EMLA Numbing Cream 5%

For most uses on intact skin, EMLA Cream is applied as a thick layer under an occlusive dressing for 1 to 2 hours before the procedure. Do not rub the cream into the skin. On some skin areas, such as the face, the numbing effect may develop more quickly, usually within 30 to 60 minutes.

However, application times vary depending on the area being treated, the procedure, age and skin condition. Do not leave the cream on intact skin for longer than 5 hours. Always follow the instructions in the patient information leaflet or the advice of your healthcare professional.

After EMLA Cream is removed, the numbing effect on intact skin usually lasts for at least 2 hours. However, this can vary depending on the area treated, application time and procedure. Longer application times generally produce deeper numbing, but you should not exceed the recommended application time for your age, treatment area or procedure.

Always read the patient information leaflet before use.

To apply EMLA Cream:

• Make sure the skin is clean and dry
• Squeeze a thick layer of EMLA Cream onto the area. Approximately 1g of cream pressed from the tube measures around 3.5 cm in length
• Do not rub the cream into the skin as it needs to sit on the surface as a thick layer
• Cover the cream with an airtight, watertight dressing (for example, an occlusive plaster or cling film)
• Leave the dressing in place for at least 1 hour, depending on your procedure or as advised by your healthcare professional
• Remove the dressing and wipe off any excess cream immediately before the procedure

EMLA Cream is most reliably absorbed when covered with an occlusive dressing, which prevents the cream from being wiped off and stops moisture from evaporating.

Therefore, for most uses on intact skin, EMLA Cream should be covered with an occlusive dressing. This helps keep the cream in place and allows it to absorb properly. Do not leave EMLA Cream uncovered unless your pharmacist, doctor, nurse or treating practitioner has specifically advised you to do so.

EMLA Cream can be used in children, including full-term newborn babies, but the dose, area treated and application time must be carefully limited depending on age.

Do not use EMLA Cream on premature babies born before 37 weeks’ gestation. Do not use it on infants up to 12 months old who are being treated with medicines that can affect methaemoglobin levels (such as sulphonamides, nitrofurantoin, phenytoin and phenobarbital). If your child is under 12 months old, has a medical condition, or takes regular medicines, speak to a doctor or pharmacist before use.

As a general guide:

• Full-term newborns to 2 months: up to 1g of cream over an area no larger than 10 cm² for no more than 1 hour, with only one dose in any 24-hour period
• 3 to 11 months: up to 2g over an area no larger than 20 cm² for around 1 hour
• 1 to 5 years: up to 10g over an area no larger than 100 cm² for 1 to 5 hours
• 6 to 11 years: up to 20g over an area no larger than 200 cm² for 1 to 5 hours
• 12 years and over: same dose as for adults

EMLA Cream is widely used in paediatric settings to help children feel more comfortable during vaccinations, blood tests and cannula insertion. Always follow the instructions in the patient information leaflet and consult a pharmacist or healthcare professional if you are unsure.

EMLA Cream can be used to numb the skin before tattoo application, medical micropigmentation or laser tattoo removal. As tattoos typically cover a larger surface area than a single injection site, multiple packs of EMLA Cream may be required. Do not use more than 60g (the equivalent of two 30g tubes) in one tattoo session.

Apply the cream around 1 hour before your appointment, cover with an occlusive dressing or cling film, and remove immediately before the procedure. Always check with your tattooist, laser practitioner, pharmacist or healthcare professional before using EMLA Cream for these procedures. Do not apply EMLA Cream over large areas or for longer than recommended in the patient information leaflet. Using too much cream, covering too large an area, or leaving it on for too long can increase the risk of side effects.

Yes. EMLA Cream 5% is classified as a Pharmacy (P) medicine in the UK, meaning it can be purchased over the counter from a pharmacy or from a UK-registered online pharmacy without a prescription. As a P medicine, the sale must be supervised by a pharmacist, which is why a short questionnaire is required at checkout when ordering from Pharmica.

The active substances in EMLA Cream are lidocaine (25 mg per gram) and prilocaine (25 mg per gram), giving a combined active concentration of 5%. The other ingredients are macrogolglycerol hydroxystearate, carbomer 974P, sodium hydroxide and purified water.

EMLA Cream contains macrogolglycerol hydroxystearate, which may cause skin reactions in a small number of users. If you have a known allergy to lidocaine, prilocaine or any of the other ingredients listed above, do not use EMLA Cream.

Do not use EMLA Cream if you are allergic to lidocaine, prilocaine, other similar local anaesthetics, or any of the listed ingredients.

Speak to your doctor, pharmacist or nurse before using EMLA Cream if any of the following apply:

• You or your child have a rare inherited blood condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency
• You or your child have porphyria
• You or your child have a problem with blood pigment levels called methaemoglobinaemia
• You or your child have an itchy skin condition called atopic dermatitis, where the application time should not exceed 30 minutes
• You intend to use EMLA Cream on skin that has a rash, cuts, grazes, eczema or other open wounds (with the exception of a leg ulcer applied under healthcare supervision)

EMLA Cream can also have interactions with other medications. Speak to your doctor, pharmacist or nurse before using EMLA Cream if you are taking any of the following:

• Medications for heart rhythm disorders such as amiodarone (your heart function may need to be monitored)
• Medications used to treat infections, called ‘sulphonamides’ and nitrofurantoin
• Medications used to treat epilepsy, called phenytoin and phenobarbital
• Other local anaesthetics
• Cimetidine or beta-blockers, which may cause an increase in the blood levels of lidocaine

Do not apply EMLA Cream to the eyes, inside the ears, or to open wounds, cuts, grazes or broken skin, unless a healthcare professional has specifically advised this. The exception is use on leg ulcers in adults, which should only be done under healthcare supervision. Avoid contact with the mouth.

Like all medicines, EMLA Cream can cause side effects, although not everyone gets them.

Common side effects are usually mild and affect the area where the cream was applied. These can include temporary paleness, redness, mild swelling, itching, tingling or warmth.

Rarely, EMLA Cream can cause an allergic reaction or a blood condition called methaemoglobinaemia, which can make the skin look bluish-grey (particularly around the lips, fingertips or toes) and may cause breathlessness, tiredness or dizziness. The risk is higher if too much cream is used, if it is left on for too long, or in newborn and young infants.

Stop using EMLA Cream and seek urgent medical help if you develop swelling of the face, lips, tongue or throat, difficulty breathing, or a widespread rash.

If you are pregnant, breastfeeding, think you may be pregnant or are planning to become pregnant, ask your doctor or pharmacist for advice before using EMLA Cream.

Ametop Gel contains tetracaine (also known as amethocaine) as its active ingredient, while EMLA Cream contains a combination of lidocaine and prilocaine. Both are topical local anaesthetics, but they are not licensed for exactly the same uses. Ametop is licensed for numbing the skin before needle procedures such as venepuncture or venous cannulation, while EMLA has a wider range of licensed uses. The additional differences include:

• Ametop is generally licensed from 1 month of age, while EMLA can be used from birth in full-term infants
• Ametop typically takes 30 to 45 minutes to numb the skin, while EMLA usually requires at least 60 minutes
• The numbing effect of Ametop tends to last longer after removal (up to 4 to 6 hours), compared with around 2 hours for EMLA

The choice between the two often depends on the procedure, the age of the patient and the time available for application. A pharmacist can advise on the most suitable option.