Emla - instructions for use, reviews, analogues and release forms (cream, ointment or gel, plaster) of an anesthetic drug for superficial anesthesia of the skin, including for hair removal in adults, children and pregnancy

In this article, you can read the instructions for using the drug Emla. Comments of visitors of the site - consumers of this medication, as well as opinions of specialists on the use of an anesthetic Emla in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Emla in the presence of existing structural analogues.Use for superficial anesthesia of the skin, including with epilation in adults, children, as well as during pregnancy and lactation.

Emla - a preparation for superficial anesthesia of the skin and mucous membranes. The action of the drug is provided by its constituent components - Lidocaine and prilocaine, which are local anesthetics of the amide type. Local anesthetics, penetrating the layers of the epidermis and the dermis, cause skin anesthesia.

The degree of anesthesia depends on the dose of the drug and the duration of the application.

After applying the cream to the intact skin for 1-2 hours, the duration of anesthesia after the removal of the occlusive dressing is 2 hours. In puncture biopsies, the use of Emla cream provides adequate anesthesia of intact skin in 90% of patients 60 minutes after application.

Anesthesia of the mucous membrane of the genital organs is achieved faster than intact skin, because of faster absorption of the drug. In women, 5-10 minutes after applying Emla cream, an anesthetic is achieved on the mucous membrane of the genital organs, sufficient for the relief of pain caused by the use of an argon laser; The duration of anesthesia is 15-20 min (taking into account individual characteristics from 5 to 45 min).

In the treatment of trophic ulcers of the lower extremities, the duration of anesthesia after application of the cream is up to 4 hours. There is no negative effect of the drug on the healing of ulcers or against bacterial flora.

Due to the action of the Emla preparation on the surface vessels, temporary blanching or reddening of the skin is possible. Similar reactions in patients with advanced neurodermatitis (atopic dermatitis) can occur more quickly, as early as 30-60 minutes after use, indicating a faster penetration of the drug through the skin.

During the puncture biopsy (diameter 4 mm), the application of the Emla preparation for 60 minutes provided an anesthesia of intact skin sufficient for the introduction of the needle to a depth of 2 mm in 90% of patients, and for the use of the Emla preparation for 120 minutes - to a depth of 3 mm. Efficacy does not depend on skin color or pigmentation (skin type 1-4).

Composition

Lidocaine + Prilocaine + excipients.

Pharmacokinetics

Systemic absorption of the drug depends on the dose, the duration of the application and the thickness of the skin (depends on the area of ​​the body), as well as other skin features.

In adults, after application to the intact skin for 3 hours, the systemic absorption for lidocaine was approximately 3% and for prilocaine 5%. Suction is slow.

In patients with advanced neurodermatitis, the rate of absorption increases.

Indications

Surface anesthesia:

• skin with puncture and catheterization of vessels and superficial surgical interventions;
• trophic ulcers of the lower extremities during surgical treatment (mechanical cleaning);
• mucous membranes of the genitals before carrying out painful manipulations and for anesthetizing before injecting local anesthetics.

Forms of release

Cream for local and external use (sometimes mistakenly called ointment or gel).

Therapeutic system TC (patch).

Instructions for use and how to use them

Patch

External to the skin.

Adults: 1 or more vehicles at a time. Time of application: not less than 1 hour.

Children from 1 to 12 years: 1 or more vehicles at the same time. Time of application: not less than 1 hour.

Children from 3 to 12 months: 1 or 2 (maximum) of the vehicle at the same time. Time of application: 1 h.

Children from 0 to 3 months: not more than 1 TC per day (maximum dose). Application time: no more than 1 hour.

Increasing the application time by more than 5 hours does not lead to an increase in anesthesia. In children with advanced neurodermatitis (atopic dermatitis), the time of application should be reduced to 30 minutes.

Cream

Adults for surface anesthesia of intact skin Emla cream is applied to the skin under the occlusive dressing.

For surface anesthesia of trophic ulcers of the lower limbs, before their surgical treatment (mechanical cleaning), the cream should be applied with a thick layer on the ulcerous surface under an occlusive dressing made of PVC at a dose of 1-2 g / 10 cm2 (no more than 10 g per procedure) for 30 minutes. If penetration of the drug into the ulcer tissue is difficult, the duration of the application can be increased to 60 minutes. Mechanical cleaning of the ulcer should be started no later than 10 minutes after removal of the cream.

