Emla Cream

What is Emla Cream?

Emla Cream is a topical local anaesthetic containing two active substances: lidocaine and prilocaine. Both belong to a group of medicines called local anaesthetics. The cream is designed to numb the surface of the skin for a short period, temporarily blocking nerve signals to prevent pain from minor procedures while still allowing sensation of pressure and touch.

Mechanism of Action

Lidocaine and prilocaine work by stabilising the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses. In simpler terms, they temporarily 'switch off' the nerve endings in the skin where applied, preventing pain signals from being sent to the brain.

What is Emla Cream Used For?

According to its official licence, Emla Cream is used to numb the skin before procedures such as:

• Needle insertion (e.g., injections, blood tests)
• Minor skin operations
• Cleansing leg ulcers (in adults)
• Minor genital procedures in adults and adolescents (applied by a professional)

Before Using Emla Cream

Before using Emla Cream, discuss the following with your doctor:

Medical History Assessment

• Allergies: Do not use if you are allergic to lidocaine, prilocaine, or other local anaesthetics
• Medical Conditions: Inform your doctor if you have or have had:
  • Glucose-6-phosphate dehydrogenase deficiency (a rare inherited blood disorder)
  • Methaemoglobinaemia (a problem with blood pigment levels)
  • Atopic dermatitis or other itchy skin conditions
  • Any cuts, grazes, or broken skin at the application site
• Other Medications: Provide a full list of all medicines you are taking

Emla Cream Contraindications

Absolute contraindications where Emla Cream must not be used:

Absolute Contraindications

• Are allergic to lidocaine, prilocaine, or any other ingredients in this cream
• Have a known susceptibility to methaemoglobinaemia

Application Restrictions

Do not apply Emla Cream to:

• Open wounds, cuts, or grazes (except leg ulcers under supervision)
• Areas with a skin rash or eczema
• Eyes, inside the nose, ears, mouth, or anus
• The genitals of children under 12 years of age
• An impaired eardrum

Special Population Considerations

Children and Adolescents

• Not for use on genital skin or mucosa of children under 12
• Not for use in preterm newborns
• Use with extreme caution in infants under 12 months due to the risk of methaemoglobinaemia

Elderly

• No specific dosage adjustment is required, but general precautions apply

Liver or Kidney Impairment

• Caution is advised, though specific guidance is limited
• Consultation with a doctor is essential

Emla Cream and Other Medicines

Tell your doctor or pharmacist if you are taking any other medicines, including:

Significant Interactions

• Anti-arrhythmics: Such as amiodarone (for heart rhythm disorders)
• Antibiotics: Sulphonamides and nitrofurantoin
• Antiepileptics: Phenytoin and phenobarbital
• Other local anaesthetics
• Cimetidine or beta-blockers: May increase lidocaine levels, but this is not clinically relevant for short-term topical use

Pregnancy & Breastfeeding

Pregnancy

• Occasional use during pregnancy is unlikely to have adverse effects on the foetus
• Always consult your doctor before use

Breastfeeding

• Small amounts of lidocaine and prilocaine pass into breast milk
• The quantity is generally considered too small to pose a risk to the infant

Fertility

• Animal studies have shown no impairment of male or female fertility

Driving & Machine Operation

• EMLA Cream has no or negligible influence on the ability to drive and use machines when used at the recommended doses

Emla Cream Ingredients

Active Ingredients

• Each gram contains Lidocaine 25 mg and Prilocaine 25 mg

Other Ingredients (Excipients)

• Macrogolglycerol hydroxystearate (which may cause skin reactions)
• Carbomer 974P
• Sodium hydroxide
• Purified water

How to Use Emla Cream

Always use this medicine exactly as your doctor has told you. For off-label use in premature ejaculation, your doctor will provide specific instructions regarding the amount to use, where to apply it, and how long to leave it on.

Emla Cream Dosage Guidelines

The following is based on licensed use for genital skin. For premature ejaculation, your doctor will determine the correct dose.

Adults and Adolescents (over 12 years)

• For minor surgery (e.g., wart removal): 5-10 g for 10 minutes without a dressing
• Before local anaesthetic injection: 1 g (1-2 g for females) per 10 cm² area for 15-60 minutes under a dressing

General Maximums

• Do not use on an area larger than 600 cm²
• The maximum dose is 60 g

Administration Instructions

If instructed to use a dressing (occlusive dressing):

Step-by-Step Application

1. Squeeze a thick layer of cream onto the skin. Do not rub it in.
2. Cover the cream with the provided plastic dressing
3. Leave it on for the time specified by your doctor (e.g., 10-15 minutes for premature ejaculation use)
4. Remove the dressing and thoroughly wipe off all the cream before sexual activity to prevent transfer to your partner

Missed Dose Management

• As Emla Cream is used on an "as-needed" basis prior to intercourse, the concept of a "missed dose" does not apply
• Do not use extra cream to make up for a previous application

Overdose Information

Using too much cream, leaving it on for too long, or applying it to large areas can lead to systemic absorption and side effects.

Symptoms

• Feeling light-headed or dizzy
• Tingling around the mouth, numbness of the tongue
• Blurred vision, ringing in the ears
• Methaemoglobinaemia: A serious condition where the skin turns bluish-grey due to lack of oxygen
• In severe cases: Fits, low blood pressure, slowed or stopped breathing, and altered heartbeat

Management

• If you suspect an overdose, remove the cream and seek immediate medical attention

Possible Side Effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Common (May affect up to 1 in 10 people)

• Transient paleness, redness, or swelling at the application site
• Mild initial burning, itching, or warmth

Uncommon (May affect up to 1 in 100 people)

• Burning, itching, or warmth on the skin
• Numbness or tingling
• Skin irritation

Rare (May affect up to 1 in 1,000 people)

• Small dot-shaped bleeding on the treated area
• Eye irritation if cream accidentally gets into the eyes

Serious Side Effects

Stop use and see a doctor immediately if you experience:

• Signs of a severe allergic reaction (anaphylaxis): skin rash, swelling, fever, difficulty breathing, fainting
• Signs of methaemoglobinaemia: bluish-grey colour of the skin, lips, or nail beds, shortness of breath, fatigue, confusion

How to Store Emla Cream

• Keep out of the sight and reach of children
• Do not store above 30°C. Do not freeze
• Do not use after the expiry date printed on the pack
• Dispose of via a pharmacy; do not throw away in household waste or wastewater

Pack Information

Pack Sizes

• A single 5g tube with 2 dressings
• A pack of 5 x 5g tubes with 12 dressings
• A single 5g tube without dressings

Appearance

• White soft cream
• Available in 5g tubes

Marketing Authorisation

• Holder: Aspen Pharma Trading Limited, Dublin, Ireland

Where Can I Buy Emla Cream Online in the UK