Cheap analogues of Emla - TOP 6 best depilatory creams

Possible during pregnancy

Possible while breastfeeding

Has restrictions for children

Can be taken by older people

Has limitations for liver problems

Can be taken for kidney problems

Emla is a medication with antibacterial properties that is used for local anesthesia. The effectiveness of Emla is due to the effect on the body of its active components - lidocaine and prilocaine. The drug is produced in the dosage form of a cream. The price of Emla is quite high, so information about cheap analogues is important for patients.

A cream is applied to anesthetize the skin over a small area, and is also effectively used during the following medical procedures:

• pain relief at the injection site;
• installation of a urethral catheter;
• installation of an intravenous catheter for administering medications and collecting arterial blood;
• performing superficial surgical procedures;
• anesthesia of the genital organs for surgical treatment;
• cleaning the skin and soft tissues of necrotic tissue, pus and fibrin;
• cleansing trophic ulcers on the legs;
• removal of molluscum contagiosum in children.

Release forms

The drug Emla can be prescribed even to infants. Do not use Emla for:

• allergies to the medicinal composition;
• open wounds at the application site;
• atopic form of dermatitis;
• herpes zoster type.

Adverse reactions are rare, but sometimes patients report the following negative symptoms:

• seizures;
• hypertension and bradycardia;
• respiratory depression and bronchospasms;
• confusion, dizziness and lethargy;
• depression;
• coma;
• dermatological allergy.

Pharmacological properties of the drug Emla

EMLA cream contains lidocaine and prilocaine, amide-type local anesthetics. Due to the penetration of lidocaine and prilocaine into the layers of the epidermis and dermis, skin anesthesia occurs. The degree of anesthesia depends on the time of application and dose. Intact skin When EMLA cream is applied to intact skin for 1–2 hours, anesthesia lasts about 2 hours after removing the occlusive sticker. There were no differences in efficacy (including time to achieve analgesic effect) and safety when applied to intact skin between young and elderly patients. Due to the effect of the cream on the superficial vessels, temporary pallor or redness of the skin area is possible. Vasomotor reactions develop faster (already 30–60 minutes after applying the cream) in patients with widespread neurodermatitis (atopic neurodermatitis), which indicates a faster penetration of the cream through the changed skin. During a puncture biopsy (up to 4 mm in diameter), the use of the cream provides adequate anesthesia of intact skin in 90% of patients 60 minutes after applying the cream when the needle is inserted into the skin to a depth of 2 mm and after 120 minutes - to a depth of 3 mm. The effectiveness of the cream does not depend on the color and pigmentation of the skin (skin types I–IV). The cream can be used for pain relief before vaccination when administering the vaccine subcutaneously or intramuscularly. Genital mucosa The anesthetic effect of the mucous membrane appears earlier, since absorption occurs faster than in cases of application to intact skin. In women, after applying EMLA cream to the mucous membrane of the genital organs, after 5–10 minutes an analgesic effect is achieved that is sufficient for manipulations using an argon laser. The duration of anesthesia is 15–20 minutes (taking into account individual characteristics - from 5 to 45 minutes). Trophic ulcers of the lower extremities After applying the cream when treating trophic ulcers of the lower extremities, the duration of the analgesic effect is about 4 hours. The cream does not have a negative effect on the wound healing process and bacterial flora. Systemic absorption depends on the amount of cream, duration of application, skin thickness (which varies in different areas of the body) and other skin characteristics. Intact skin In adults, after applying 60 g of EMLA cream to 400 cm2 of intact skin on the thigh (1.5 g per 10 cm2) over 3 hours, systemic absorption was 3% for lidocaine and 5% for prilocaine. Absorption occurs slowly. At the above dose, the maximum plasma concentration of lidocaine (average 0.12 mcg/ml) and prilocaine (average 0.07 mcg/ml) was achieved approximately 4 hours after application. The risk of developing toxic symptoms exists only at doses of 5–10 mcg/ml. Trophic ulcers of the lower extremities After applying 5–10 g of EMLA cream to trophic ulcers with an exposure of 30 minutes, the maximum levels of lidocaine and prilocaine in the blood plasma were achieved after 1–2.5 hours (lidocaine concentration in the range of 0.05–0.84 μg/ml , prilocaine - 0.02–0.08 mcg/ml). After repeated application of EMLA cream to trophic ulcers, no significant accumulation of lidocaine, prilocaine or their metabolites in the blood plasma was noted (EMLA cream was applied at a dose of 2–10 g for 30–60 min to an area of ​​62 cm2 15 times a month for 3–7 sessions per week). Genital mucosa The maximum plasma concentration is achieved approximately 35 minutes after applying 10 g of EMLA cream to the vaginal mucosa with an exposure of 10 minutes (the average concentration of lidocaine was 0.18 mcg/ml; prilocaine - 0.15 mcg/ml) .