For surface anesthesia of the genitals before injections of local anesthetics cream should be applied a thick layer on the skin to men in a dose of 1-2 g / 10 cm2 for 15 minutes, for women - in a dose of 1 g / 10 cm2 for 60 min.

For superficial anesthesia of the mucous membrane of the genital organs, when removing genital warts and before injecting local anesthetics, 5-10 g of cream (depending on the area of ​​the treated surface) is applied to the entire surface of the mucous membrane, including folds. Application time 5-10 min.The procedure should be carried out immediately after removal of the cream.

Children for superficial anesthesia of the intact skin before the puncture of the vessel or superficial surgical interventions Emla cream is applied a thick layer on the skin under the occlusive dressing. The dose of the drug should correspond to the surface to be treated and should not exceed 1 g of cream per 10 cm2.

Side effect

• pallor;
• hyperemia;
• swelling at the site of application (due to the action on surface vessels);
• slight burning and itching immediately after application;
• hemorrhagic rash or pinpoint hemorrhages, especially after prolonged use in children with a common neurodermatitis or molluscum contagiosum;
• allergic reactions (in severe cases - anaphylactic shock);
• methemoglobinemia in children.

Contraindications

• methemoglobinemia;
• premature babies born at the gestational age of less than 37 weeks;
• hypersensitivity to local anesthetics of the amide type or any other component of the preparation.

Application in pregnancy and lactation

In animal studies, there was no direct or indirect adverse effect of the drug on pregnancy,intrauterine fetal development, on the process of birth or postnatal development.

It is possible to use Emla during pregnancy and lactation according to indications and in recommended doses.

Lidocaine and prilocaine are excreted in breast milk in quantities that do not pose a risk to the baby.

Use in children

In children under 3 months of age, the safety and efficacy of using Emla cream is determined after a single dose. In children of this age, after the application of the cream, there may be a temporary increase in the concentration of methhemoglobin in the blood up to 13 hours, which has no clinical significance.

Patients (especially children) with a common neurodermatitis (atopic dermatitis) should be reduced to 15-30 minutes.

The effectiveness of the cream in newborns is not established in the procedure for taking blood samples from the heel.

special instructions

Care should be taken when applying Emla cream near the eyes, as the preparation causes irritation of the cornea.

Patients with glucose-6-phosphate dehydrogenase deficiency or hereditary or idiopathic methaemoglobinemia are more at risk of developing drug-dependent methaemoglobinaemia.

Do not use the cream if it can penetrate into the middle ear.

Do not apply the cream to open wounds.

There is information about the use of the drug in the form of a patch when performing cosmetic procedures (hair removal, depilation).

Lidocaine and prilocaine in concentrations above 0.5-2% have bactericidal and antiviral properties. In this regard, it is recommended to pay special attention to the use of the drug before subcutaneous administration of a live vaccine (for example, BCG).

Drug Interactions

With the simultaneous use of Emla with other local anesthetics and structurally similar drugs (including tokaine), the risk of systemic side effects may be increased.

With the simultaneous use of the Emla preparation with drugs that induce the development of methemoglobinemia, drugs containing a sulfo group may increase the concentration of methemoglobin in the blood.

Analogues of the drug Emla

Emla does not have structural analogs for the active substance.

Analogues for the pharmacological group (local anesthetics):

• Alfacaine;
• Amprovisol;
• Anestesol;
• Articaine;
• Artifrin;
• Artifrin forte;
• Aurobin;
• Dent;
• Dentinox;
• Drill;
• Instillagel;
• Kamistad;
• Lidocaine cage;
• Lidocaine;
• Lidochlor;
• Markain Adrenaline;
• Menovazine;
• Novosept Forte;
• Otypax;
• Otyrerelax;
• Primacaine with adrenaline;
• Procto Glivenol;
• Relief Advance;
• Septanest with adrenaline;
• Scandinibs forte;
• Ubistezin;
• Ubistezin forte;
• Ultracaine;
• Fastin 1;
• Folikap;
• Cytokapin.

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