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Lidocaine 4%/Tetracaine 2% Topical Ointment

The Lidocaine 4%/Tetracaine 2% Topical Ointment is a semi-solid formulation intended for external application to the skin. This ointment is dispensed in a tube and possesses a greasy or oily base, which facilitates the localized delivery of the active ingredients, lidocaine and tetracaine. These agents work synergistically to provide topical anesthesia, making the ointment suitable for use in various dermatological conditions that require numbing of the skin surface.

This compounded ointment is primarily used for the temporary relief of pain and discomfort associated with conditions such as minor skin irritations, insect bites, minor cuts, and burns. It is also utilized in medical settings to numb the skin before certain dermatological procedures. The combination of lidocaine and tetracaine in this formulation helps to reduce pain by blocking nerve signals in the body, offering patients a more comfortable experience during treatment of the aforementioned disease states.

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Lidocaine Hydrochloride
Tetracaine Hydrochloride
Topical Ointment
65b091695383b83f12faa536
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Formula Information

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Lidocaine 4%/Tetracaine 2% Topical Ointment is a compounded medication specifically designed for external application to the skin. This semi-solid formulation is dispensed in a tube and is characterized by its greasy or oily base, which not only facilitates the application process but also enhances the penetration of the active ingredients into the skin. The combination of lidocaine and tetracaine, both local anesthetics, works synergistically to provide localized pain relief by blocking the transmission of nerve impulses in the area where the ointment is applied.

The lidocaine component, a well-known amide local anesthetic, provides rapid onset of action, making it effective for immediate relief of pain and discomfort. Tetracaine, on the other hand, is an ester local anesthetic that complements lidocaine by offering a longer duration of action. This dual-action profile makes the Lidocaine 4%/Tetracaine 2% Topical Ointment particularly suitable for a range of conditions that require both immediate and prolonged pain relief. It is commonly used for the treatment of skin inflammation, minor burns, insect bites, and other conditions where pain relief is a primary concern.

Additionally, the ointment may be used as an anesthetic prior to minor dermatological procedures, thereby reducing the discomfort associated with needle insertion or superficial skin surgery. The formulation's base also provides a protective barrier, which can aid in the healing process of minor wounds by preventing the ingress of contaminants and maintaining a moist environment conducive to healing.

It is important for both patients and prescribers to understand that this formulation should be used as directed, and it is intended for topical use only. The area of application should be clean and intact skin, and care should be taken to avoid contact with the eyes, mouth, and mucous membranes. Patients should be advised of the potential for systemic absorption and the risk of local and systemic side effects, particularly if applied to large areas or used over a prolonged period.

As compounding pharmacists at Bayview Pharmacy, we are committed to providing high-quality, customized medications to meet the specific needs of our patients. We encourage patients and prescribers with questions or concerns about the Lidocaine 4%/Tetracaine 2% Topical Ointment or its use in specific disease states to reach out to us for more information. Our team is ready to assist with dosing recommendations, potential interactions, and any other inquiries to ensure safe and effective treatment outcomes.

Drug Interactions

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The Lidocaine 4%/Tetracaine 2% Topical Ointment is a combination anesthetic formulation intended for external application to the skin. Lidocaine and tetracaine are both local anesthetics that work by blocking sodium channels, which are necessary for the initiation and conduction of neuronal impulses. When applied to the skin, this ointment can provide localized pain relief by numbing the area. It is commonly used for conditions that require local anesthesia, such as minor skin procedures, needle insertions, and relief of pain from skin inflammations or infections.

While the risk of systemic drug interactions with topical lidocaine and tetracaine is generally low due to minimal systemic absorption, certain interactions may still occur, particularly in cases of excessive application, prolonged use, or application to highly permeable or broken skin. Patients should be advised to use the ointment as directed and to avoid applying it to large areas of skin or over long periods, as this can increase the risk of systemic absorption and potential interactions.

Concomitant use of other local anesthetics or medications with a similar mechanism of action should be approached with caution, as the additive systemic effects could increase the risk of systemic toxicity, including central nervous system (CNS) and cardiovascular effects. Patients taking class I antiarrhythmic drugs (such as tocainide and mexiletine) or other medications that affect cardiac conduction should use lidocaine and tetracaine with caution, as the combination may alter cardiac function.

