Drug reference

Emla

Local Anesthetic · Local Anaesthesia

Also known as Denela, Nulbia, Eutectic Mixture of Local Anesthetics (Lidocaine/Prilocaine)

Local AnestheticLocal Anaesthesia

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Emla, a eutectic mixture of lidocaine and prilocaine, permits anesthetic penetration of the keratinized layer of skin, producing localized numbness. Lidocaine, as an amide local anesthetic, provides fast, intense, long-lasting, and extensive anesthesia. Prilocaine's duration of action is slightly longer than lidocaine.

Indications

Anesthetize skin prior to venipunctureAnesthetize skin prior to intravenous catheter placementSkin graft harvestingInfiltration of anesthetics into genitaliaMinor procedures

Dosing

Adult: Apply a thick layer under an occlusive dressing 1–5 hours before procedure (2–5 hours before procedures on large areas, e.g., split skin grafting).
Pediatric: For children with atopic dermatitis, a shorter application time of 15–30 minutes is recommended (30 minutes before removal of mollusca) under an occlusive dressing.

Pharmacokinetics

Metabolism

Prilocaine is metabolized to ortho-toluidine, an oxidizing agent that can induce methemoglobinemia. Lidocaine is metabolized to monoethylglycine xylidide and glycine xylidide, which may contribute to toxicity.