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Lidocaine Tetracaine Brand Names- Pliaglis | Synera
What is Lidocaine Tetracaine
Lidocaine, an amide-type local anesthetic, and tetracaine, an ester-type local anesthetic, are used together in a topical preparation for local anesthesia. Multiple dosage forms are available for clinical use.
A patch (Synera™) contains 70 mg of each anesthetic; the cream (Pliaglis™) contains 70 mg of each anesthetic per gram. Synera™ patch is an emulsion that becomes warm once the outer packaging is removed.
The warming occurs from a chemical reaction that is initiated with oxygen exposure and is intended to enhance local anesthetic delivery. The skin temperature under the patch may increase by up to approximately 5 degrees C, but maximum skin temperature will not exceed 40 degrees C.
The lidocaine tetracaine patch is applied for 20—30 minutes before a procedure. Lidocaine tetracaine cream is applied for 20—30 minutes before superficial procedures such as dermal filler injections or facial laser resurfacing, and for 60 minutes before procedures such as laser-assisted tattoo removal.
The cream is designed to form a pliable peel on the skin when exposed to air.
The FDA approved the Synera™ patch in June 2005 and Pliaglis™ cream in June 2006.
Indications
- local anesthesia
- topical anesthesia
Cream dose based on treatment site surface area:
- Area of 2 inch2: 1 inch (equivalent to 1 gram)
- Area of 3 inch2: 2 inches (equivalent to 3 grams)
- Area of 6 inch2: 5 inches (equivalent to 5 grams)
- Area of 12 inch2: 9 inches (equivalent to 11 grams)
- Area of 16 inch2: 12 inches (equivalent to 13 grams)
- Area of 23 inch2: 18 inches (equivalent to 20 grams)
- Area of 31 inch2: 24 inches (equivalent to 26 grams)
- Area of 39 inch2: 30 inches (equivalent to 33 grams)
- Area of 47 inch2: 36 inches (equivalent to 40 grams)
- Area of 54 inch2: 42 inches (equivalent to 46 grams)
- Area of 62 inch2: 48 inches (equivalent to 53 grams)
For use as local anesthesia to provide topical anesthesia to normal intact skin
for superficial dermatological procedures such as excision, electrodesiccation, and shave biopsy of skin lesions
Side Effects
- acne vulgaris
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- anxiety
- arrhythmia exacerbation
- blurred vision
- bradycardia
- bronchospasm
- bullous rash
- cardiac arrest
- coma
- confusion
- contact dermatitis
- dehydration
- diaphoresis
- dizziness
- drowsiness
- ecchymosis
- edema
- erythema
- euphoria
- fever
- headache
- hyperventilation
- hypotension
- maculopapular rash
- methemoglobinemia
- nausea
- pallor
- paresthesias
- pharyngitis
- pruritus
- rash
- respiratory arrest
- respiratory depression
- restlessness
- seizures
- skin discoloration
- syncope
- tinnitus
- tremor
- urticaria
- vesicular rash
- vomiting
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- accidental exposure
- amide local anesthetic hypersensitivity
- breast-feeding
- burns
- cardiac disease
- children
- eczema
- ester local anesthetic hypersensitivity
- G6PD deficiency
- geriatric
- heart failure
- hepatic disease
- hepatic encephalopathy
- hepatitis
- infants
- magnetic resonance imaging (MRI)
- methemoglobinemia
- neonates
- occlusive dressing
- ocular exposure
- para-aminobenzoic acid, PABA hypersensitivity
- paraben hypersensitivity
- pregnancy
- pseudocholinesterase deficiency
- pulmonary disease
- skin abrasion
Interactions
- Adapalene; Benzoyl Peroxide
- Benzocaine
- Benzocaine; Butamben; Tetracaine
- Benzoyl Peroxide
- Benzoyl Peroxide; Clindamycin
- Benzoyl Peroxide; Erythromycin
- Benzoyl Peroxide; Sulfur
- Chloroxylenol; Hydrocortisone; Pramoxine
- Dibucaine
- Ethyl Chloride
- Hydrocortisone; Pramoxine
- Pramoxine