Yes

Local Anesthetic

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

C

Children <1 year of age; secondary bacterial infection of area; ophthalmic use; known hypersensitivity to benzocaine or other ester type local anesthetics

Not intended for use when infections are present

Dose-related and may result in high plasma levels

Dermatologic: Angioedema, contact dermatitis

Local: Burning, stinging

<1%: Edema, urticaria, urethritis, methemoglobinemia in infants, tenderness

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.

May antagonize actions of sulfonamides

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

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

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

Administer nonprescription diet aid just prior to food consumption

No information available to require special precautions

No effects or complications reported

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.

Patient should not eat within 1 hour after application to oral mucosa

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)

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.