult

Note: General dosing guidelines provided; refer to specific product labeling for dosing instructions.

Dermal irritation

Dermal irritation: Topical (external): Ointment 5%, spray 5% and 20%: Apply to affected area or use 1 spray up to 3 to 4 times daily as needed (frequency may vary by product; also refer to manufacturer's labeling). In cases of bee stings, remove stinger before treatment.

Hemorrhoids, anorectal pain/itch

Hemorrhoids, anorectal pain/itch:

Note: Combine with dietary modifications, bowel hygiene, and warm sitz baths for best results (Ref). General dosing guidelines provided; refer to specific product labeling for dosing instructions.

Ointment 20%: Topical (external): Apply to anal area, as needed, up to 6 times daily.

Mouth and gum irritation

Mouth and gum irritation: Topical (oral): Cream 20%, gel 10% or 20%, liquid 10% or 20%, ointment 20%, spray 5%: Apply thin layer to affected area or use 1 spray up to 4 times daily as needed.

Poison ivy/sumac

Poison ivy/sumac: Topical (external): Spray 5% (Ivy-Rid only): Spray affected area until wet.

Sore throat/mouth

Sore throat/mouth: Topical (oral):

Gel, liquid, or spray 20% (Hurricaine products only): Spray on affected area or throat up to 4 times daily.

Lozenge: Allow 1 lozenge to dissolve slowly in mouth; may repeat every 2 hours as needed.

Topical anesthetic

Topical anesthetic: Topical (oral): Gel or spray 20% (Topex products only): Apply a small amount to mucosa to achieve topical anesthesia.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Benzocaine: Pediatric drug information")

Note: General dosing recommendations provided; refer to specific product labeling for dosing instructions. Due to risk of methemoglobinemia, AAP, FDA, and the American Academy of Pediatric Dentistry do NOT recommend use for teething and mouth pain in infants and children <2 years (Ref).

Dermal irritation

Dermal irritation (insect bites, minor cuts, scrapes, minor burns, sunburn): Topical: 20% spray, 5% ointment: Children ≥2 years and Adolescents: Apply to affected area 3 to 4 times daily as needed.

Mouth and gum irritation

Mouth and gum irritation (including fever blisters and cold sores): Topical:

Oral 10% or 20% gel/liquid: Children ≥2 years and Adolescents: Apply thin layer to affected area up to 4 times daily as needed.

Oral 5% spray: Children ≥6 years and Adolescents: Use 1 spray to affected area up to 4 times daily.

Sore throat/mouth, gag reflex suppression

Sore throat/mouth, gag reflex suppression:

Oral: Oral lozenge: Children ≥5 years and Adolescents: Allow 1 lozenge to dissolve slowly in mouth; may repeat every 2 hours as needed.

Topical: Note: Consult product labeling for specific dose recommendations.

Oral spray 5%: Children ≥6 years and Adolescents: Use 1 spray to affected area or throat up to 4 times daily.

Oral spray 20%: Children ≥2 years and Adolescents: Spray on affected area or throat up to 4 times daily.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

There are no adverse reactions listed in the manufacturer's labeling.

Postmarketing:

Dermatologic: Acute generalized exanthematous pustulosis (O’Toole 2014), allergic contact dermatitis (González-Rodríguez 2013), dermatologic disorder (erosive papulonodular dermatosis) (Robson 2006)

Hematologic & oncologic: Methemoglobinemia (Maraj 2021)

Hypersensitivity: Anaphylaxis (Vu 2006), hypersensitivity reaction (Sidhu 1999), type IV hypersensitivity reaction (Vu 2006)

Contraindications

Hypersensitivity to benzocaine, para-aminobenzoic acid (PABA), or any component of the formulation

OTC labeling: When used for self-medication, do not use if you have allergy to local anesthetics (procaine, butacaine, benzocaine, or other "caine" anesthetics). Do not use over deep or puncture wounds, animal bites, infections, serious burns, or lacerations. Do not use products indicated for topical oral use in children <2 years of age or for teething.