Patients who are on medications that inhibit cytochrome P450 3A4 (CYP3A4) enzymes, such as certain antifungals (e.g., ketoconazole), macrolide antibiotics (e.g., erythromycin), or protease inhibitors (e.g., ritonavir), may have an increased risk of lidocaine systemic toxicity due to decreased metabolism and clearance of the drug. Similarly, tetracaine metabolism could be affected by drugs that inhibit plasma cholinesterase, potentially leading to prolonged effects of the anesthetic.

It is also important to consider the potential for methemoglobinemia, a condition where hemoglobin is modified such that it cannot effectively release oxygen to tissues. Both lidocaine and tetracaine, especially when used in large doses or on compromised skin, can increase the risk of inducing methemoglobinemia. Caution is advised when using this formulation in conjunction with other drugs known to increase methemoglobin levels, such as sulfonamides, nitrates, and certain antimalarials.

Patients with known hypersensitivity to amide or ester-type anesthetics should not use this formulation, as cross-sensitivity between members of these classes can occur. Additionally, the use of this ointment in conjunction with other topical medications has not been extensively studied, so it is recommended to avoid simultaneous application of different topical drugs in the same area without medical advice.

It is essential for patients and prescribers to be aware of the patient's overall medication profile, including over-the-counter drugs and supplements, to assess the risk of interactions. If there are any concerns or questions regarding the use of Lidocaine 4%/Tetracaine 2% Topical Ointment with other medications, please reach out to us at Bayview Pharmacy for further guidance and consultation.

How Does it Work

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The Lidocaine 4%/Tetracaine 2% Topical Ointment is a compounded medication that combines two local anesthetics, lidocaine and tetracaine, in a semi-solid dosage form. This ointment is specifically designed for external application to the skin and is dispensed in a tube. The base of the ointment is greasy or oily, which not only facilitates the application of the medication but also enhances the penetration of the active ingredients through the skin layers.

Lidocaine and tetracaine are both amide-type local anesthetics that work by blocking sodium channels in the neuronal cell membrane. By doing so, they inhibit the initiation and conduction of nerve impulses, leading to a reversible loss of sensation in the area where the ointment is applied. Lidocaine has a rapid onset of action and is well-known for its efficacy in providing local anesthesia. Tetracaine, on the other hand, has a longer duration of action, which complements lidocaine's effects, resulting in prolonged analgesic effects.

When applied to the skin, the Lidocaine 4%/Tetracaine 2% Topical Ointment numbs the targeted area, providing relief from pain associated with various conditions such as skin inflammation, minor burns, insect bites, and needle insertions. It is also used to alleviate pain before minor dermatological procedures. The ointment's base aids in the delivery of the active ingredients and also serves as a protective layer, which can be beneficial in promoting wound healing and preventing further irritation or infection.

It is important for patients and prescribers to understand that while this ointment provides localized pain relief, it does not treat the underlying cause of skin conditions. It should be used as directed by a healthcare professional, and the area of application should be clean and free from any cuts or open wounds unless otherwise advised. The duration of action typically lasts for a period sufficient to carry out minor procedures or to provide temporary relief from pain and discomfort.

As with any medication, there may be potential side effects, and it is crucial to use the ointment as prescribed to minimize the risk of systemic absorption and adverse reactions. If you have any questions or require further information about the Lidocaine 4%/Tetracaine 2% Topical Ointment, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide the necessary support and guidance for both patients and prescribers.

Other Uses

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The lidocaine 4%/tetracaine 2% topical ointment is a combination anesthetic formulation that extends its utility beyond the treatment of skin inflammation, infections, or wound healing. It is designed primarily to provide local anesthesia to the skin and mucous membranes, offering a synergistic effect that enhances pain relief and improves patient comfort during minor surgical procedures, such as biopsies, dermal procedures, or dental work. Additionally, the formulation may serve as a beneficial agent for patients experiencing pain associated with conditions like post-herpetic neuralgia or other nerve-related pain syndromes, by numbing the painful area and reducing the discomfort associated with these conditions.

