Indications 

Emla Cream is a topical anesthetic used for local analgesia on normal, intact skin. It is also used for superficial minor surgery and as a pretreatment for infiltration anesthesia on genital mucous membranes. 

Emla Cream is a eutectic mixture of lidocaine and prilocaine, both belonging to the amide-type local anesthetic class. They act by stabilizing neuronal membranes, inhibiting the required ionic fluxes for the initiation and conduction of impulses.  

This mechanism ultimately impacts the local anesthetic effect of the cream temporarily numbing the skin and its surrounding area.  

Uses and Dosage 

Before using Emla and every time you get a refill, carefully read its patient information leaflet and medication guide. Seek the guidance of your doctor or pharmacist for questions and clarifications. 

The dosage and duration of application of Emla Cream are based on the individual’s age, medical condition, and the nature of the procedure being undertaken. For pediatric patients, weight may also be considered. 

Typically, Emla Cream is administered at least 1 hour before needle punctures and at least 2 hours ahead of minor dermatological procedures. 

In certain genital procedures, a healthcare practitioner may administer the cream. In such instances, it is advisable to remain in a supine position to ensure the medication stays in the intended area. 

Emla Cream should be applied exclusively on intact, healthy skin and the genital region. Refrain from applying the cream to irritated, broken skin or open wounds, unless specifically instructed by a physician. 

To apply the cream: 

1. Wash hands before applying the cream 
2. Dispense the recommended amount of Emla Cream onto the skin, or alternatively, use a measuring guide to ensure accurate dosing before application. 
3. Avoid rubbing the cream into the skin, and instead, leave it in a thick layer as directed by a physician. 
4. Cover the treated area with an airtight dressing or bandage, according to the physician’s instructions. 
5. The cream should be left in place until shortly before the scheduled procedure, as specified by the healthcare provider. 
6. Finally, as directed by the physician, remove the dressing and cream, and clean the treated area thoroughly. 

In pediatric use, ensure that the cream and dressing/bandage remain in place and that the child does not ingest either. Employing an additional covering may be advisable to prevent the child from coming into contact with the cream. 

After use, wash hands immediately, unless treating the hands. Avoid contact with eyes, nose, ears, or mouth. If the medication enters the eyes, rinse thoroughly with water or saline to avoid injury from reduced sensation. Protect the eye until the sensation returns. 

Following the procedure, the affected area may remain numb for several hours. To prevent injury, avoid any impact, rubbing, scratching, or exposure to hot or cold temperatures until the sensation returns. 

Avoid using Emla Cream on extensive skin areas, applying heat, or exceeding the recommended application duration, as this may result in severe adverse effects. 

Side Effects 

Potential adverse reactions associated with the use of Emla Cream are listed below. Should any of these symptoms persist or deteriorate, promptly notify your physician. 

Common Side Effects 

• Mild burning sensation at the application site 
• Itching and rash 
• Alterations in skin pigmentation at the medication site 

Serious Side Effects 

• Intense burning, stinging, or irritation at the application site 
• Swelling and redness 
• Abrupt onset of dizziness or drowsiness after medication application 
• Disorientation, blurred vision, tinnitus 
• Bruising or purplish discoloration of the skin 
• Atypical perceptions of temperature 

Call your doctor right away if any of the severe symptoms listed above occur. 

Allergic Reactions 

Immediate medical assistance must be sought in the event of displaying signs of an allergic reaction to Emla Cream, including: 

• Skin rash 
• Itching/swelling, particularly of the face, tongue, or throat 
• Severe dizziness 
• Trouble breathing 

The listed adverse effects here do not include all side effects associated with the use of Emla Cream. If any adverse effects not mentioned above are experienced, promptly notify your physician. 

Cautions 

Before using Emla Cream, inform your healthcare provider or pharmacist if you are allergic to lidocaine or prilocaine, to any other amide anesthetics such as bupivacaine, or if you have any other allergies.  

Emla Cream may contain inactive ingredients that can cause allergic reactions or other problems. Ask your pharmacist for more details. 

To ensure Emla Cream is safe for you, disclose your medical history to your doctor, especially of: 

• Cardiac disease (such as arrhythmia) 
• Renal impairment 
• Hepatic dysfunction 
• Methemoglobinemia (a specific blood disorder) 

To avoid drug interaction, tell your doctor and pharmacist about all the prescription and non-prescription medications, dietary supplements, vitamins, and herbal products you are presently using or planning to use. 

Emla Cream can be harmful to the ear. Do not use it in any situation where the cream might go beyond the eardrum and into the middle ear. 

Pregnant women should only utilize Emla Cream if it is deemed essential. Discuss the potential risks and benefits with your physician. 

Lidocaine is known to be passed through human breast milk, and there is a likelihood that prilocaine may also be passed through. Talk to your healthcare provider before nursing an infant while using this cream.