Benzocaine / Lidocaine / Tetracaine Cream

Benzocaine / Lidocaine / Tetracaine Cream
Usage
Benzocaine, lidocaine, and tetracaine cream is a compounded topical local anaesthetic formulation used to provide temporary numbness of the skin or mucous membranes. It is commonly used prior to procedures or to relieve localised pain and discomfort.
It may be prescribed for:
• Dermatological procedures (e.g., laser therapy, microneedling, minor excisions)
• Cosmetic procedures (e.g., injections, tattooing)
• Minor skin procedures (e.g., biopsies, suturing)
• Relief of localised pain, itching, or irritation
• Other practitioner-directed uses requiring topical anaesthesia
Use should be under the direction of a qualified healthcare professional.

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 layer to the affected area prior to the procedure
• Leave in place for a specified period (commonly 20–60 minutes) before removal, depending on the desired depth of anaesthesia
• The treated area may be covered with an occlusive dressing if directed by the healthcare provider
• Remove excess cream before the procedure
Avoid applying to large surface areas or using excessive amounts.

Mechanisms of Action
This combination contains three local anaesthetic agents that work synergistically.
Benzocaine
A surface anaesthetic that blocks sodium channels in nerve membranes, reducing nerve signal transmission.
Lidocaine
An amide-type local anaesthetic that stabilises neuronal membranes by inhibiting sodium ion influx, preventing nerve impulse initiation and conduction.
Tetracaine
An ester-type local anaesthetic with potent and longer-lasting effects, enhancing depth and duration of anaesthesia.
Together, these agents block nerve conduction, producing temporary loss of sensation in the treated area.

Contraindications
This cream should not be used in patients with:
• Hypersensitivity to benzocaine, 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, particularly for lidocaine metabolism
• Infants and young children, who may be more sensitive to systemic effects
Additional precautions include:
• Excessive use may increase the risk of systemic toxicity, including central nervous system or cardiovascular effects
• Rare risk of methemoglobinemia, particularly with benzocaine
• Avoid contact with eyes and mucous membranes unless specifically directed
• Do not apply under occlusion unless instructed by a healthcare professional
Patients should seek medical attention if they experience dizziness, irregular heartbeat, breathing difficulty, or cyanosis (bluish skin discoloration).

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.