Lidocaine / Tetracaine Cream

Lidocaine / Tetracaine Cream
Usage
Lidocaine / tetracaine cream is a compounded topical local anaesthetic formulation used to provide temporary numbness of the skin prior to medical or cosmetic procedures, or for relief of localised pain.
It may be prescribed for:
• Dermatological procedures (e.g., laser therapy, minor excisions, biopsies)
• Cosmetic procedures (e.g., injectables, microneedling, tattooing)
• Minor surgical procedures
• Relief of localised pain, itching, or irritation
• Other practitioner-directed uses requiring topical anaesthesia

Dosage
Dosage and application time should be determined by the prescribing practitioner based on the procedure and treatment area.
Typical dosing considerations include:
• Apply a thin, even layer to the affected area
• Leave in place for 20–60 minutes (or as directed) before the procedure
• May be used with or without an occlusive dressing, depending on instructions
• Remove excess cream prior to the procedure
• Avoid application to large surface areas or prolonged use

Mechanisms of Action
Lidocaine (Amide-type local anaesthetic)
• Blocks voltage-gated sodium channels in nerve membranes
• Prevents initiation and conduction of nerve impulses
Tetracaine (Ester-type local anaesthetic)
• Also blocks sodium channels
• Provides potent and longer-lasting anaesthetic effect
Combined Effect
• Synergistic action results in enhanced depth and duration of local anaesthesia
• Produces temporary loss of sensation in the treated area

Contraindications
This formulation should not be used in patients with:
• Hypersensitivity to lidocaine, tetracaine, or other local anaesthetics
• Known allergy to amide- or ester-type anaesthetics
• Severely damaged, infected, or inflamed skin, unless directed by a healthcare professional
• Conditions where local anaesthesia is contraindicated

Precautions
Use with caution in patients with:
• Large treatment areas, which may increase systemic absorption
• Compromised skin barrier (e.g., wounds, burns)
• Cardiovascular disease or arrhythmias
• Hepatic impairment (affecting lidocaine metabolism)
• Infants and young children, who may be more sensitive to systemic effects
Additional considerations include:
• Excessive use may increase risk of systemic toxicity (e.g., CNS or cardiac effects)
• Rare risk of methemoglobinemia
• Avoid contact with eyes and mucous membranes unless specifically directed
• Possible local side effects:
• Redness
• Irritation
• Burning sensation
Patients should seek medical attention if they experience dizziness, irregular heartbeat, breathing difficulty, or bluish discoloration of the skin.

Storage
• Store below 25°C unless otherwise directed
• Keep the container tightly closed when not in use
• Protect from heat, moisture, and direct light
• Do not freeze unless specifically instructed
• Keep out of reach of children and pets
Patients should follow the storage instructions provided on the dispensing label supplied by the pharmacy.