1. Introduction
NUMBEXÂ is a topical anesthetic cream containing:
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Lidocaine 2.5%Â (amide local anesthetic)
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Prilocaine 2.5%Â (amide local anesthetic)
This eutectic mixture provides enhanced skin penetration for effective surface anesthesia prior to minor medical procedures.
2. Description
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Generic Name:Â Lidocaine/Prilocaine cream
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Brand Names:Â NUMBEX (India), EMLA (international brand)
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Dosage Form:Â Topical cream in 5g/10g/30g tubes
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Drug Class:Â Local anesthetic combination
3. Uses
✔ Pre-procedural anesthesia for:
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Venipuncture
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IV cannulation
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Superficial surgical procedures
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Laser treatments
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Tattoo removal
✔ Pediatric pain management: -
Vaccination pain relief
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Circumcision (neonatal)
4. Mechanism of Action
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Blocks voltage-gated sodium channels
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Prevents nerve impulse conduction
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Synergistic effect (lower melting point than individual components)
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Onset:Â 30-60 minutes under occlusion
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Duration:Â 1-2 hours after removal
5. Side Effects
Common (1-10%):
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Application site reactions (pallor, redness, edema)
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Mild burning/stinging
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Temperature sensation changes
Serious (Rare):
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Methemoglobinemia (especially in infants)
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Systemic toxicity (with excessive application)
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Allergic contact dermatitis
6. Storage
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Temperature: Below 25°C
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Do not freeze
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Keep tube tightly closed
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Shelf life:Â 2-3 years (check packaging)
7. Precautions & Warnings
âš Â Contraindications:
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Congenital or idiopathic methemoglobinemia
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Hypersensitivity to amide anesthetics
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Application to broken skin/mucous membranes
âš Â Special Populations:
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Infants <12 months: Higher methemoglobinemia risk
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Pregnancy: Category B (use if clearly needed)
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Elderly: More sensitive to systemic effects
âš Â Drug Interactions:
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Class I antiarrhythmics: Additive cardiac effects
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Sulfonamides: Increased methemoglobinemia risk
8. Application Guidelines
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Clean and dry application site
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Apply thick layer (1-2g per 10cm²)
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Cover with occlusive dressing
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Wait time:
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Normal skin: 60 minutes
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Genital mucosa: 15-30 minutes
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Maximum dose:
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Adults: 20g
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Children: 1g/kg (max 10g)
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9. Conclusion
NUMBEX provides effective, predictable surface anesthesia for various minor procedures. Its eutectic formulation enhances skin penetration while maintaining safety. Particularly valuable for pediatric patients and needle-phobic individuals.
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