Warnings/Precautions

Concerns related to adverse effects:

• Methemoglobinemia: Has been reported following topical use, particularly with higher concentration (14% to 20%) spray formulations applied to the mouth or mucous membranes. When applied as a spray to the mouth or throat, multiple sprays (or sprays of longer than indicated duration) are not recommended. Use caution with breathing problems (asthma, bronchitis, emphysema, in smokers), inflamed/damaged mucosa, heart disease, children <6 months of age, and hemoglobin or enzyme abnormalities (glucose-6-phosphate dehydrogenase deficiency, hemoglobin-M disease, NADH-methemoglobin reductase deficiency, pyruvate-kinase deficiency). Alternatives to benzocaine sprays, such as topical lidocaine preparations, should be considered for patients at higher risk of this reaction. The classical clinical finding of methemoglobinemia is chocolate brown-colored arterial blood. However, suspected cases should be confirmed by co-oximetry, which yields a direct and accurate measure of methemoglobin levels. Standard pulse oximetry readings or arterial blood gas values are not reliable. Clinically significant methemoglobinemia requires immediate treatment (Anderson 1988; Cooper 1997; Moore 2004).

Special populations:

• Pediatric: Due to risk of methemoglobinemia, AAP, FDA, and the American Academy of Pediatric Dentistry do NOT recommend use for teething and mouth pain in infants and children <2 years of age (AAP 2011; AAPD 2012; FDA 2018).

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol with caution in neonates. See manufacturer's labeling.

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP 1997; Zar 2007). See manufacturer’s labeling.

• Rectal ointment: For external use only; do not insert into rectum using fingers or any mechanical device or applicator.

Other warnings/precautions:

• Self-medication (OTC use): When used for self-medication, notify healthcare provider if condition worsens, or does not improve within 7 days; clears up and occurs again within a few days; or if accompanied by additional symptoms (eg, swelling, rash, headache, nausea, vomiting, or fever). Do not use topical products on open wounds; avoid contact with the eyes. Do not use for a prolonged time and/or on large portions of the body.

• Topical application: When topical anesthetics are used prior to cosmetic or medical procedures, the lowest amount of anesthetic necessary for pain relief should be applied. High systemic levels and toxic effects (eg, methemoglobinemia, irregular heartbeats, respiratory depression, seizures, death) have been reported in patients who (without supervision of a trained professional) have applied topical anesthetics in large amounts (or to large areas of the skin), left these products on for prolonged periods of time, or have used wraps/dressings to cover the skin following application.

Warnings: Additional Pediatric Considerations

There is a significant safety risk of methemoglobinemia with benzocaine use. The majority of cases of methemoglobinemia associated with benzocaine use have been in infants and children <2 years of age for treatment of teething and mouth pain; also at greater risk for development are patients with asthma, bronchitis, emphysema, mucosal damage, or inflammation at the application site, heart disease, and malnutrition. The FDA has strengthened their warning against using topical OTC benzocaine for teething pain and are urging manufacturers to stop marketing OTC oral benzocaine products for treatment of teething in infants and children <2 years of age and to add contraindications to use in teething and treatment in infants and children <2 years (FDA Safety Announcement 2018). The use of OTC topical anesthetics (eg, benzocaine) for teething pain is also discouraged by AAP and The American Academy of Pediatric Dentistry (AAP 2011; AAPD 2012). The AAP recommends managing teething pain with a chilled (not frozen) teething ring or gently rubbing/massaging with the caregiver's finger.

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Aerosol, External:

Ivy-Rid: 2% (85 g)

Aerosol, Mouth/Throat:

Hurricaine: 20% (57 g) [contains polyethylene glycol (macrogol), saccharin; mint flavor]

Hurricaine: 20% (57 g) [contains polyethylene glycol (macrogol), saccharin sodium]

Hurricaine: 20% (57 g) [contains polyethylene glycol (macrogol), saccharin sodium; wild cherry flavor]

Topex Topical Anesthetic: 20% (57 g [DSC]) [contains alcohol, usp, polyethylene glycol (macrogol), saccharin sodium; cherry flavor]

Disk, Mouth/Throat:

CankerMelts: 15 mg (20 ea)

Gel, Mouth/Throat:

Anbesol: 10% (9 g [DSC]) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), fd&c yellow #6 (sunset yellow), methylparaben, propylene glycol, quinoline yellow (d&c yellow #10), saccharin; cool mint flavor]

Anbesol Maximum Strength: 20% (9 g) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), methylparaben, polyethylene glycol (macrogol), polysorbate 80, propylene glycol, quinoline yellow (d&c yellow #10), saccharin sodium]

Anbesol Maximum Strength: 20% (9 g [DSC]) [contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), methylparaben, quinoline yellow (d&c yellow #10), saccharin]

Baby Anbesol: 7.5% (9 g)

Benz-O-Sthetic: 20% (15 g [DSC], 29 g [DSC]) [contains benzyl alcohol, saccharin sodium]

GoodSense Oral Pain Relief: 20% (14 g) [gluten free; contains polyethylene glycol (macrogol), saccharin sodium]

Hurricaine: 20% (1.2 g) [contains polyethylene glycol (macrogol), saccharin sodium]

Hurricaine: 20% (1.2 g, 42.52 g) [contains polyethylene glycol (macrogol), saccharin sodium; fresh mint flavor]

Hurricaine: 20% (1 ea, 60 ea, 28.4 g) [contains polyethylene glycol (macrogol), saccharin sodium; mint flavor]

Hurricaine: 20% (1 ea, 60 ea, 1.2 g, 30 g, 42.52 g) [contains polyethylene glycol (macrogol), saccharin sodium; pina colada flavor]

Hurricaine: 20% (1 ea, 60 ea, 30 g, 42.52 g) [contains polyethylene glycol (macrogol), saccharin sodium; strawberry flavor]

Hurricaine: 20% (1 ea, 60 ea, 1.5 g [DSC], 30 g, 42.52 g) [contains polyethylene glycol (macrogol), saccharin sodium; watermelon flavor]

Hurricaine: 20% (1 ea, 60 ea, 1.2 g, 5.25 g, 30 g, 42.52 g) [contains polyethylene glycol (macrogol), saccharin sodium; wild cherry flavor]

Instant Oral Pain Relief Max: 20% (14.2 g) [contains polyethylene glycol (macrogol), saccharin sodium]

LolliCaine: 20% (120 ea) [contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), quinoline yellow (d&c yellow #10), saccharin sodium]

Zilactin Baby: 10% (9.4 g) [alcohol free, dye free, saccharin free]

Kit, Mouth/Throat:

HurriPak Starter Kit: 20% [contains polyethylene glycol (macrogol), saccharin sodium]

Liquid, Mouth/Throat:

Anbesol: 10% (12 mL [DSC]) [contains fd&c blue #1 (brilliant blue), fd&c yellow #6 (sunset yellow), methylparaben, quinoline yellow (d&c yellow #10), saccharin; cool mint flavor]

Anbesol Maximum Strength: 20% (12 mL) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), methylparaben, polyethylene glycol (macrogol), polysorbate 80, propylene glycol, quinoline yellow (d&c yellow #10), saccharin sodium]

Anbesol Maximum Strength: 20% (12 mL [DSC]) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), methylparaben, polyethylene glycol (macrogol), propylene glycol, quinoline yellow (d&c yellow #10), saccharin]

Benz-O-Sthetic: 20% (56 g [DSC]) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), polyethylene glycol (macrogol), propylene glycol, quinoline yellow (d&c yellow #10), saccharin]

Dent-O-Kain/20: 20% (9 mL [DSC]) [contains benzyl alcohol, d&c yellow #11 (quinoline yellow ss), fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), propylene glycol, saccharin]

Lozenge, Mouth/Throat:

Cepacol: Benzocaine 15 mg and menthol 2.3 mg (16 ea [DSC]) [contains fd&c yellow #6 (sunset yellow); tangerine flavor]

Cepacol INSTAMAX: Benzocaine 15 mg and menthol 20 mg (16 ea [DSC]) [contains fd&c red #40 (allura red ac dye), quinoline yellow (d&c yellow #10); cherry flavor]

Cepacol INSTAMAX: Benzocaine 15 mg and menthol 20 mg (16 ea [DSC]) [sugar free; contains fd&c yellow #6 (sunset yellow); berry flavor]

Ointment, External:

Anacaine: 10% (30 g [DSC])

Anbesol Cold Sore Therapy: (9 g) [contains aloe, vitamin e (vit e)]

Foille: 5% (28 g [DSC])

Solution, Mouth/Throat:

Allevacaine: 20% (1 ea, 25 ea) [contains alcohol, usp, polyethylene glycol (macrogol), saccharin sodium]

Benz-O-Sthetic: 20% (30 mL [DSC]) [contains polyethylene glycol (macrogol), saccharin]

Hurricaine: 20% (30 mL) [contains polyethylene glycol (macrogol), saccharin sodium; pina colada flavor]

Hurricaine: 20% (30 mL) [contains polyethylene glycol (macrogol), saccharin sodium; wild cherry flavor]

HurriCaine One: 20% (2 ea, 25 ea) [contains polyethylene glycol (macrogol), saccharin sodium]

Kank-A Mouth Pain: 20% (9.75 mL [DSC]) [contains benzyl alcohol, propylene glycol, saccharin sodium]

Stick, External:

Aftertest Topical Pain Relief: 10% (4 mL [DSC]) [contains menthol, propylene glycol]

Strip, Mouth/Throat:

Ora-film: 6% (12 ea) [contains fd&c blue #1 (brilliant blue), fd&c yellow #5 (tartrazine), menthol, methylparaben, propylparaben]

Swab, Mouth/Throat:

Benz-O-Sthetic: 20% (2 ea [DSC]) [contains benzyl alcohol, polyethylene glycol (macrogol), saccharin sodium]

Hurricane Snap-n-Go: 20% (72 ea) [contains polyethylene glycol (macrogol), saccharin sodium; wild cherry flavor]

Generic Equivalent Available: US

May be product dependent

Pricing: US

Aerosol (Hurricaine Mouth/Throat)

20% (per gram): $0.55

Disk (CankerMelts Mouth/Throat)

15 mg (per each): $0.57

Gel (Baby Anbesol Mouth/Throat)

7.5% (per gram): $0.46

Gel (Hurricaine Mouth/Throat)

20% (per gram): $2.48

Gel (LolliCaine Mouth/Throat)

20% (per each): $0.53

Gel (Zilactin Baby Mouth/Throat)

10% (per gram): $0.40

Kit (HurriPak Starter Kit Mouth/Throat)

20% (per mL): $1.46

Solution (Allevacaine Mouth/Throat)

20% (per each): $10.97

Solution (Hurricaine Mouth/Throat)

20% (per mL): $0.30

Solution (HurriCaine One Mouth/Throat)

20% (per each): $14.78

Strip (Ora-film Mouth/Throat)

6% (per each): $0.28

Swab (Hurricane Snap-n-Go Mouth/Throat)

20% (per each): $0.42

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Note: Avoid contact with eyes and other mucous membranes. Some spray products may contain flammable ingredients, do not use near fire, flame, or heat. Some products may stain certain fabrics; avoid contact with clothing or furniture. Product-specific application instructions may vary; also refer to manufacturer's labeling.

Topical, external:

Ointment: Apply evenly. For hemorrhoids, when possible, cleanse affected area with mild soap and warm water then thoroughly rinse; gently dry with toilet tissue or soft cloth before applying ointment.

Spray: Shake well prior to use. Hold 6 to 12 inches or as directed from the affected area. For application to face, first spray into palm of hand, then touch hand to face. Do not apply to broken, blistered, or abraded skin.

Topical, oral:

Cream: Apply directly to the gums or to the denture surface that comes in contact with the affected area of the gums; if using with dentures, wait a few minutes then reinsert dentures (may use regular denture adhesive with this product).

Gel/liquid: Apply with cotton applicator or fingertip or as directed to affected area. Allow to remain in place at least 1 minute then spit out. For dental irritation, do not reinsert dentures until irritation or pain is relieved; rinse mouth well before reinserting.

Lozenge: Allow to dissolve slowly in mouth.

Ointment: Apply evenly.

Spray: Shake well prior to use; some products may be used with extension tube for finer direct application; hold extension tube 1 to 2 inches from affected area and spray for ½ second.

Administration: Pediatric

Note: Some products may contain flammable ingredients, do not use near fire, flame or heat. Some products may stain certain fabrics; avoid contact with clothing or furniture.

Oral gel/solution (topical): Apply with cotton applicator or fingertip to affected area. Children <12 years of age should be supervised during use.

Oral lozenge: Allow to dissolve slowly in mouth. Do not crush, chew, or swallow whole.

Topical ointment: Apply evenly. Do not apply over large areas, deep or puncture wounds, animal bites, or serious burns.

Topical spray: Shake spray well prior to use. Hold 6 to 12 inches from the affected area or may use with extension tube for finer direct application (eg, oral mucosal spray). For application to face (eg, for cold sores), first spray into palm of hand, then touch hand to face; avoid contact with the eyes. Do not apply to deep or puncture wounds, infections, lacerations, or to serious burns. Children <12 years of age should be supervised during use.

Use: Labeled Indications

Note: Approved ages and uses for products may vary; consult product labeling for specific information:

Topical, external:

Dermal irritation: Ointment 5%, spray 5% and 20%: Temporary relief of pain and itching associated with minor skin irritations, cuts, scrapes, minor burns, sunburn, and insect bites; prevention of infection in minor cuts, scrapes and burns.

Hemorrhoids, anorectal pain/itch: Ointment 20%: Temporary relief of hemorrhoid symptoms.

Poison ivy/sumac: Spray 5% (Ivy-Rid only): Temporary relief of pain and itching associated with poison ivy/oak/sumac.

Topical, oral:

Mouth and gum irritation:

Cream 20%, Gel 10% and 20%, liquid 10% and 20%, lozenge, spray 5% and 20%: Temporary relief of pain associated with toothache, sore gums, sore throat, canker sores, braces, minor dental procedures, or minor injury of the mouth and gum caused by dentures or orthodontic appliances.

Ointment 20%: Temporary relief of dryness and pain associated with fever blisters and cold sores.

Topical anesthetic: Gel or spray 20% (Topex products only): Topical anesthetic for use on oral mucosa prior to local anesthetic injections, scaling and prophylaxis; to relieve discomfort associated with taking impressions and intraoral radiographs.

Medication Safety Issues
Sound-alike/look-alike issues:

Orabase may be confused with Orinase

Pediatric patients: High-risk medication:

KIDs List: Benzocaine, when used in pediatric patients <2 years of age for teething or pharyngitis, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of methemoglobinemia (strong recommendation; high quality of evidence) (PPA [Meyers 2020]).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

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

Local Anesthetics: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy

Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: 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. Risk C: 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. Risk C: 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. Risk C: Monitor therapy

Monitoring Parameters

Monitor patients for signs and symptoms of methemoglobinemia such as pallor, fatigue, cyanosis, nausea, muscle weakness, dizziness, confusion, agitation, dyspnea and tachycardia. The classical clinical finding of methemoglobinemia is chocolate brown-colored arterial blood. However, suspected cases should be confirmed by co-oximetry, which yields a direct and accurate measure of methemoglobin levels. Standard pulse oximetry readings or arterial blood gas values are not reliable. Clinically significant methemoglobinemia requires immediate treatment.

Mechanism of Action

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

Pharmacokinetics (Adult Data Unless Noted)

Onset: Anesthetic effect: Spray: 15 to 30 seconds.

Absorption: Poor through intact skin; well absorbed from mucous membranes and traumatized skin

Metabolism: Hepatic (to a lesser extent) and plasma via hydrolysis by cholinesterase (Tucker 1986)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AT) Austria: Anaestherit;
  • (BR) Brazil: Solarcaine;
  • (CH) Switzerland: Benzocaine pd;
  • (CL) Chile: Anbesol;
  • (CO) Colombia: Hemorrodil;
  • (DE) Germany: Anaesthesierende salbe | Anaesthesin | Anginhexal dolo | Benzocain | Benzocaine 1a pharma | Lemocin forte mit benzocain | Neo angin benzocain dolo;
  • (DO) Dominican Republic: Americaine | Graneodin | Graneodin B | Orabase dental | Oragard B;
  • (EC) Ecuador: Graneodin Benzoca;
  • (ES) Spain: Dentispray | Hurricaine | Lanacane | Normobucal;
  • (FR) France: Prothyl;
  • (GB) United Kingdom: Burneze | Children's chloraseptic | Lanacane | Ultra chloraseptic;
  • (IE) Ireland: Burneze;
  • (IL) Israel: Lanacane | Vicks;
  • (IN) India: Mucopain | Vagisil;
  • (JP) Japan: Ethyl aminobenzoate;
  • (KR) Korea, Republic of: Benzocain | Hurricaine | J.O.N | Long | Longmen | Varofos;
  • (LB) Lebanon: Vicks;
  • (LV) Latvia: Comsi;
  • (MX) Mexico: Garde-b | Graneodin | Graneodin b;
  • (NZ) New Zealand: Codral actirelief sore throat;
  • (PL) Poland: Rectosec;
  • (PR) Puerto Rico: Benz o sthetic | Benzodent | Cora Caine | Orabase | Orabase-B | Vencedor | Zilactin Tooth and Gum;
  • (PY) Paraguay: Mastixan | Mastixan cherry | Mastixan eucalipto | Mastixan menta | Mastixan miel y limon;
  • (RU) Russian Federation: Relief advance;
  • (SK) Slovakia: Akut angin;
  • (TR) Turkey: Vision;
  • (TW) Taiwan: Americaine | Pancaine;
  • (UA) Ukraine: Anaesthesin
  1. Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319. [PubMed 11487763]
  2. Americaine (benzocaine) spray [prescribing information]. Tarrytown, New York: Insight Pharmaceuticals LLC; received September 2020.
  3. Americaine Hemorrhoidal Ointment [prescribing information]. Tarrytown, NY: Insight Pharmaceuticals LLC; 2015.
  4. American Academy of Pediatric Dentistry. Guideline on infant oral health care. 2012. http://www.aapd.org/media/Policies_Guidelines/G_infantOralHealthCare.pdf. Accessed September 12, 2016.
  5. American Academy of Pediatrics. Benzocaine products can cause rare, but fatal condition. AAP News. 2011. http://www.aappublications.org/content/early/2011/04/08/aapnews.20110408-1?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed September 12, 2016.
  6. American Academy of Pediatrics Oral Health Initiative. A pediatric guide to children's oral health. January, 2011. Available at http://www2.aap.org/commpeds/dochs/oralhealth/docs/OralHealthFCpagesF2_2_1.pdf
  7. Anbesol Cold Sore Therapy (benzocaine) ointment [prescribing information]. Madison, NJ: Pfizer; received February 2021.
  8. Anbesol Maximum Strength (benzocaine) gel [prescribing information]. Madison, NJ: Pfizer; received February 2021.
  9. Anbesol Regular Strength Cool Mint Gel (benzocaine) [prescribing information]. Madison, NJ: Pfizer; received February 2021.
  10. Anbesol Regular Strength Cool Mint Liquid (benzocaine) [prescribing information]. Madison, NJ: Pfizer; received February 2021.
  11. Anderson ST, Hajduczek J, Barker SJ. Benzocaine-induced methemoglobinemia in an adult: accuracy of pulse oximetry with methemoglobinemia. Anesth Analg. 1988;67(11):1099-1101. [PubMed 3189900]
