Emla

Emla is a medicine with local anesthetic effect.

[1]

Indications of the emla

It is used in the form of a surface anesthetic used in the execution of injections, catheterization in the vascular region, and in addition, during surgical operations and punctures.

Also, the cream is used on the legs to perform superficial anesthesia with ulcers of a trophic nature, and in addition to performing painful procedures in the area of the genital mucosa (exclusively in adult patients).

Along with this, the medication is often used in certain cosmetic procedures:

• removal of previously made tattoos, hair removal, correction of scars;
• elimination of wrinkles, as well as correction affecting nasolabial folds, etc .;
• before the procedure of mesotherapy;
• before the introduction of drugs (Restylane, Botox, etc.);
• elimination of telangiectasias.

[2], [3]

Release form

The release is carried out in the form of a cream, in tubes with a volume of 5 g. Inside the pack - 5 such tubes complete with 12 hermetic labels. Also can be produced in tubes with a volume of 30 grams - inside the box contains 1 such tube.

[4], [5], [6], [7]

Pharmacodynamics

Emla's anesthetic medication prevents the process of pulse generation inside the receptors of the sensory nerves, and besides it prevents the excitation pulses in the region of nerve fibers.

[8], [9], [10], [11], [12], [13]

Pharmacokinetics

Peak efficacy of the cream is noted after a lapse of 60 minutes after the application of the drug. The duration of its exposure is 30 minutes.

[14], [15], [16], [17], [18], [19]

Dosing and administration

It is necessary to use the drug externally - treat it with the skin or mucous membranes.

For carrying out small surgical procedures or injections, 1.5-2 g of cream are often used to treat 10 cm ^{2 of} skin surface, after which this area is closed with a sealed sticker (for 1-5 hours).

If it is necessary to perform the procedure on a large area of the skin, apply 1.5-2 g / cm ^{2 of the} substance, then close this place with a sealed sticker (for 2-5 hours).

As a surface anesthetic in the treatment of trophic ulcers on the legs, the drug is applied in a portion of about 1-2 g / cm ² (treated with a thick layer of cream). It is allowed to apply a maximum of 10 grams of drugs per procedure. A sealed sticker is applied for 30 minutes. In the presence of difficulties with the penetration of the substance into tissues, it is possible to prolong the time of retention of the sticker up to 60 minutes. Mechanical cleaning should be started a maximum of 10 minutes after the removal of the sticker. In the period of 30-60 days, the cream is allowed to use no more than 15 times.

There are several different schemes of application of the drug in the treatment of mucous in the genital area.

As an anesthetic substance before the injection of local anesthetic agents, it is prescribed in the amount of 1-2 g / 10 cm ² surface. Apply the cream should be a thick layer. For women, the drug application period is 1 hour, and for men, a maximum of 15 minutes.

During the elimination of genital warts, as well as for anesthesia, before injections of local anesthetics, approximately 5-10 g of the substance must be applied in the mucosa area. Keep the substance required for 5-10 minutes. Carry out the manipulation immediately after cleansing the cream with mucous.

For children, the medicine is used as an anesthetic for injections, as well as for other surgical procedures of a superficial nature - in a dose of at most 1 g / 10 cm ². The medication should be applied in a thick layer, then close the treated area with a leakproof label.

When treating the atopic form of dermatitis, it is necessary to shorten the application time to 15-30 minutes.

Emla is often used for cosmetic procedures - for example, for epilation in the field of bikini and other areas. In this case, a thick layer of cream is treated with the required skin areas and keeps the drug for about 0.5-1 hour before the procedure. If it is necessary to carry out epilation on a large area of the skin, several tubes with the drug may be required.

[28], [29]

Use of the emla during pregnancy

There is insufficient information on the use of prilocaine with lidocaine in pregnant women.

The above elements are able to pass through the placenta. There is no information that they can lead to reproductive disorders (increased risk of developmental anomalies, as well as direct or indirect adverse effects on the fetus), but in any case, the risk of using drugs in humans has not been adequately studied.

