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benzocaine

R02AD01

Forms & Strengths

Topical gel: 5%, 10%, 20%
Topical solution: 20%
Topical spray: 20%
Topical cream: 20%
Lozenges: 5 mg, 15 mg
Ointment: 20%

Adult Dosing

Oral pain/canker sores: Apply a small amount to the affected area up to 4 times daily
Mucosal local anesthesia (spray/gel): Apply as directed for procedure, typically 1-2 sprays
Lozenges: Dissolve 1 lozenge slowly in the mouth every 2 hours as needed

Pediatric Dosing

Children < 2 years: Contraindicated due to risk of methemoglobinemia
Children ≥ 2 years: Apply a small amount to affected area no more than 4 times daily, under adult supervision

Indications

Temporary relief of pain associated with sore throat and mouth
Local anesthesia of mucous membranes prior to minor procedures
Temporary relief of toothache, denture irritation, and canker sores

Mechanism of Action

Ester-type local anesthetic
Reversibly binds to voltage-gated sodium channels in neuronal membranes
Decreases neuronal membrane permeability to sodium ions
Inhibits depolarization and blocks the initiation and conduction of nerve impulses

Contraindications

History of methemoglobinemia (idiopathic or congenital)
Children under 2 years of age
Hypersensitivity to benzocaine or other ester-type local anesthetics
Application to large, open, or infected wounds

Adverse Reactions

Methemoglobinemia (cyanosis, dyspnea, fatigue, headache)
Local irritation, tenderness, or burning at application site
Contact dermatitis and allergic hypersensitivity reactions
Edema or erythema of the oral mucosa

Drug Interactions

Drugs associated with methemoglobinemia (e.g., sulfonamides, acetaminophen, nitrates, antimalarials) increase risk of additive toxicity
Cholinesterase inhibitors may decrease the metabolism of ester local anesthetics
Other local anesthetics may cause additive systemic toxicity

Curated Content: Needs Vetting Before Put to Clinical Use