Tuesday, 3 April 2012

Cetacaine Topical Anesthetic



benzocaine, butamben and tetracaine hydrochloride

Dosage Form: topical liquid
Cetacaine Topical Anesthetic

Action




The onset of Cetacaine-produced anesthesia is rapid (approximately

30 seconds) and the duration of anesthesia is typically 30-60 minutes,

when used as directed. This effect is due to the rapid onset, but short

duration of action of Benzocaine coupled with the slow onset, but extended

duration of Tetracaine HCI and bridged by the intermediate action

of Butamben.


It is believed that all of these agents act by reversibly blocking nerve

conduction. Speed and duration of action is determined by the ability

of the agent to be absorbed by the mucous membrane and nerve

sheath and then to diffuse out, and ultimately be metabolized (primarily

by plasma cholinesterases) to inert metabolites which are excreted in

the urine.



Indications




Cetacaine is a topical anesthetic indicated for the production of anesthesia

of all accessible mucous membrane except the eyes. Cetacaine

Spray is indicated for use to control pain or gagging.

Cetacaine in all forms is indicated to control pain and for use for surgical

or endoscopic or other procedures in the ear, nose, mouth, pharynx,

larynx, trachea, bronchi, and esophagus. It may also be used for

vaginal or rectal procedures when feasible.



Dosage and Administration




Cetacaine Liquid

Instructions for Subgingival Delivery:

  1. Remove the shipping cap, discard and replace with Luer-lock dispensing cap.  Note:  Once dispensing cap is in place, it should not be removed.

  2. Remove the small cap from the Luer-lock port.  Retain for replacement after use.

  3. Lock a 1.2 mL Luer-lock syringe into the port.

  4. Invert the bottle and slowly draw liquid (0.4 mL maximum) into syringe.  If air is drawn into syringe, push the liquid back into the bottle and slowly redraw liquid into syringe.

  5. Holding bottle upright, remove the syringe from the port and replace the small port cap.

  6. Attach a 27 ga Vista-Probe Tip to the syringe.  The tip may be bent to improve access.  Do not bend tip more than once in the same location.  If more than a 45 degree angle is desired, bend in two locations.  Bending at the hub may increase the risk of breakage.

  7. Apply Cetacaine Liquid drop-wise to accessible mucous membrane (such as the buccal and lingual sulcus) by slowly depressing the syringe plunger.

  8. Wait 1 minute for maximum anesthesia before beginning procedure.  The duration of anesthesia is typically 3--60 minutes, when used as directed.  Discard syringe and tip after use.


Alternate Method:  Instructions for Topical Delivery

                          using a Microbrush

  1. Remove the shipping cap, discard and replace with Luer-lock dispensing cap.  Note:  Once dispensing cap is in place, it should not be removed. 

  2. Remove the small cap from the Luer-lock port.  Retain for replacement after use.

  3. Luer-lock port allows single dip of appropriate brush or applicator.

  4. Applhy Cetacaine Liquid to accessible mucous membrane using the microbrush.

  5. Wait 1 minute for maximum anesthesia before beginning procedure.  The duration of anesthesia is typically 30-60 minutes, when used as directed.  Discard microbrush after use.





Cetacaine Spray should be applied for approximately one second or

less for normal anesthesia. Only a limited quantity of Cetacaine is

required for anesthesia. Spray in excess of two seconds is

contraindicated. Average expulsion rate of residue from spray, at normal

temperatures, is 200 mg per second.


To apply, insert the Jetco cannula (J-4) firmly onto the protruding plastic

stem on the bottle and press the cannula forward to actuate the spray

valve. The cannula may be removed and reinserted as many times as

required for cleaning, or sterilization, and is autoclavable.


Cetacaine Liquid Apply 200 mg (approximately 6 – 7 drops or 0.2 cc)

with a cotton applicator or directly to tissue. Do not hold the cotton

applicator in position for extended periods of time, since local reactions

to benzoate topical anesthetics are related to the length of time

of application. Liquid in excess of 400 mg (approx. 12 – 14 drops or

0.4 cc) is contraindicated.


*See Cetacaine Liquid Kit instructions for additional directions for application

by Luer-lock syringe and applicator tip.


Cetacaine Gel Apply 200 mg of gel (a bead approximately 0.5 inch

(13 mm) in length and 3/16 inch (5 mm) in diameter) and spread thinly

and evenly over the application area. Gel in excess of 400 mg (a bead

approximately 1 inch (26 mm) in length and 3/16 inch (5 mm) in diameter)

is contraindicated.


