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lidocaine / tetracaine

Generic Pliaglis
Used for Pain, Anesthesia
Used for Pain, Anesthesia

Pliaglis (lidocaine / tetracaine) is a cream that's applied to the skin to numb an area before certain medical procedures. It can cause some serious side effects, so you should closely follow your provider's instructions for use. It's only available as a brand-name medication, so it can be expensive.

Reviewed by:
reviewer
Sarah Lobello Pearson, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on May 25, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesPricesMedicare
basics-icon

What is Pliaglis (lidocaine / tetracaine)?

What is Pliaglis (lidocaine / tetracaine) used for?

To numb the skin before procedures, such as:

  • Dermal filler injections

  • Laser resurfacing of the face

  • Laser tattoo removal

How Pliaglis (lidocaine / tetracaine) works

Pliaglis (lidocaine / tetracaine) is a combination of two local anesthetics: lidocaine and tetracaine. Both medications are absorbed through your skin, where they temporarily block your nerves from sending pain signals to your brain. Pliaglis (lidocaine / tetracaine) causes a loss of feeling on the area of skin where it's applied. This is useful for certain procedures involving the skin that can be painful.

Are you looking for information on Synera (lidocaine / tetracaine) patch or Aprizio Pak (lidocaine / prilocaine) instead?

Drug Facts

Common BrandsPliaglis
Drug ClassLocal anesthetic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Avg retail price
$1359.99(save 80.73%)
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$262.09
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What are the side effects of Pliaglis (lidocaine / tetracaine)?

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

  • Skin redness (47%)
  • Changes in skin color (16%)
  • Swelling (14%)

Other Side Effects

  • Rash
  • Itching
  • Dry skin
  • Headache
  • Dizziness
  • Fever

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Blood problems (methemoglobinemia): bluish coloring of skin, headache, trouble breathing, tiredness, seizures, coma
  • Severe allergic reaction: rash, hives, swelling, dizziness, trouble breathing

Source: DailyMed

The following 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):

  • Change in skin color
  • Irritation at application site
pros-and-cons

Pros and cons of Pliaglis (lidocaine / tetracaine)

thumbs-up

Pros

Can help reduce pain related to certain skin procedures

Two medications combined into one product to help with pain

Comes with a tool for applying the medication, so you don't have to get it on your hands

Can measure medication using dosing ruler to get an accurate dose

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Cons

Only available as a brand-name product, so it can be expensive

Can take up to 9 hours for numbness to wear off

Can't be used on broken skin

Can't be applied to the treatment area for pain after the procedure

Can cause severe eye irritation if it makes contact with the eyes

pharmacist-tips

Pharmacist tips for Pliaglis (lidocaine / tetracaine)

pharmacist

  • Don't use more Pliaglis (lidocaine / tetracaine) than your provider instructed you to use. Also make sure you don't leave it on your skin for longer than 2 hours. In addition, avoid covering the treated area with a tight bandage. These things can cause you to absorb too much of the medication and might lead to serious side effects.

    • Don't apply Pliaglis (lidocaine / tetracaine) to skin that's broken, cut, scratched, or irritated. Also, don't apply the medication to the treatment area after your procedure. This can raise your risk of side effects from the medication.

      • Avoid getting Pliaglis (lidocaine / tetracaine) in your eyes or on your lips. If the medication does make contact here, rinse the area with water right away. Pliaglis (lidocaine / tetracaine) can cause severe eye irritation if it makes contact with the eyes.

        • If you experience skin irritation or a burning sensation after applying Pliaglis (lidocaine / tetracaine), remove the medication right away by washing the area with soap and water. Contact your provider if the irritation or burning doesn't go away after washing off the medication.

          • After carefully peeling off the dried Pliaglis (lidocaine / tetracaine) film, you can place it in your household trash. Just make sure this is an area that children or pets don't have access to. It can cause serious harm if touched or ingested by a child or pet.

            • The area that you treat with Pliaglis (lidocaine / tetracaine) will be numb for several hours, so be gentle with the treated skin. You can accidentally damage your skin by scratching or rubbing too hard, because you won't have feeling in that area. Also, don't expose the treated area to extreme temperatures until the numbing sensation is gone.

              faqs

              Frequently asked questions about Pliaglis (lidocaine / tetracaine)

              How long will my skin be numb after applying Pliaglis (lidocaine / tetracaine)?
              The area of skin where you apply Pliaglis (lidocaine / tetracaine) might be numb for up to 9 hours.
              How do I use Pliaglis (lidocaine / tetracaine)?
              Measure out your dose of Pliaglis (lidocaine / tetracaine) in grams with the ruler included with the medication. Your provider should tell you the amount in grams that you need to apply. Apply the cream using the applicator included with the medication or another flat-surfaced tool. The cream should be applied in a 1 millimeter (mm) thick layer (about the thickness of a dime). Don't rub the medication into your skin. Let the cream air dry, and don't touch the area. You'll leave Pliaglis (lidocaine / tetracaine) on your skin for 20 to 60 minutes, depending on the type of procedure you're having. Then, peel the dried cream off your skin and wipe off any that remains. Wash your hands well after handling this medication. Wash and dry the ruler and applicator to keep for your next treatment.
              How do I store Pliaglis (lidocaine / tetracaine)?
              Pliaglis (lidocaine / tetracaine) can be stored in the refrigerator or at room temperature. If stored in the refrigerator, the medication will expire on the date printed on the package. If stored at room temperature, it will expire after 3 months.
              What's the difference between Pliaglis (lidocaine / tetracaine) and lidocaine/prilocaine) cream?
              Pliaglis (lidocaine / tetracaine) and lidocaine/prilocaine cream both contain lidocaine and one other local anesthetic. When applied to the skin, they both provide a numbing sensation to help with pain. Lidocaine/prilocaine is typically rubbed into the skin in order to produce the numbing effect, while Pliaglis (lidocaine / tetracaine) shouldn't be rubbed in, but rather left to dry on the skin, and then removed. The numbing sensation typically lasts longer with Pliaglis (lidocaine / tetracaine) than with lidocaine/prilocaine cream. These two medications are also approved for procedures at different locations of the body. For instance, lidocaine/prilocaine cream can be used to numb the genital area, while Pliaglis (lidocaine / tetracaine) shouldn't be applied to this area.
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              What are the risks and warnings for Pliaglis (lidocaine / tetracaine)?