  12. Bachmann P, Berthier JC, Storme B, et al, “Methemoglobinemia From Ingestion of Benzocaine. A Case of Pediatric Intoxication,” J Toxicol Clin Exp, 1986, 6(2):123-8. [PubMed 3783485]
  13. Benzodent Dental Pain Relieving Cream (benzocaine) [prescribing information]. Chattanooga, TN: Chattem; received September 2016.
  14. Brown S, Girling C, Thapa Magar H, et al. Guidelines, guidelines and more guidelines for haemorrhoid treatment: a review to sort the wheat from the chaff. Colorectal Dis. 2022;24(6):764-772. doi:10.1111/codi.16078 [PubMed 35119707]
  15. Centers for Disease Control (CDC). Neonatal deaths associated with use of benzyl alcohol—United States. MMWR Morb Mortal Wkly Rep. 1982;31(22):290-291. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm [PubMed 6810084]
  16. Cepacol Extra Strength (benzocaine and menthol) [prescribing information]. Parsippany, NJ: RB Health (US); received February 2019.
  17. Cepacol InstaMax (benzocaine and menthol) [prescribing information]. Parsippany, NJ: RB Health (US); received March 2019.
  18. Cepacol InstaMax Sugar Free (benzocaine and menthol) [prescribing information]. Parsippany, NJ: RB Health (US); received March 2019.
  19. Cooper HA. Methemoglobinemia caused by benzocaine topical spray. South Med J. 1997;90(9):946-948. [PubMed 9305310]
  20. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids. Dis Colon Rectum. 2018;61(3):284-292. doi:10.1097/DCR.0000000000001030 [PubMed 29420423]
  21. Dermoplast First Aid (benzocaine) spray [prescribing information]. Cedar Knolls, NJ: Moberg Pharma North America; received March 2018.
  22. Dermoplast Pain Relieving (benzocaine) spray [prescribing information]. Cedar Knolls, NJ: Moberg Pharma North America; received March 2018.
  23. FDA Drug Safety Communication. Reports of a rare, but serious and potentially fatal adverse effect with the use of over-the-counter (OTC) benzocaine gels and liquids applied to the gums or mouth. US Food and Drug Administration website. https://www.fda.gov/Drugs/DrugSafety/ucm250024.htm. Published April 7, 2011.
  24. FDA Safety Announcement. Risk of serious and potentially fatal blood disorder prompts FDA action on oral over-the-counter benzocaine products used for teething and mouth pain and prescription local anesthetics. US Food and Drug Administration website. https://www.fda.gov/Drugs/DrugSafety/ucm608265.htm. Published May 23, 2018. Accessed May 29, 2018.
  25. Food and Drug Administration. Benzocaine and Babies: Not a Good Mix. 2016. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm306062.htm. Accessed September 12, 2016.
  26. Foille Medicated First Aid (benzocaine) ointment [prescribing information]. Oak Brook, IL: Blistex; March 2013.
  27. González-Rodríguez AJ, Gutiérrez-Paredes EM, Revert Fernández Á, Jordá-Cuevas E. Allergic contact dermatitis to benzocaine: the importance of concomitant positive patch test results. Actas Dermosifiliogr. 2013;104(2):156-158. doi:10.1016/j.ad.2011.07.023 [PubMed 22551703]
  28. Guertler AT, Pearce WA. A prospective evaluation of benzocaine-associated methemoglobinemia in human beings. Ann Emerg Med. 1994;24(4):626-630. doi: 10.1016/s0196-0644(94)70272-1 [PubMed 8092589]
  29. Hurricaine (benzocaine) gel [prescribing information]. Bunnell, FL: Beutlich Pharmaceuticals, LLC; received July 2019.
  30. Hurricaine (benzocaine) liquid [prescribing information]. Bunnell, FL: Beutlich Pharmaceuticals, LLC; January 2020.
  31. Hurricaine (benzocaine) spray [prescribing information]. Bunnell, FL: Beutlich Pharmaceuticals; received November 2020.
  32. "Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Pediatrics. 1997;99(2):268-278. doi:10.1542/peds.99.2.268 [PubMed 9024461]
  33. Ivy-Rid (benzocaine) spray [prescribing information]. Fort Myers, FL: Medique Products; August 2013.
  34. Kank-A Mouth Pain (benzocaine) liquid [prescribing information]. Oak Brook, IL: Blistex: received February 2021.
  35. Lanacane First Aid Spray (benzocaine) [prescribing information]. Parsippany, NJ: RB Health US; received November 2023.
  36. Maraj DC, Barak-Norris R, Dankha M. A rare case of benzocaine-induced methemoglobinemia. Cureus. 2021;13(11):e19259. doi:10.7759/cureus.19259 [PubMed 34881122]
  37. Meyers RS, Thackray J, Matson KL, et al. Key potentially inappropriate drugs in pediatrics: the KIDs list. J Pediatr Pharmacol Ther. 2020;25(3):175-191. [PubMed 32265601]
  38. Moore TJ, Walsh CS, Cohen MR, et al. Reported adverse event cases of methemoglobinemia associated with benzocaine products. Arch Intern Med. 2004;164(11):1192-1196. [PubMed 15197044]
  39. O'Toole A, Lacroix J, Pratt M, Beecker J. Acute generalized exanthematous pustulosis associated with 2 common medications: hydroxyzine and benzocaine. J Am Acad Dermatol. 2014;71(4):e147-e149. doi:10.1016/j.jaad.2014.05.041 [PubMed 25219740]
  40. Robson KJ, Maughan JA, Purcell SD, Petersen MJ, Haefner HK, Lowe L. Erosive papulonodular dermatosis associated with topical benzocaine: a report of two cases and evidence that granuloma gluteale, pseudoverrucous papules, and Jacquet's erosive dermatitis are a disease spectrum. J Am Acad Dermatol. 2006;55(5 Suppl):S74-S80. doi:10.1016/j.jaad.2005.12.025 [PubMed 17052539]
  41. Rynn KO, Jahns BE, and Sabbun R, “Acute Myocardial Infarction (AMI) Secondary to Benzocaine-Induced Methemoglobinemia,” Clin Toxicol, 1995, 33(5):495.
  42. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
  43. Shua-Haim JR, Gross JS. Methemoglobinemia toxicity from topical benzocaine spray. J Am Geriatr Soc. 1995;43(5):590. doi: 10.1111/j.1532-5415.1995.tb06117.x [PubMed 7730550]
  44. Sidhu SK, Shaw S, Wilkinson JD. A 10-year retrospective study on benzocaine allergy in the United Kingdom. Am J Contact Dermat. 1999;10(2):57-61. doi:10.1016/s1046-199x(99)90000-3 [PubMed 10357712]
  45. Stein JM, Warfield CA. Local anesthetics: principles of safe use. Hosp Pract (Off Ed). 1983;18(5):73-74, 75-78. doi: 10.1080/21548331.1983.11702539 [PubMed 6404808]
  46. Topex (benzocaine) gel [prescribing information]. York, PA: Sultan Healthcare; November 2014.
  47. Topex (benzocaine) spray [prescribing information]. York, PA: Sultan Healthcare; January 2019.
  48. Tucker GT. Pharmacokinetics of local anaesthetics. Br J Anaesth. 1986; 58(7):717-731. [PubMed 3524638]
  49. Vu AT, Lockey RF. Benzocaine anaphylaxis. J Allergy Clin Immunol. 2006;118(2):534-535. doi:10.1016/j.jaci.2006.04.035 [PubMed 16890789]
  50. Zar T, Graeber C, Perazella MA. Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial. 2007;20(3):217-219. doi: 10.1111/j.1525-139X.2007.00280.x [PubMed 17555487]
  51. Zilactin-B (benzocaine) gel [prescribing information]. Columbus, IN: Blairex Laboratories; received February 2021.
Topic 9092 Version 373.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