Use of Emla

Adults:

Trophic ulcers of the lower extremities During surgical treatment (mechanical cleansing) of trophic ulcers, apply 1–2 g of cream per 10 cm2 of surface. The cream is applied in a thick layer to the surface of the ulcer, no more than 10 g of cream per procedure. Cover the surface of the ulcer with an occlusive sticker. Duration of cream application is 30 minutes. The open tube is intended for one-time use; after each procedure, the unused cream is thrown away. When treating ulcers into which tissue penetration of the drug is difficult, the duration of application can be increased to 60 minutes. Surgical treatment of the wound surface should begin no later than 10 minutes after removing the cream. In the treatment of trophic ulcers of the lower extremities, EMLA cream is used up to 15 times over 1–2 months without reducing effectiveness or increasing the incidence of local reactions. Superficial anesthesia of the genital organs Skin of the genital organs Application of local anesthetics before injection:

• men: 1 g per 10 cm2. A thick layer of cream is applied to the skin. Duration of application - 15 minutes;
• women: 1–2 g per 10 cm2. A thick layer of cream is applied to the skin. Duration of application - 60 minutes.

Mucous membrane of the genital organs To remove condylomas or before injection of local anesthetics: 5–10 g of cream, depending on the area of ​​treatment, is applied to the entire surface, including the folds of the mucous membrane. No occlusal adhesive is required. Application duration is 5–10 minutes. The surgical procedure should begin immediately after removing the cream. Children When performing percutaneous injections, removal of molluscum contagiosum and other superficial surgical manipulations: the dose of EMLA cream should not exceed 1 g per 10 cm2 of surface, the cream is applied in a thick layer to the surface of the skin and covered with an occlusive sticker.

Children with atopic dermatitis need to reduce the duration of application to 30 minutes. Recommendations regarding the method of use Pierce the sealed membrane of the tube with a spike located in the upper outer part of the lid. Squeeze out the required amount of cream and apply to the procedure site. When anesthetizing the skin, occlusive stickers are used, included in the kit with the cream (12 pieces, size 6x7 cm).

Side effects of Emla

True adverse reactions caused by the use of local anesthetics occur with a frequency of 1/1000 patients.

Isolated cases of local reactions at the site of application of the cream, such as hemorrhagic rashes or petechiae, have been reported, especially after prolonged application in children with atopic dermatitis or warts. If the drug accidentally gets into the eyes, corneal irritation may occur.

Advantages and disadvantages

Consumers appreciated Emla and noted its following advantages:

• effective skin pain relief before epilation/depilation;
• Possibility of use in the intimate area;
• no odor;
• good consistency of the product, which does not allow the cream to spread after application;
• easy and convenient use;
• a small list of contraindications;
• the ability to purchase tubes individually, which saves money.

However, consumers also discovered disadvantages:

• the need to wait until the components of the drug begin to act;
• the likelihood of side effects;
• high price of the drug.

Special instructions for the use of Emla

Patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia are more likely to develop drug-dependent methemoglobinemia. EMLA cream should be used with caution on the skin in the eye area, since the drug irritates the mucous membrane of the eyes. In addition, loss of protective reflexes due to anesthetic contact with the cornea can lead to irritation and damage to the cornea. If EMLA cream gets into your eyes, they should be immediately rinsed with water or saline (sodium chloride solution) and protected until sensitivity of the cornea is restored. In patients with atopic dermatitis, the cream should be used with caution, and the duration of application should be reduced to 15–30 minutes. The effectiveness of using the cream in newborns when taking blood from the heel has not been established. The safety and effectiveness of the drug in children under 3 months of age have been studied only using a single dose. In such children, after applying the cream, a temporary increase in the level of methemoglobin in the blood is often observed, lasting up to 13 hours. However, this fact is probably not clinically significant. The cream should not be applied to a damaged eardrum and should not be used in situations where the drug may penetrate into the middle ear cavity. The cream should not be applied to open wounds. The drug should not be applied to the genital mucosa in children due to insufficient data regarding absorption. At concentrations exceeding 0.5–2.0%, lidocaine and prilocaine exhibit bactericidal and antiviral properties. Therefore, if the drug is used during vaccination (intradermal administration of a live vaccine, for example BCG), careful monitoring of the results of vaccination is necessary. EMLA cream should not be used in children aged 0 to 12 months receiving concomitant therapy with drugs that induce methemoglobinemia due to the lack of sufficient clinical experience with its use. It is necessary to monitor patients receiving antiarrhythmic drugs belonging to class III (for example, amiodarone), taking into account the results of the ECG in such patients, since lidocaine and class III antiarrhythmic drugs have additive effects. Pregnancy and lactation period Data regarding treatment of pregnant women with EMLA cream are insufficient. The results of studies conducted on animals do not contain sufficiently complete and reliable information regarding the effect on pregnancy, embryonic/fetal development, childbirth and development after birth. Lidocaine and prilocaine penetrate the placental barrier and can be absorbed by fetal tissues. There were no reports of reproductive disturbances, such as an increased incidence of malformations or direct or indirect effects on the fetus. However, when using the drug during pregnancy, it is necessary to weigh the benefit/risk ratio. Lidocaine and, probably, prilocaine pass into breast milk, but in such small quantities that the effect of therapeutic doses of the drug on the child is unlikely. Does not affect the ability to drive vehicles and operate machinery.

