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Lidocaine with cetrimide oromucosal

Drugs List

  • lidocaine 150mg/g and cetrimide 1.5mg/g oromucosal spray sugar-free
  • lidocaine 50mg/g and cetrimide 1.5mg/g oromucosal gel sugar-free
  • XYLONOR 150mg+1.5mg/g oromucosal spray
  • XYLONOR 50mg+1.5mg/g gel
  • Therapeutic Indications

    Uses

    Anaesthesia - topical

    Topical anaesthesia in the buccal cavity.
    Disinfection of the mucous membrane in the buccal cavity.

    Dosage

    Use the lowest dose resulting in effective anaesthesia. Adapt the dose to the physical state of the patient.

    Adults

    5% gel
    0.5 to 1g applied locally using a cotton pellet.

    10% spray
    1 spray is usually sufficient but a maximum of 2 sprays per site may be used.
    Up to 5 sites may be treated simultaneously, although no more than 3 sites per quadrant and only one quadrant should be anaesthetused during one sitting.

    Children

    Children aged 3 years and above.
    (See Dosage; Adult).

    Administration

    Oromucosal application only.

    Contraindications

    Children under 3 years

    Precautions and Warnings

    Damaged mucosa
    Sepsis
    Breastfeeding
    Pregnancy

    Do not spray into back of mouth or throat
    Use the lowest dose resulting in effective analgesia
    Advise patient not to eat until sensitivity returns to the affected area(s)

    Pregnancy and Lactation

    Pregnancy

    Use with caution in pregnancy.

    At the time of writing there is limited published information available regarding the use of topical lidocaine or cetrimide during pregnancy. Available information regarding the use of parenteral lidocaine as a local anaesthetic does not indicate any known negative influences on pregnancy. Caution during early pregnancy is advised by the manufacturer.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Lactation

    Use with caution in breastfeeding.

    At the time of writing there is limited published information available regarding the use of topical lidocaine or cetrimide during breastfeeding. Available information regarding the use of parenteral lidocaine as a local anaesthetic does not indicate any risks during breastfeeding. Caution is advised by the manufacturer.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

    Side Effects

    Blurred vision
    Bradycardia
    Cardiac arrest
    Dizziness
    Hives
    Impaired consciousness
    Itching
    Light-headedness
    Nervousness
    Rash
    Respiratory arrest
    Tremor

    Overdosage

    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Further Information

    Last Full Review Date: April 2018

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Xylonor 5% gel. Septodont UK Ltd. Revised July 2017.

    Summary of Product Characteristics: Xylonor 10% spray. Septodont UK Ltd. Revised July 2017.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
    lidocaine Last revised: 11 April 2017
    Last accessed: 16 March 2018

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