|
|
|
Pronunciation |
|
(BEN
zoe
kane) |
|
|
U.S. Brand
Names |
|
Americaine®[OTC]; Anbesol®[OTC];
Anbesol® Maximum Strength [OTC]; Babee®
Teething®[OTC]; Benzocol®[OTC]; Benzodent®[OTC];
Chiggertox®[OTC]; Cylex®[OTC]; Dermoplast®[OTC];
Foille®[OTC]; Foille® Medicated First Aid [OTC];
Hurricaine®; Lanacane®[OTC]; Maximum Strength
Anbesol®[OTC]; Maximum Strength Orajel®[OTC];
Mycinettes®[OTC]; Numzitdent®[OTC]; Numzit
Teething®[OTC]; Orabase®-B [OTC]; Orabase®-O [OTC];
Orajel® Brace-Aid Oral Anesthetic
[OTC]; Orajel® Maximum Strength [OTC]; Orajel® Mouth-Aid
[OTC]; Orasept®[OTC]; Orasol®[OTC]; Rhulicaine®[OTC];
Rid-A-Pain®[OTC]; Slim-Mint®[OTC]; Solarcaine®[OTC];
Spec-T®[OTC]; Tanac®[OTC]; Trocaine®[OTC];
Unguentine®[OTC]; Vicks Children's Chloraseptic®[OTC]; Vicks
Chloraseptic® Sore Throat
[OTC]; Zilactin-B® Medicated
[OTC] |
|
|
Generic
Available |
|
Yes |
|
|
Synonyms |
|
Ethyl Aminobenzoate |
|
|
Pharmacological Index |
|
Local Anesthetic |
|
|
Use |
|
Dental: Ester-type topical local anesthetic for temporary relief of pain
associated with toothache, minor sore throat pain and canker sore
Medical: Temporary relief of pain associated with local anesthetic for
pruritic dermatosis, pruritus, minor burns, acute congestive and serous otitis
media, swimmer's ear, otitis externa, toothache, minor sore throat pain, canker
sores, hemorrhoids, rectal fissures, anesthetic lubricant for passage of
catheters and endoscopic tubes; nonprescription diet aide |
|
|
Pregnancy Risk
Factor |
|
C |
|
|
Contraindications |
|
Children <1 year of age; secondary bacterial infection of area; ophthalmic
use; known hypersensitivity to benzocaine or other ester type local
anesthetics |
|
|
Warnings/Precautions |
|
Not intended for use when infections are present |
|
|
Adverse
Reactions |
|
Dose-related and may result in high plasma levels
Dermatologic: Angioedema, contact dermatitis
Local: Burning, stinging
<1%: Edema, urticaria, urethritis, methemoglobinemia in infants,
tenderness |
|
|
Overdosage/Toxicology |
|
Methemoglobinemia has been reported with benzocaine in oral overdose
Treatment is primarily symptomatic and supportive; termination of anesthesia
by pneumatic tourniquet inflation should be attempted when the agent is
administered by infiltration or regional injection. Seizures commonly respond to
diazepam, while hypotension responds to I.V. fluids and Trendelenburg
positioning. Bradyarrhythmias (when the heart rate is <60) can be treated
with I.V., I.M., or S.C. atropine 15 mcg/kg. With the development of metabolic
acidosis, I.V. sodium bicarbonate 0.5-2 mEq/kg and ventilatory assistance should
be instituted. |
|
|
Drug
Interactions |
|
May antagonize actions of sulfonamides |
|
|
Mechanism of
Action |
|
Ester local anesthetic blocks both the initiation and conduction of nerve
impulses by decreasing the neuronal membrane's permeability to sodium ions,
which results in inhibition of depolarization with resultant blockade of
conduction |
|
|
Pharmacodynamics/Kinetics |
|
Absorption: Topical: Poorly absorbed after administration to intact skin, but
well absorbed from mucous membranes and traumatized skin
Metabolism: Hydrolyzed in the plasma and, to a lesser extent, the liver by