Emla cream: composition and mechanism of action on the skin

Why does a person experience pain? In general, this feeling performs a kind of protective function in the body. When the skin is injured or otherwise damaged, the nerve endings immediately send an impulse to the brain about it. Thus, the biological meaning of pain is that it instantly mobilizes the body for self-preservation.

The epilation process is always accompanied by painful sensations

However, pain becomes a serious obstacle during some beauty procedures, in particular during hair removal or depilation, when hairs are removed, damaging the hair follicle, or pulled out along with the root. In this case, Emla cream is often used, which blocks the nerve endings, as a result of which the brain does not receive any alarm signals.

The drug contains the anesthetic components lidocaine and prilocaine. Lidocaine exhibits its analgesic properties much faster than prilocaine, but its duration of action is shorter than that of the second anesthetic.

The combination of these two components in Emla provides, although not instantaneous, a relatively quick and fairly long-lasting effect, which allows epilation or depilation over large areas of the skin.

Research shows that Emla is a highly effective drug. 91% of women noted complete pain relief after applying the cream. The remaining 9% experienced minor pain. This could be due to the use of an insufficient amount of the drug, or the exposure time was incorrectly chosen .

Another reason for inadequate anesthesia may be a physiological feature of the skin: the thicker the skin, the longer it takes the drug to reach the nerve endings. Therefore, in this case, the application time of Emla should be increased so that the components of the drug can penetrate the skin layers as deeply as possible.

Emla drug interactions

EMLA cream may increase the formation of methemoglobin in patients receiving treatment with methemoglobin-inducing drugs (eg, sulfonamides). When using EMLA cream in high doses in patients receiving local anesthetics or drugs structurally similar to local anesthetics, such as tocainide, the risk of systemic additive effects must be considered. Specific studies of the interaction of the drug with local anesthetics and antiarrhythmic drugs belonging to class III have not been conducted, so caution is recommended when using them together.

Precautionary measures

To ensure that the hair removal or depilation process is painless and that no side effects occur after using Emla, certain precautions must be observed.

When applying an anesthetic to the skin of the face, you need to ensure that the cream does not get on the mucous membrane of the eyes, since Emla causes irritation of the cornea. If accidental contact with the drug does occur, the eyes should be thoroughly rinsed with running water.

The use of cream for anesthesia of the upper lip should also be careful, since getting the product into the oral cavity is undesirable.

To avoid any unpleasant moments when using Emla before hair removal or depilation, experts advise studying the instructions for the drug and strictly following the instructions.

Emla drug overdose, symptoms and treatment

If the recommended dosage regimen is followed, the development of systemic toxicity is unlikely. The probable symptoms of intoxication are the same as with the use of other local anesthetics: at the beginning, stimulation of the central nervous system, in severe cases, depression of the central nervous system and cardiac activity. Cases of clinically significant methemoglobinemia have been very rarely reported in children, as prilocaine in high doses can increase methemoglobin levels. Superficial application of 125 mg of prilocaine for 5 hours caused the development of moderate methemoglobinemia in a three-month-old child. Topical application of 8.6–17.2 mg/kg lidocaine led to the development of severe intoxication in infants. Severe neurological symptoms (convulsions, central nervous system depression) require symptomatic treatment: the use of mechanical ventilation and anticonvulsants. The antidote for methemoglobinemia is methylthionine. Due to the slow systemic absorption of the drug, the patient's condition must be monitored for several hours after the symptoms of intoxication have resolved.