Information on the effects of prilocaine with lidocaine on the course of pregnancy, fetal and embryonic development, as well as the process of birth and development of the infant after birth, which were obtained during animal tests, are not considered complete.

But at the same time there is an opinion that with the short use of Emla in a pregnant woman, the benefit from its use will be higher than the risk of complications.

Small amounts of lidocaine with prilokainom pass into the mother's milk. When using the cream in recommended portions, the risk of exposure to the baby will be extremely low. This allows you to continue breastfeeding during the period of drug use.

Contraindications

The main contraindications:

• the presence of intolerance with respect to the drug;
• Use in infants who were born at a gestational age of less than 37 weeks;
• The appointment of the cream is prohibited for newborns weighing less than 3 kg, and the therapeutic system is prohibited from treating surfaces with open wounds.

Caution is required when prescribing a cream for people with G6FD element deficiency, atopic dermatitis, and in addition methemoglobinemia is idiopathic or hereditary.

Therapeutic system is used carefully when applied in the area near the eyes (this can cause irritation), before the BCG procedure, for atopic dermatitis and for G6PD deficiency.

[20], [21], [22], [23], [24], [25]

Side effects of the emla

The use of medication can cause some side effects: the appearance of edemas, allergies, erythema, and pallor. Along with this, there may be local symptoms - itching or burning on the treatment site.

[26], [27]

Overdose

When using drugs in accordance with the instruction, the probability of developing poisoning is extremely low. Among the possible symptoms of an overdose, there is a feeling of intense arousal, and in addition, suppression of cardiac function and the functioning of the central nervous system.

With the development of neurological manifestations, severe symptomatic measures are required. For example, if seizures occur, anticonvulsants should be used.

After the beginning of elimination of symptoms of systemic poisoning, it is necessary to monitor the patient's condition for several hours.

[30], [31]

Interactions with other drugs

People using anti-arrhythmic drugs of the 3rd class should carefully apply Emla cream.

It is not recommended to combine the medication with drugs that cause the development of methemoglobinemia in patients younger than 1 year.

[32]

Storage conditions

Emla should be kept in a place that is closed from small children. Do not freeze the cream. The temperature at the content of the medicinal product can not exceed 30 ° C.

Shelf life

Emla can be used for 3 years from the date of manufacture of the medicament.

[33], [34], [35]

Application for children

Emla can be prescribed to children from birth, taking into account the indications for different age categories. Newborns up to 2 months, infants of 3-11 months, as well as children 1-11 years of age, are used for superficial anesthesia of the skin at the site of the injection (for example, when taking blood samples or for insertion into the peripheral vein of the catheter) , as well as when performing superficial surgical operations.

Also, the cream can be used to remove molluscum contagiosum.

[36], [37], [38], [39], [40]

Analogues

Analogues of the cream are the following medicines: Artifrin with Anestezolum, Lidocaine and Artikain with Kamistad and Ultrakain, in addition, Catejel with lidocaine, Detinox and Menovazin. Most of these drugs are solutions for external use. Also among them there are also gels.

[41], [42], [43], [44], [45], [46], [47], [48], [49], [50], [51],

Reviews

Emla receives quite a lot of different responses from patients. Most of them are positive, although there are also comments from dissatisfied people. Often among the comments are the opinions of girls who used the drug during the procedures of hair removal, and most of them say that the cream was useful. But at the same time there are also negative reviews of those people who did not feel the anesthetic effect of the medication at all.

As a result, we can say that the effectiveness of the cream for each individual patient is individual. There is also an opinion that possessing such properties of creams are capable of anesthetizing exclusively the dermal surface, and hairs are placed more deeply, because of what painful sensations still arise. Therefore, individual cosmetologists refuse to use Emla as an anesthetic in epilation procedures, together doing this to their clients with painkillers injections.