              Pliaglis (lidocaine / tetracaine) 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.

              risk-warning

              Blood problem (methemoglobinemia)

              • Risk factors: Glucose-6-phosphate dehydrogenase (G6PD) deficiency | Heart or lung problems

                Pliaglis (lidocaine / tetracaine) can cause a serious reaction known as methemoglobinemia. Methemoglobinemia is a condition where the blood doesn't deliver oxygen to the body very well. It can occur right away or take several hours to develop. The signs of this reaction are a bluish coloring of the skin (due to lack of oxygen), trouble breathing, tiredness, seizures, coma, or even death. If your skin turns blue or you have trouble breathing after using Pliaglis (lidocaine / tetracaine), get medical help right away.

                risk-warning

                Serious side effects if too much medication gets absorbed

                • Risk factors: Leaving on the skin for longer than recommended | Applying to a larger area than recommended | Applying to broken or damaged skin | Using other local anesthetics at the same time | Covering the area with a tight bandage

                  You might be at risk for serious side effects from Pliaglis (lidocaine / tetracaine) if you absorb too much of the medication into your skin. Only use the dose recommended by your provider on the area where you're going to have the procedure. If you apply too much medication, leave it on for too long, or cover it with a tight bandage, you could absorb too much Pliaglis (lidocaine / tetracaine). Using this medication along with other local anesthetics can also cause you to get too high of a dose of Pliaglis (lidocaine / tetracaine).

                  risk-warning

                  Risks of exposure to children and pets

                  Pliaglis (lidocaine / tetracaine) can cause serious harm if children or pets are exposed to the medication. Be sure to keep the medication in a place that's out of reach of children and pets. Place the cap back onto the tube of cream properly. This is a child-resistant cap that should keep children from being able to open the tube of medication. When throwing away the dried cream film, make sure it's in a place that children or pets cannot access.

                  risk-warning

                  Severe allergic reactions

                  Pliaglis (lidocaine / tetracaine) can cause a severe allergic reaction in some people. Get medical help right away if you develop hives, swelling of the face, mouth, or lips, or trouble breathing. These could be signs of a serious allergic reaction.

                  risk-warning

                  Eye irritation if it gets into the eyes

                  Pliaglis (lidocaine / tetracaine) can cause severe eye irritation if it makes contact with the eyes. Be sure to wash your hands after handling this medication. If you get Pliaglis (lidocaine / tetracaine) in your eyes, rinse them right away with water or saline. You might lose sensation in your eye, so make sure to protect the eye until the sensation returns. If the irritation doesn't go away after rinsing your eyes, contact your provider.

                  dosage

                  Pliaglis (lidocaine / tetracaine) dosage forms

                  The average cost for 1 tube of 30g of 7%/7% of Pliaglis (lidocaine / tetracaine) is $262.09 with a free GoodRx coupon. This is 80.73% off the average retail price of $1359.99.
                  tube of cream
                  Tube of cream
                  DosageQuantityPrice as low asPrice per unit
                  30g of 7%/7%1 tube$262.09$262.09

                  Typical dosing for Pliaglis (lidocaine / tetracaine)

                  Each gram of medication contains 70 mg of lidocaine and 70 mg of tetracaine. The dose depends on the size of the area that's being treated. Your provider will tell you the total number of grams to apply to your treatment area, and how long you should leave it on your skin. Measure out your dose using the ruler that's provided with the medication (see FAQs for more information).

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                  How much does Pliaglis (lidocaine / tetracaine) cost?

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                  Pliaglis (brand)
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                  contraindications-icon

                  Pliaglis (lidocaine / tetracaine) contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Pliaglis (lidocaine / tetracaine) will not be safe for you to take.

                  • Sensitivity to lidocaine, tetracaine, or other local anesthetics

                  • Sensitivity to para-aminobenzoic acid (PABA)

                  alternatives

                  What are alternatives to Pliaglis (lidocaine / tetracaine)?

                  There are a number of medications that your doctor can prescribe in place of Pliaglis (lidocaine / tetracaine). Compare a few possible alternatives below.
                  Pliaglis (lidocaine / tetracaine)
                  Used for:

                  To numb the skin before procedures, such as:

                  • Dermal filler injections

                  • Laser resurfacing of the face

                  • Laser tattoo removal

                  $262.09 Lowest GoodRx priceView Prices
                  Lidocaine/prilocaine
                  Used for:

                  • Pain on unbroken skin

                  • Pretreatment for local infiltration anesthesia (when a medication is injected in an area of your body to take away feeling, usually before surgery) of inner lining of genitals

                  • Pain from minor surgery on inner lining of genitals

                  $10.97 Lowest GoodRx priceView Prices
                  Topical lidocaine
                  Used for:

                  • Minor burns

                  • Sunburns

                  • Minor cuts

                  • Scrapes

                  • Insect bites

                  • Minor skin irritations

                  • Joint and muscle pain

                  • Hemorrhoids and other irritations in the anal area

                  • Tattoos, piercings, microblading, and other skin procedures

                  $23.66 Lowest GoodRx priceView Prices

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