Summary
Commonly reported side effects of lidocaine/tetracaine topical include: edema, erythema of skin, and localized blanching. Continue reading for a comprehensive list of adverse effects.
Applies to lidocaine/tetracaine topical: topical application cream, topical application patch extended release.
Serious side effects
Along with its needed effects, lidocaine/tetracaine topical may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking lidocaine / tetracaine topical:
More common
- Flushing or redness of the skin
- swelling
- unusually warm skin
Less common
- Blistering, burning, crusting, dryness, or flaking of the skin
- change in the color of treated skin
- itching, scaling, severe redness, soreness, or swelling of the skin
- rash
Rare
- Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chills
- cough
- fainting or loss of consciousness
- fast or irregular breathing
- fever
- hives or welts
- hoarseness
- lower back or side pain
- painful or difficult urination
- swelling of the eyes or eyelids
- tightness in the chest
- trouble with breathing
Incidence not known
- Blurred vision
- chest pain or discomfort
- cold, clammy, or pale skin
- confusion
- difficulty with breathing
- difficulty with swallowing
- dizziness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, slow, or irregular heartbeat
- feelings of coldness, heat, or numbness
- irregular, fast or slow, or shallow breathing
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
- no breathing
- noisy breathing
- pale or blue lips, fingernails, or skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- seizures
- shakiness in the legs, arms, hands, or feet
- slow heart rate
- sweating
- trembling or shaking of the hands or feet
- twitching
- unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur while taking lidocaine / tetracaine topical:
Symptoms of overdose
- Change in consciousness
- fast, pounding, or irregular heartbeat or pulse
- no blood pressure or pulse
- stopping of the heart
Other side effects
Some side effects of lidocaine / tetracaine topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
- Headache
- nausea
- sleepiness or unusual drowsiness
- vomiting
Incidence not known
- Continuing ringing or buzzing or other unexplained noise in the ears
- depression
- double vision
- drowsiness
- false or unusual sense of well-being
- fear
- hearing loss
- nervousness
For Healthcare Professionals
Applies to lidocaine / tetracaine topical: topical cream, topical film.
Local
Local side effects have included erythema , blanching, edema, or abnormal sensation at the site of treatment. The most common of the local reactions were erythema (71%), blanching (12%), and edema (12%). These reactions were generally mild, and resolved spontaneously soon after treatment.[Ref]
Hypersensitivity
Hypersensitivity side effects have included allergic or anaphylactoid reactions to the active or inactive ingredients. They may be characterized by urticaria, angioedema, bronchospasm, and shock.[Ref]
Nervous system
Nervous system side effects are unlikely with appropriate use of lidocaine-tetracaine topical. Potential side effect include CNS excitation and/or depression (light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold, or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest). Excitatory CNS reactions may be brief or not occur at all, in which case the first manifestation may be drowsiness developing into unconsciousness. Signs of CNS toxicity may start at plasma concentrations of lidocaine as low as 1000 ng/mL. The plasma concentrations at which tetracaine toxicity may occur are less well characterized; however, systemic toxicity with tetracaine is thought to occur with much lower plasma concentrations compared with lidocaine. The toxicity of co-administered local anesthetics is thought to be at least additive.[Ref]
Cardiovascular
Cardiovascular side effects are unlikely with appropriate use of lidocaine-tetracaine topical. Potential side effects include bradycardia, hypotension and cardiovascular collapse leading to arrest.[Ref]
