PRILOX CREAM

1. Introduction

Prilox Cream is a topical anesthetic combination containing:

• Lidocaine 2.5% (amide anesthetic)

• Prilocaine 2.5% (amide anesthetic)

Used for surface anesthesia prior to minor dermatological procedures and needle insertions.

2. Key Features

✔ Eutectic mixture (enhanced skin penetration) ✔ Onset within 30-60 minutes ✔ Duration: 1-2 hours after removal ✔ FDA-approved for:

• Venipuncture

• IV cannulation

• Superficial surgical procedures

3. Mechanism of Action

• Blocks voltage-gated sodium channels

• Prevents nerve impulse propagation

• Synergistic effect (lower melting point than individual components)

4. Clinical Applications

• Dermatology:

  • Laser treatments

  • Skin biopsies

  • Tattoo removal

• Pediatrics:

  • Vaccination pain relief

  • Circumcision (neonatal)

• Aesthetics:

  • Dermal filler injections

  • Thread lifts

5. Application Protocol

1. Clean target area

2. Apply thick layer (1-2g per 10cm²)

3. Occlude with dressing

4. Wait time:

   • Normal skin: 60 min

   • Mucosa: 15-30 min

5. Maximum dose:

   • Adults: 20g

   • Children: 1g/kg

6. Safety Profile

Common (1-10%):

• Blanching/redness

• Mild edema

• Temperature sensation changes

Serious (Rare):

• Methemoglobinemia (risk factors: infants, G6PD deficiency)

• Systemic toxicity (if applied to large areas)

7. Contraindications

✖ Congenital methemoglobinemia ✖ Allergy to amide anesthetics ✖ Application to broken skin

8. Cost Comparison

9. Clinical Tips

• Test patch for allergies before procedures • Avoid eyes/mucous membranes • Remove completely before procedures • Monitor infants for cyanosis

10. Alternatives

• EMLA Cream (original branded version)

• Rapidan Cream (lidocaine+tetracaine)

• BLT Cream (benzocaine+lidocaine+tetracaine)