lidocaine + prilocaine at a glance
Medicine class
Amide-type local anaesthetics
Cream use
Numbs skin or genital tissue before certain procedures and can facilitate leg-ulcer cleansing.
Spray use
Reduces sensitivity of the glans penis in adult men with primary premature ejaculation.
Important practical point
Avoid the eyes and ears, wash hands after use and remove excess product as instructed.
What is lidocaine + prilocaine used for?
Licensed uses depend on the product:
Cream: topical anaesthesia before needle insertion, blood sampling and superficial surgical procedures in adults and children.
Cream: topical anaesthesia of genital mucosa before specified procedures in adults and adolescents aged 12 years or older.
Cream: topical anaesthesia to facilitate mechanical cleansing or debridement of leg ulcers in adults.
Cutaneous spray: treatment of primary premature ejaculation in adult men.
How does lidocaine + prilocaine work?
The ingredients block ion movement needed for nerves to conduct electrical impulses, producing temporary local numbness. On the glans penis, reduced nerve transmission lowers sensitivity and can delay ejaculation.
lidocaine + prilocaine preparations and strengths
Cutaneous spray
Route: Cutaneous
Strengths: 150 mg/mL + 50 mg/mL
How to take lidocaine + prilocaine
Use only the formulation and body site specified in its leaflet or by a healthcare professional.
For cream on intact skin, apply it to clean, dry skin without rubbing and secure it with the advised occlusive dressing. Wash your hands afterwards.
Do not apply cream to open wounds other than leg ulcers under professional supervision. Genital and leg-ulcer applications should be performed by or under healthcare-professional supervision.
Remove the dressing and wipe away excess cream before the procedure as instructed.
The spray is for the glans penis only. Shake and prime the container as directed, retract the foreskin if present, hold the container upright and cover the glans evenly. Wipe off excess before intercourse.
Avoid transfer of spray to a partner’s mouth, genital or anal lining because numbness may mask injury.
Do not use the spray with polyurethane condoms. Compatible materials listed in the SmPC include latex rubber, polyisoprene, nitrile and silicone.
lidocaine + prilocaine side effects
Common or expected effects
- Temporary burning, itching, tingling, warmth, redness, pallor or swelling where cream is applied.
- With the penile spray: reduced genital sensation, genital burning or erectile difficulty.
- A female partner exposed to transferred spray may experience vulvovaginal burning or reduced sensation.
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling, breathing difficulty or collapse.
- Methaemoglobinaemia, which may cause blue or grey skin or lips, breathlessness, confusion or unusual drowsiness.
- Systemic local-anaesthetic toxicity, potentially causing severe dizziness, visual or hearing disturbance, tremor, muscle twitching, seizures or cardiovascular collapse.
- Persistent pain, irritation or visual symptoms after eye exposure.
lidocaine + prilocaine in pregnancy
Topical lidocaine skin cream is considered acceptable in pregnancy by the NHS, but the EMLA SmPC advises care because data for the combination are limited. The penile spray should preferably be avoided when a partner is pregnant unless an effective male barrier prevents exposure. Discuss the product and application site with a healthcare professional.
lidocaine + prilocaine while breastfeeding
The cream can be used during breastfeeding when clinically needed because only small amounts are expected in milk. Wash your hands and keep cream away from the breast and nipple, removing it thoroughly before feeding if accidental contact occurs. Exposure from a male partner’s spray use is not expected to affect a breastfed infant.
lidocaine + prilocaine interactions
Correct topical use usually produces limited systemic exposure, but important interactions remain possible in susceptible people or with excessive exposure.
Methaemoglobin-inducing medicines, including dapsone, sulphonamides, nitrofurantoin, nitrates, phenytoin and phenobarbital
May increase the risk of methaemoglobinaemia, particularly in infants or people with G6PD deficiency, anaemia or an existing methaemoglobin disorder.
Other local anaesthetics or related medicines such as mexiletine
Toxic effects may be additive if systemic exposure is substantial.
Common questions about lidocaine + prilocaine
Answers are fully visible for fast scanning and source review.
What is lidocaine + prilocaine used for?
Depending on the product, it numbs skin or genital tissue before procedures, assists leg-ulcer cleansing, or reduces penile sensitivity in adult men with primary premature ejaculation.
Can the cream be put on broken skin?
Not generally. It is not intended for open wounds except leg ulcers treated for debridement under healthcare-professional supervision.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.