Adult Dosing
Topical local anesthetic for superficial dermatological procedures
Synera
- Apply TOPICAL patch to intact skin for 20 to 30 min prior to procedure
Pliaglis
- Dermal filler injection or facial laser ablation: Apply to intact skin for 20-30 min prior to procedure
- Laser-assisted tattoo removal: Apply to intact skin for 60 min prior to procedure
Topical local anesthetic for superficial venous access
Synera
- Apply TOPICAL patch to intact skin for 20-30 min prior to venipuncture
Pediatric Dosing
Topical local anesthetic for superficial dermatological procedures
3 years: Apply TOPICAL patch to intact skin for 20-30 min prior to procedure
Topical local anesthetic for superficial venous access
- 3 years: Apply TOPICAL patch to intact skin for 20-30 min prior to venipuncture
[Outline]
See Supplemental Patient Information
- Serious adverse effects may occur on topical application of this combination drug for longer duration than recommended, or the simultaneous or sequential application of multiple patches
- Potential exists from a child or pet for suffering serious adverse effects from chewing or ingesting a new or used patch
- Store this patch and dispose this patch away from reach of children and pets
- Allergic or anaphylactoid reactions associated with this combination drug may occur. Manage allergic reactions by conventional means
- Avoid contact with eyes as corneal irritation and potential abrasion may occur on loss of protective reflexes
- If eye contact occurs immediately wash out the eye with water or saline and protect the eye until sensation returns
- This drug is not recommended for use on mucous membranes or on areas with a compromised skin barrier. Toxic blood concentrations of lidocaine and tetracaine may occur on application to broken or inflamed skin
- Patients with severe hepatic disease or pseudocholinesterase deficiency are at higher risk for developing toxic plasma concentrations
- Methemoglobinemia associated with tetracaine component of this combination drug may occur. Patients with congenital or idiopathic methemoglobinemia, and infants <12 months who are receiving treatment with methemoglobin-inducers are more susceptible. Very young patients or patients with G6PD deficiencies are more prone for development of methemoglobinemia
- Exercise caution that the doses, areas of application, and duration of application are consistent with recommended dose
- Consider the amount absorbed from all formulations on concomitant use as the systemic toxic effects are additive and potentially synergistic with lidocaine and tetracaine
- Inhibition of viral and bacterial growth may occur
- Remove patch before a patient undergoes magnetic resonance imaging
Cautions: Use cautiously in
- Hepatic impairment
- Pseudocholinesterase deficiency
- Acutely ill or debilitated patients
Supplemental Patient Information
- Instruct patients to avoid trauma to the treated area as topical application may lead to diminished or blocked sensation in the treated skin
Pregnancy Category:B
Breastfeeding: Concentration of lidocaine is very low in milk, and it is poorly absorbed by the infant. No special precautions are required as it is not expected to cause any adverse effects in breastfed infants. This information is based on LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 April 2011). As per manufacturer's data, lidocaine is excreted in breastmilk and caution should be exercised during nursing. Topical application of tetracaine to the mother is unlikely to affect her breastfed infant. However, an alternate drug might be preferred especially while nursing a newborn or preterm infant. Manufacturer advises caution.
US Trade Name(s)
US Availability
Pliaglis (lidocaine/tetracaine)
Synera (lidocaine/tetracaine)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]