Emla

How does it work?

Emla cream contains two active ingredients, lidocaine (previously known as lignocaine in the UK) and prilocaine. These are both a type of medicine called a local anaesthetic. They are used to numb areas that would otherwise feel pain.

Pain is caused by the stimulation of pain receptors at the ends of nerves. The stimulation causes sodium to enter the nerve ending, which causes an electrical signal to build up in the nerve. When this electrical signal is big enough, it passes along the nerve to the brain, where the signal is interpreted as pain.

Lidocaine and prilocaine work by temporarily blocking this pathway of pain signals along nerves. They do this by stopping the sodium entering the nerve ending at the site of the pain. This prevents an electrical signal building up and passing along the nerve fibres to the brain.

When Emla cream is applied to the skin, the lidocaine and prilocaine prevent pain signals passing from that area to the brain and so numb the skin. This means otherwise painful procedures can be performed without causing pain.

The cream can be used to temporarily numb the surface of the skin before procedures such as injections, taking blood samples and minor skin surgery. The cream is applied in a thick layer underneath a dressing for at least one hour (at least two hours for procedures on large areas, eg split skin grafting) and up to five hours before the procedure. Your doctor, pharmacist or nurse will either apply the cream, or show you how much to use and where to apply it. This will depend on the procedure that will be performed. The dressing is removed just before the medical procedure starts. You can get dressings to use with the cream from your pharmacist or doctor.

Under the supervision of a medical professional, the cream may also be used to temporarily numb the genitals in adults before the removal of genital warts (no dressings required for this use). The cream is applied five to ten minutes before this procedure starts.

What is it used for?

Temporarily numbing the surface of the skin before potentially painful procedures such as injections, taking blood and minor skin surgery.

Temporarily numbing the genitals in adults before the removal of genital warts (only under the supervision of a medical professional).

Warning!

Wash your hands after applying the cream, unless your hands are the area being treated.

Take care to avoid contact with the eyes, as this can numb the eye, preventing its protective reflexes, and cause irritation. If you accidentally get the cream in your eyes, rinse well with lukewarm water or saline solution and protect the eye until sensation returns.

Use with caution in

Lack of the enzyme glucose-6-phosphate dehydrogenase in the blood (G6PD deficiency).

Disorder of the red blood cells called methaemoglobinaemia.

Anaemia.

People taking medicines to treat an irregular heart beat, for example amiodarone.

Not to be used in

Children under one year of age.

Allergy to other local anaesthetics (amide type).

You should NOT apply the cream to cuts, grazes or wounds, areas where there is a skin rash or eczema, in or near the eyes, inside the nose, ears, mouth or anus (back passage), or to the genitals of children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Lidocaine and prilocaine have been widely used for many years without apparant ill consequence when used during pregnancy. However, as with all medicines, this cream should be used with caution during pregnancy and only on the advice of a doctor. Seek medical advice from your doctor.

Lidocaine and prilocaine pass into breast milk, but in amounts that are probably too small to be harmful to a nursing infant. However, women who are breastfeeding should seek medical advice from a doctor before using this medicine. If you are breastfeeding you should not apply this cream to the skin of the breast to prevent the child ingesting it.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Paleness, redness or swelling of the skin at the application site.

Mild burning, tingling or itching sensation at the application site.

Allergic reactions.

Disorder of the red blood cells called methaemoglobinaemia.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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