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Emla General Information

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Emla contains 2 amide-type local anesthetics, lidocaine and Emla. It is used on normal, unbroken skin or on the outer genital area to prevent pain before certain procedures such as inserting a needle, skin grafts, or skin laser surgery. It works by temporarily numbing the skin and surrounding area. Do not use Emla in the ears.

If Emla alone cannot completely numb the area being treated, it may be used to numb the area before a lidocaine injection is given to provide enough pain relief for certain procedures (e.g., removal of genital warts).

How to Use Emla

Emla comes with a Patient Information Leaflet. Read it carefully for instructions on how to use Emla. Ask your doctor, nurse, or pharmacist any questions that you may have about Emla.

Use Emla only on normal skin and the genital area. Do not apply to broken/irritated skin or open wounds unless directed by your doctor. Wash your hands before using Emla.

Apply Emla to the area at the proper time as directed. The length of time for the medication to stay on the skin depends on the type of procedure you are having. It is usually applied at least 1 hour before needle sticks and 2 hours before minor skin procedures. It may be applied by a health care professional before certain genital procedures. In this case, it is recommended that you remain lying down so the medication will stay in place.

To apply, squeeze out the prescribed amount of cream directly onto the skin. You can also squeeze it onto a measuring guide to make sure you get the right dose and then apply it to the area. Do not rub in. Cover with an airtight dressing/bandage as directed by your doctor. Allow the cream to remain in place, usually in a thick layer, as directed by your doctor. Remove the dressing and cream and clean the area thoroughly, usually shortly before the procedure or as directed by your doctor.

Dosage and length of application time are based on your age and medical condition and the procedure you are having. In children, dosage may also be based on weight. Do not use larger amounts than prescribed. Do not use on large areas of skin, apply heat, or leave it in place longer than directed or serious side effects may occur.

If you are applying Emla on a child, make sure the medication stays in place and that your child does not put the medication or dressing/bandage in his/her mouth. You may want to use a second covering to prevent the child from touching the cream.

Wash hands immediately after use unless you are treating an area on the hands. Avoid getting the product in your eyes, nose, ears, or mouth. If Emla gets in the eyes, rinse the affected eye immediately and completely with water or saline. Numbness in the eye can lead to injury because you cannot feel particles in the eye or other dangers. Therefore, protect the eye until feeling returns.

The area may be numb for several hours after the procedure. Protect the area from injury. Be careful not to bump, rub, or scratch the area or expose it to heat/cold until feeling returns.

Emla Possible Side Effects

Redness, swelling, tingling/burning, or lightening of the skin may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed Emla because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using Emla do not have serious side effects.

Notify your doctor immediately if you develop blistering of the skin where the medication is applied.

Remove the cream and get medical help right away if any of these rare but very serious side effects occur: slow/shallow breathing, pale/bluish skin around the mouth/lips, dizziness, fainting, fast/slow/irregular heartbeat, mental/mood changes (e.g., confusion, nervousness), seizures, severe drowsiness.

A very serious allergic reaction to Emla is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Emla Precautions

Before using Emla, tell your doctor or pharmacist if you are allergic to lidocaine or Emla; or to any other amide anesthetics (e.g., bupivacaine); or if you have any other allergies. Emla may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Emla should not be used if you have certain medical conditions. Before using Emla, consult your doctor or pharmacist if you have: certain blood disorder (methemoglobinemia).

Before using Emla, tell your doctor or pharmacist your medical history, especially of: certain blood disorder (G6PD deficiency, especially in children), heart disease (e.g., irregular heartbeat), kidney disease, liver disease.

Caution is advised when using Emla in the elderly because they may be more sensitive to the effects of the drug, especially the dizziness effect.

Caution is advised when using Emla in children, especially if your child is younger than 3 months or small for their age. These children are at greater risk for a certain rare blood problem (methemoglobinemia). Contact the doctor immediately in the unlikely event your child has symptoms such as pale/bluish skin around the mouth/lips or fast heartbeat. The risk for serious side effects (including methemoglobinemia) is increased if Emla is applied over too large an area at one time in young children.

During pregnancy, Emla should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether Emla passes into breast milk. Consult your doctor before breast-feeding.

Emla Possible Intercations

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using Emla, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs that may rarely cause a certain blood disorder called methemoglobinemia (e.g., acetaminophen, benzocaine, phenobarbital, antimalarials such as chloroquine/primaquine/quinine, nitrates such as nitroglycerin, certain antibiotics such as sulfonamides/nitrofurantoin/dapsone), heart rhythm medications (e.g., amiodarone, bretylium, mexiletine, phenytoin, sotalol).

This document does not contain all possible interactions. Therefore, before using Emla, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

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