Topical local anaesthetic
Lidocaine with prilocaine
Brand names: EMLA, Denela
Adult dose
Dose: Apply 1.5–2g per 10 cm² under occlusion 60 min before procedure (max 60g per session)
Route: Topical
Frequency: 60 min before procedure
Clinical pearls
- Topical anaesthesia before venepuncture, cannulation, minor procedures
- Allow ≥60 min for full effect
Contraindications
- Methaemoglobinaemia
- Glucose-6-phosphate dehydrogenase deficiency (caution)
- Children <1 month
- Open wounds
Side effects
- Local pallor/erythema
- Methaemoglobinaemia (esp. neonates and with sulfonamides)
- Allergic reactions
Interactions
- Class I antiarrhythmics
- Sulfonamides (methaemoglobin)
Reference: BNF; NICE CG104; https://bnf.nice.org.uk/drugs/lidocaine-with-prilocaine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD