Over-the-counter lidocaine: uses, side effects, and warnings


Lidocaine is an anesthetic and causes a temporary loss of sensation (eg, pain) in the skin and surrounding tissues. Creams containing lidocaine are used to prevent and treat pain and discomfort during certain medical procedures. It is also available as an over-the-counter medicine that can be used to relieve itching and pain from minor burns, scratches, and insect bites.

Lidocaine-only creams and ointments include AneCream, Aspercreme with Lidocaine, BenGay , CidalEaze, Ela-Max, LidaMantle, Lidosense 4, Lidotral, LMX 4, LMX 4 with Tegaderm, LMX 5, MENTHO-CAINE, RectotheCareSmootheSmoothe. SALPAK and xylocaine.

The difference between an ointment and a cream is their thickness. The ointment is 80% oil and 20% water, and the cream is 50% oil and 50% water.

Marina Vol / Getty Images

How to use lidocaine cream

Wash your hands with soap and water before using lidocaine cream or ointment. For medical use, apply topically by squeezing the required amount onto sterile gauze and placing it on the affected area. Wash your hands very well again after application.

Although the likelihood of side effects with lidocaine cream or ointment is quite low, be careful, especially when using large amounts, as side effects are directly related to the total dose of lidocaine used.

Avoid getting lidocaine in your mouth, nose, or eyes. If this substance gets in your eyes, it can cause severe irritation and cause blurred vision and temporary vision loss. If the ointment gets into your eyes, rinse them with water for at least 15 minutes. Do not touch or rub your eyes and call your doctor immediately. Do not cover lidocaine-treated areas with a bandage or plastic wrap without consulting your doctor, as wrapping the treated area increases absorption into your system.

Safety measures


When applying lidocaine cream to large areas of damaged skin, do not use more than the dosage recommended by your healthcare professional or the manufacturer. Do not allow your child to scratch or rub the skin while they are sleepy, and do not let the skin get too hot or cold. When using lidocaine cream, avoid sources of heat (such as electric blankets or heating pads). Also, do not allow your child to take long hot baths or sunbathe because his temperature can rise and cause too much medicine to enter the body.

For children under 3 years of age, lidocaine should only be used when no other treatment is available. Always consult your doctor before applying lidocaine cream to your child. Health problems such as seizures have occurred in children under the age of 3 if they are not used correctly or as recommended by a doctor. Do not use it to treat babies and children with teething pain.

The pregnancy

Although there have been some studies in animals, there are no adequate and well-controlled studies to demonstrate the safety of using lidocaine cream in pregnant women. Therefore, extreme precautions are recommended, especially in the early stages of pregnancy, when the main development of embryonic organs occurs. It is not known whether lidocaine ointment is transmitted to a baby through breast milk, but since there are other medications present in the milk of nursing mothers, caution should be exercised when prescribing lidocaine to a nursing woman.


Elderly patients should be prescribed reduced doses depending on their age and physical condition. Lidocaine should also be used with caution in people with severe shock or heart block .

Research has shown that although local anesthetics are considered safe, the rate at which some people absorb lidocaine is unpredictable. The study also showed that the concentration of lidocaine, the composition of the drug and the physical condition of the individual are of great importance. affects the amount of lidocaine that is absorbed into the bloodstream. Even over-the-counter local anesthetics should be monitored by a healthcare professional to avoid toxic effects and, in rare cases, death.

Side effects

Call your doctor if you experience any of the following side effects after using lidocaine cream:

  • Acne
  • Itching or hives
  • Swelling of the face, lips, or tongue
  • Respiratory problems
  • Vision changes
  • Confusion of conscience, excitability, nervousness, restlessness.
  • Dizziness, drowsiness
  • Fever or chills
  • Headache
  • Arrhythmia
  • Nausea vomiting
  • Capture
  • Shaking

In rare cases, frequent use of lidocaine can reduce the ability of iron in red blood cells to carry oxygen to tissues. This serious and even life-threatening condition is known as methemoglobinemia. Because the blood cannot carry enough oxygen to the tissues, people with this condition look very pale or even blue, feel very tired, and feel short of breath.

Oral lidocaine used by dentists is not available without a prescription. Do not swallow lidocaine cream or put lidocaine cream in your mouth. Lidocaine can cause numbness in the mouth and throat, which can lead to swallowing problems and even choking. If a significant amount is ingested, a sufficient amount can enter the bloodstream and affect vital organs, primarily the brain and heart.

Combination products

Some products contain lidocaine in addition to other medications, such as additional pain relievers or steroids:

  • BLT (benzocaine, lidocaine, and tetracaine)
  • Denela cream (lidocaine and prilocaine)
  • EMLA (lidocaine and prilocaine)
  • Evolution 10 (lidocaine and local anesthetic)
  • Ice lidocaine (menthol and lidocaine)
  • LidaMantle (lidocaine and hydrocortisone)

Before using lidocaine ointment or cream, tell your doctor if you have any of the following symptoms:

  • Heart problems
  • Infected, broken, or damaged skin
  • An unusual or allergic reaction to lidocaine, other medicines, foods, dyes, or preservatives.
  • If you are pregnant or trying to get pregnant
  • If you are breastfeeding
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