lidocaine / menthol
Lidocaine/menthol topical products are over-the-counter medications that are applied to the skin for temporary pain relief. They come in many different forms, such as ointment, creams, gels, or spray. Most people experience few to no side effects if they use these medications as directed. Lidocaine/menthol topical products are available as lower-cost generics.
What is Lidocaine/menthol topical products?
What is Lidocaine/menthol topical products used for?
- Short-term relief of minor pain
How Lidocaine/menthol topical products works
Lidocaine/menthol topical products is a combination of two medications.
- Lidocaine is a local anesthetic. It eases skin discomfort by numbing the nerves and making them less sensitive to pain or irritation. Lidocaine works locally, which means it lowers pain in the area of skin closely around or directly in contact with the medication.
- Menthol is a chemical found in peppermint or other mint plants. It works by causing a cooling sensation that makes the nerves on your skin less sensitive to pain.
Drug facts
| Common Brands | AvaDerm, Lidothol, 1st Relief, Zylotrol |
|---|---|
| Drug Class | Local analgesic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Over-the-counter |
Side effects of Lidocaine/menthol topical products
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Please note: The following side effects are those reported with lidocaine 5% ointment and LiDORx (lidocaine) 3% gel:
- Lightheadedness
- Dizziness
- Feeling sleepy and tired
- Ringing in the ears
- Blurry or double vision
- Vomiting
- Feeling hot, cold, or numb
- Twitching, shaking
- Seizures
- Coma
- Trouble breathing
- Slow heart rate
- Low blood pressure
Less Common Side Effects
Please note: The following side effects are those reported with topical menthol:
- Skin burning
Please note: The following side effects are those reported with lidocaine 5% ointment and LiDORx (lidocaine) 3% gel:
- Nervousness
- Overwhelming feeling of happiness and joy
- Feeling confused
Lidocaine/menthol topical products serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Too much lidocaine in your body: Drowsiness, confusion, slow heart beat, trouble breathing, difficulty controlling muscle movements
- Serious blood problems with methemoglobinemia: Gray or blue-colored skin (cyanosis), headache, slow or fast heart beat, shortness of breath, dizziness, general lack of energy, chest pain, confusion, convulsions
- Serious allergic reactions: Swelling of the face, difficulty breathing, trouble speaking, throat tightening up, red and itchy rash, lightheadedness, clammy skin
The following Lidocaine/menthol topical products side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Headache, unusual weakness or fatigue, shortness of breath, nausea, vomiting, rapid heartbeat, blue skin or lips, which may be signs of methemoglobinemia
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Irritation at application site
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Pros and cons of Lidocaine/menthol topical products
Pros
- Available over the counter
- Available as lower-cost generics
- Combines 2 topical medications into one product for convenience
- Many formulations to choose from, such as ointment, creams, and spray
Cons
- Not ideal for pain with swelling
- Not recommended for use over large areas of injured or blistered skin because of higher risk of side effects
- Can sometimes cause a skin reaction where applied
- Generally not recommended for use for longer than 1 week, unless directed by your provider
Pharmacist tips for Lidocaine/menthol topical products
- Different formulations of lidocaine/menthol topical products have different age cut-offs. Always read the package labels for instructions and age limits before using lidocaine/menthol topical products on your child.
- Make sure to not inhale (breathe in) the medication while using lidocaine/menthol topical spray. Also, avoid applying this medication to your face or skin folds (e.g., armpits).
- If you're using the lidocaine/menthol topical spray, don't apply it near an open flame or while smoking. This product can catch on fire very easily. Also, don't store it near heat or puncture the bottle. The bottle is under a lot of pressure and might explode in these conditions.
- Don't use multiple lidocaine/menthol topical products at once. Lidocaine can be found in many over-the-counter pain medications, so make sure you read the labels carefully. Using too much lidocaine can cause you to absorb more of the medication, which can lead to skin irritations or more serious side effects, such as seizure, heart rhythm problems, and coma.
- Don't cover the treated area with a bandage or heating pad after applying lidocaine/menthol topical products because this can change how your body absorbs the medication.
- Lidocaine/menthol topical products should only be used on the outside of your body (e.g., skin). Don't use it on damaged areas like wounds, cuts, or irritated skin. Tell your provider right away if you have signs or symptoms of a skin injury, such as pain, swelling, or blistering where the medication was applied.
- Don't put lidocaine/menthol topical products in your mouth, and never use it in your eyes, nose, or ears to avoid side effects. Wash your hands before and after applying lidocaine/menthol topical products to prevent getting the medication in your eyes or mouth.
- Stop using your lidocaine/menthol topical product and talk with your provider if you've been using this medication for more than a week or if symptoms (e.g., pain or irritation) come back after getting better. Let your provider know if your skin is very irritated or if your pain has gotten worse. You might need more medical attention.
- Put lidocaine/menthol topical products up and away and out of children's reach and sight. This prevents them from accidentally swallowing medicine that was left out. Always put medication away after every time you use it. If you think that your child might’ve accidentally swallowed a lidocaine/menthol topical products, call your Poison Control Center at 1-800-222-1222 right away, even if you aren't completely sure.
Risks and warnings for Lidocaine/menthol topical products
Lidocaine/menthol topical products can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Absorbing too much medication
- Risk factors: Applying medication over large areas of skin | Using medication on red, irritated, swollen, blistered, or broken skin | Using medication for more than a week
Your body can absorb too much lidocaine over time if you use lidocaine/menthol topical products over large areas of skin or for longer than recommended. It might also happen if you apply the medication to broken skin or if you use a heating pad over the area with medication. Absorbing too much lidocaine is dangerous because it can cause life-threatening side effects. If you feel lightheaded or dizzy, or experience twitching or uncontrolled muscle movements in your body, wash off the medication and get medical help right away.
Serious allergic reaction to local anesthetic medications
Don't use lidocaine/menthol topical products if you have a history of an allergy to local anesthetic medications, such as procaine, bupivacaine, benzocaine, or other ‘caine’ medications. Watch out for signs and symptoms of allergic reactions, such as hives, shortness of breath, swelling of your face, lips, or throat. Please get medical attention immediately if you have these signs and symptoms.
Use only on your skin
Lidocaine/menthol topical products should only be used on your skin. Don’t put it in your eyes, nose, mouth, or ears. If you think that your child might have accidentally swallowed this medication, call your Poison Control Center at 1-800-222-1222 right away.
Risk of serious blood problem (methemoglobinemia)
- Risk factors: Young children | Older people with heart or lung problems | History of smoking cigarettes | People with low levels of glucose-6-phosphodiesterase (G6PD)
Lidocaine/menthol topical products can cause a rare but serious medical condition called methemoglobinemia, which prevents red blood cells from bringing enough oxygen to your body. You can experience methemoglobinemia even if you’re using lidocaine/menthol topical products at the recommended dose. If you have one of the risk factors listed above, please talk with your provider before using lidocaine/menthol topical products. Please get medical attention right away if you notice signs and symptoms such as gray or blue-colored skin, headache, fast heart beat, shortness of breath, dizziness, and lack of energy.
Severe pain
Stop using lidocaine/menthol topical products and talk with your provider if you've been using this medication for more than a week or if symptoms (e.g., skin pain) come back after clearing up. Also let your provider know if your pain is worse or hasn't gotten better after a week. Your provider can check your symptoms and let you know if you need more medical care.
Lidocaine/menthol topical products dosage
Bottle of topical solution| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50ml of 4%/1% | 1 bottle | $23.45 | $23.45 |
Typical dosage for Lidocaine/menthol topical products
Lidocaine/menthol topical products made by different manufacturers might have different directions and age-cutoffs. To make sure you're taking this medication correctly, follow the specific product instructions on the package or talk with your provider or pharmacist about how to use it.
Examples of some lidocaine/menthol topical products include:
Lidocaine 4% / menthol 1% topical lotion, solution, gel, and ointment
- Apply a small amount to the affected area(s) 3 to 4 times daily.
Lidocaine 4% / menthol 1% topical cream and spray
- Apply a small amount to the affected area(s) every 6 to 8 hours daily. Don't apply more than 3 times in 24 hours.
How much does Lidocaine/menthol topical products cost?
What are alternatives to Lidocaine/menthol topical products?
Topical lidocaine products come in many forms and strengths. Each can be used for different conditions.
In general, they're used for temporary relief of pain, itching, burning, or discomfort from:
