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cinchocaine

S02DA04

Forms & Strengths

5% ointment (topical)
2% gel
2% spray
0.5% solution for mucosal use
0.5% injectable solution

Adult Dosing

Topical: apply thin layer to area up to 3‑4 times daily, max 6 g/day
Mucosal: 5‑10 drops 2‑3 times daily
Infiltration: 0.5‑1 mg/kg IV/IM, max 300 mg
Do not exceed total recommended dose

Pediatric Dosing

Topical: up to 2‑3 g/day, not more than 4 times daily
Mucosal: 2‑5 drops 2‑3 times daily, ≤0.5 mg/kg per dose
Infiltration: 0.5 mg/kg, max 150 mg total

Indications

Local anesthesia of skin, mucous membranes, and anal region
Hemorrhoid and anal fissure pain relief
Otitis externa pain control
Epistaxis control
Minor dermatologic procedures

Mechanism of Action

Reversible blockade of voltage‑gated Na⁺ channels in neuronal membranes
Prevents depolarization and nerve impulse transmission
Higher lipid solubility confers greater potency than procaine

Contraindications

Hypersensitivity to dibucaine or amide‑type local anesthetics
Severe hepatic impairment
Infected or ulcerated skin at application site
Predisposition to methemoglobinemia

Adverse Reactions

Local burning, stinging, erythema, edema
Allergic dermatitis, urticaria, pruritus
Systemic CNS toxicity: tinnitus, dizziness, seizures
Cardiovascular: hypotension, arrhythmias
Rare methemoglobinemia

Drug Interactions

Concurrent use of other local anesthetics → additive toxicity
MAO inhibitors may potentiate CNS effects
CYP3A4 inhibitors (e.g., ketoconazole) increase dibucaine levels
Epinephrine may prolong systemic absorption
β‑blockers may augment cardiovascular depression

Curated Content: Needs Vetting Before Put to Clinical Use