cholinesterase
Elimination: Metabolites excreted in urine |
|
|
Usual Dosage |
|
Children and Adults:
Mucous membranes: Dosage varies depending on area to be anesthetized and
vascularity of tissues
Oral mouth/throat preparations: Do not administer for >2 days or in
children <2 years of age, unless directed by a physician; refer to specific
package labeling
Topical: Apply to affected area as needed
Adults: Nonprescription diet aid: 6-15 mg just prior to food consumption, not
to exceed 45 mg/day |
|
|
Dietary
Considerations |
|
Administer nonprescription diet aid just prior to food
consumption |
|
|
Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
|
No information available to require special precautions |
|
|
Dental Health:
Effects on Dental Treatment |
|
No effects or complications reported |
|
|
Patient
Information |
|
Use as directed; do not overuse. Do not apply when infections are present and
do not apply to large areas of broken skin. Do not eat or drink for 1 hour
following oral application. Discontinue application and report if swelling of
mouth, lips, tongue, or throat occurs; or if skin irritation occurs at
application site. Pregnancy/breast-feeding precautions: Inform
prescriber if you are pregnant. Consult prescriber if
breast-feeding. |
|
|
Nursing
Implications |
|
Patient should not eat within 1 hour after application to oral
mucosa |
|
|
Dosage Forms |
|
Mouth/throat preparations:
Cream: 5% (10 g)
Gel: 6.3% (7.5 g); 7.5% (7.2 g, 9.45 g, 14.1 g); 10% (6 g, 9.45 g, 10 g, 15
g); 15% (10.5 g); 20% (9.45 g, 14.1 g)
Liquid: (3.7 mL); 5% (8.8 mL); 6.3% (9 mL, 22 mL, 14.79 mL); 10% (13 mL); 20%
(13.3 mL)
Lotion: 0.2% (15 mL); 2.5% (15 mL)
Lozenges: 5 mg, 6 mg, 10 mg, 15 mg
Ointment: 20% (30 g)
Paste: 20% (5 g, 15 g)
Nonprescription diet aid:
Candy: 6 mg
Gum: 6 mg
Topical for mucous membranes:
Gel: 6% (7.5 g); 20% (2.5 g, 3.75 g, 7.5 g, 30 g)
Liquid: 20% (3.75 mL, 9 mL, 13.3 mL, 30 mL)
Topical for skin disorders:
Aerosol, external use: 5% (92 mL, 105 g); 20% (82.5 mL, 90 mL, 92 mL, 150 mL)
Cream: (30 g, 60 g); 5% (30 g, 1 lb); 6% (28.4 g)
Lotion: (120 mL); 8% (90 mL)
Ointment: 5% (3.5 g, 28 g)
Spray: 5% (97.5 mL); 20% (20 g, 60 g, 120 g, 13.3 mL, 120 mL)
|
|
|
References |
|
Anderson ST, Hajduczek J, and Barker SJ,
"Benzocaine-Induced Methemoglobinemia in an Adult: Accuracy of Pulse Oximetry With Methemoglobinemia,"
Anesth Analg, 1988, 67(11):1099-101.
Bachmann P, Berthier JC, Storme B, et al,
"Methemoglobinemia From Ingestion of Benzocaine. A Case of Pediatric Intoxication,"
J Toxicol Clin Exp, 1986, 6(2):123-8.
Guertler AT and Pearce WA,
"A Prospective Evaluation of Benzocaine-Associated Methemoglobinemia in Human Beings,"
Ann Emerg Med, 1994, 24(4):628-30.
Rynn KO, Jahns BE, and Sabbun R,
"Acute Myocardial Infarction (AMI) Secondary to Benzocaine Induced Methemoglobinemia,"
Clin Toxicol, 1995, 33(5):495.
Shua-Haim JR and Gross JS,
"Methemoglobinemia Toxicity From Topical Benzocaine Spray," J Am Geriatr
Soc, 1995, 43(5):590.
Stein JM and Warfield CA, "Local Anesthetics: Principles of Safe Use,"
Hosp Pract (Off Ed), 1983, 18(5):73-8.
|
|
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
| |