Furthermore, the ointment may be used to alleviate itching and discomfort resulting from skin conditions such as eczema, insect bites, or minor burns, by dulling the nerve endings that transmit the itching sensation. It could also be explored as an off-label option to apply to the site of intravenous (IV) cannulation or other needle punctures to minimize procedural pain, thus making it a versatile tool within a clinician's armamentarium for managing localized pain and discomfort.

Given its numbing effect, this formulation may be particularly useful for patients with hypersensitive skin or for children who struggle with pain tolerance during invasive skin procedures. For patients receiving laser hair removal or tattoo application and removal, this ointment could potentially be used to reduce procedural pain. However, it is essential to consult with a healthcare professional to ensure that the application is safe, especially in scenarios with extensive skin involvement, due to the risk of systemic absorption and potential toxicity.

It should be noted that the ointment should be used with caution in patients with a history of methemoglobinemia, a condition that can be exacerbated by local anesthetics. It is also critical to ensure this medication is not applied to broken or inflamed skin beyond the intended treatment area or used under occlusive dressings unless directed by a healthcare provider, as this could increase systemic absorption and potentially result in adverse effects.

The ointment's utility in anal-rectal procedures is another consideration. Its use might be appropriate to alleviate discomfort from hemorrhoids or pre-rectal examination preparation, subject to a doctor's approval. Lastly, in cosmetology, the formulation can be considered for pre-procedure numbing prior to microneedling treatments or similar aesthetic interventions, always under professional supervision and advice.

Its range of applications makes it an indispensable tool in various clinical and outpatient settings. If you have any questions about the formulation or its potential uses, or if you require personalized advice on whether this lidocaine 4%/tetracaine 2% topical ointment is suitable for your specific situation, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is ready to assist you with any inquiries you may have.

Frequently Asked Questions

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What is Lidocaine 4%/Tetracaine 2% Topical Ointment used for?

Lidocaine 4%/Tetracaine 2% Topical Ointment is used to numb the skin in preparation for medical procedures or to relieve pain from conditions affecting the skin’s surface. It is often applied before procedures such as tattoo application, minor skin surgeries, or other dermatological treatments.

How does this topical ointment work?

The ointment works by combining two local anesthetics, Lidocaine and Tetracaine, that block nerve signals in the skin. This temporarily numbs the area, providing relief from pain or discomfort.

How should this ointment be applied?

The ointment should be applied to the affected area in a thin layer. It is important to follow your healthcare provider's instructions regarding the amount to use and the frequency of application. Do not apply to broken or inflamed skin unless directed by a physician.

Can this ointment be used for all age groups?

It is essential to consult with a healthcare provider before using this ointment on infants or elderly patients, as they may be more sensitive to its effects. Use in these age groups should be under the supervision of a healthcare professional.

Are there any side effects associated with Lidocaine 4%/Tetracaine 2% Topical Ointment?

Possible side effects may include mild skin irritation, redness, or a burning sensation at the site of application. If you experience severe reactions or if the side effects worsen, you should contact your healthcare provider immediately.

What should I do if the ointment gets into my eyes or other mucous membranes?

If the ointment comes into contact with your eyes, nose, mouth, or other mucous membranes, rinse the area thoroughly with water. It is important to avoid touching these areas while the ointment is on your hands and seek medical attention if irritation persists.

Is it okay to cover the treated area with a bandage?

Do not cover the treated area with a bandage or other occlusive dressing unless directed by your doctor. Covering the area can increase the absorption of the medication and may lead to increased side effects.

How long does it take for the ointment to take effect?

The onset of action can vary, but typically the numbing effect of the ointment begins within 30 minutes of application. The duration of the effect will also depend on the individual and the specific condition being treated.

Can I use this ointment if I am pregnant or breastfeeding?

If you are pregnant or breastfeeding, consult your healthcare provider before using Lidocaine 4%/Tetracaine 2% Topical Ointment to understand the potential risks and benefits.

How should I store this ointment?

Store the ointment at room temperature, away from heat and direct sunlight. Keep the tube tightly closed when not in use and out of reach of children and pets.

What happens if I miss a dose or apply too much?

If you miss a dose, apply it as soon as you remember unless it is nearly time for your next dose. If you apply too much ointment, remove the excess with a clean tissue and monitor for any adverse effects. In case of an overdose, seek medical attention immediately.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.