Class I antiarrhythmias - use with caution in patients receiving  Class I antiarrhythmic drugs ( eg . toacinde and mexiletene ) since the toxic effects are additives and potentially syngergistic

Skin disorders - for topical anesthesia in skin disorders

Mucous membranes - for local mucous membranes, including oral. nasal, and laryngeal mucous membranes

Adverse reactions are dose related and may result from high plasma levels due to excessive dosage or rapid absorption

Hypersensitivity - cutaneous lesions, urticaria, edema, contact dermititis, bronchospasm, shock, anaphyloid reactions

Miscellaneous- yrethritis with or without bleeding

Few cases of methemoglobinemia characterizedc by cyanosis has followed topical application of benzocaine or lidocaine/prilocaine

Local - burning, stinging, tenderness, sloughing

Hypersenstivity to any component of these products, opthalmic use

Warnings-

Systemic efects - use the lowest dose effective for anesthesia to avoid high plasma levels and serious adverse effects. Repeated doses of lidocaine and dyclonine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug or its metabolites

Methomoglobinemia - benzocaine,lidocaine and prilocaine should not be used in those rare patients with congenital or idiopathic methoglobinemia and in infants < 12 months of age who are receiving treatment with methemoglobin -inducing agents Very young glucose -6- phosphate deficiencies are more susceptible to methemoglobinemia

Hepatic function impairment- patients with severe hepatic disease are at greater risk of developing toxic plasma conc. of lidocaine and prilocaine, becuase of their inability to metabolize local anesthestics normally.

Pregnancy - use in women of child bearing potential and particularly during early pregnancy only when benefits otweigh the risks

Lactation- excercise caution when administeing to nursing women

Children- safety and efficacy for use in children < 12 years have not been established

Precautions-

For external or mucous membrane use only. Do not use in the eyes Minimal effective dose - use minimal efective. Not for prolonged use

Severe shock/heart block - use lidocaine and dyclonine with caution

Oral use - topical anesthetics may impair swallowing and enhance danger of aspiration

Do not ingest food for 1 hour following use of of oral topical prepns. in the mouth or throat. topical anesthesia may impair swallowing , thus enhancing the danger of aspiration

Indication-

Skin disorders - for topical anesthesia in skin disorders

Mucous membranes - for local mucous membranes, including oral. nasal, and laryngeal mucous membranes

Dosage-

Apply to affected areas as needed. Ointments and creams may be applied to gauze or to a bandage prior to applying to the skin

1. Do not ingest food for 1 hour following use of of oral topical prepns. in the mouth or throat. topical anesthesia may impair swallowing , thus enhancing the danger of aspiration

2. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma.

3. Do not eat or chew gum while the mouth or throat is anethetized

4. When lidocaine /prilocaine is used thepatient should be aware that production of dermal analgesia may be accompanied by the block of all sensations in the treated skin

5. For this reason, the patient should avoid inadvertent trauma to the treated area by scratching, rubbing, or exposure to extreme hot or cold temperature until complete sensation has returned

Pregnancy -

use in women of child bearing potential and particularly during early pregnancy only when benefits otweigh the risks

Lactation-

excercise caution when administeing to nursing women

Childen-

safety and efficacy for use in children < 12 years have not been established