An appropriate pediatric dosage has not been established for Cetacaine

Spray, Liquid or Gel.


Dosages should be reduced in the debilitated elderly, acutely ill, and

very young patients.


Tissue need not be dried prior to application of Cetacaine. Cetacaine

should be applied directly to the site where pain control is required.

Anesthesia is produced within one minute with an approximate

duration of thirty minutes. Each 200 mg dose of Cetacaine (Spray

residue, Liquid or Gel) contains 28 mg of benzocaine, 4 mg of butamben

and 4 mg of tetracaine HCl.



Adverse Reactions




Hypersensitivity Reactions: Unpredictable adverse reactions (i.e. hypersensitivity,

including anaphylaxis) are extremely rare.


Localized allergic reactions may occur after prolonged or repeated use

of any aminobenzoate anesthetic. The most common adverse reaction

caused by local anesthetics is contact dermatitis characterized by erythema

and pruritus that may progress to vesiculation and oozing. This

occurs most commonly in patients following prolonged self-medication,

which is contraindicated. If rash, urticaria, edema, or other manifestations

of allergy develop during use, the drug should be discontinued. To minimize

the possibility of a serious allergic reaction, Cetacaine preparations should not

be applied for prolonged periods except under continual supervision. Dehydration

of the epithelium or an escharotic effect may also result from prolonged contact.


Precaution: On rare occasions, methemoglobinemia has been reported

in connection with the use of benzocaine-containing products.

Care should be used not to exceed the maximum recommended

dosage (see Dosage and Administration). If a patient becomes cyanotic, treat appropriately

to counteract (such as with methylene blue, if medically indicated).



Use in Pregnancy


Safe use of Cetacaine has not been established

with respect to possible adverse effects upon fetal development.

Therefore, Cetacaine should not be used during early pregnancy, unless

in the judgment of a physician, the potential benefits outweigh

the unknown hazards. Routine precaution for the use of any topical

anesthetic should be observed when Cetacaine is used.





Cetacaine is not suitable and should never be used for injection. Do

not use on the eyes. To avoid excessive systemic absorption, Cetacaine

should not be applied to large areas of denuded or inflamed tissue.

Cetacaine should not be administered to patients who are

hypersensitive to any of its ingredients or to patients known to have

cholinesterase deficiencies. Tolerance may vary with the status of the

patient.


Cetacaine should not be used under dentures or cotton rolls, as retention

of the active ingredients under a denture or cotton roll could possibly

cause an escharotic effect. Routine precaution for the use of any

topical anesthetic should be observed when using Cetacaine.




How Supplied


• Cetacaine Liquid Kit (NDC 10223-0202-3, Item # 0210 ) which includes

   one 14 g bottle of Cetacaine Liquid with Leur-lock dispenser

   cap, 20 syringes and 20 applicator tips.

• Cetacaine Liquid, 14 g bottle (NDC 10223-0202-2, Item # 0203)

• Cetacaine Liquid, 30 g bottle (NDC 10223-0202-4, Item # 0211)


Available From Your Dealer:


• 1.2 mL Luer-lock syringes

• Tips, 27 ga

• Microbrushes



Cetacaine Liquid is not suitable for injection.  Do not use on the eyes.

RX Only.




















Cetacaine Topical Anesthetic  
benzocaine, butamben and tetracaine hydrochloride topical aerosol  liquid










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)10223-0202
Route of AdministrationTOPICALDEA Schedule    














Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Benzocaine (Benzocaine)Benzocaine0.028 g  in 0.2 g
Butamben (Butamben)Butamben0.004 g  in 0.2 g
Tetracaine hydrochloride (Tetracaine)Tetracaine hydrochloride0.004 g  in 0.2 g





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorBANANA (Artificial Banana Flavor)Imprint Code
Contains      


















Packaging
#NDCPackage DescriptionMultilevel Packaging
110223-0202-214 g In 1 BOTTLE, GLASSNone
210223-0202-430 g In 1 BOTTLE, GLASSNone
310223-0202-314 g In 1 KITNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other01/01/1958


Labeler - Cetylite Industries Inc. (001283704)

Registrant - Cetylite Industries Inc. (001283704)









Establishment
NameAddressID/FEIOperations
Cetylite Industries Inc.001283704manufacture
Revised: 03/2011Cetylite Industries Inc.

More Cetacaine Topical Anesthetic resources


  • Cetacaine Topical Anesthetic Side Effects (in more detail)
  • Cetacaine Topical Anesthetic Use in Pregnancy & Breastfeeding
  • Cetacaine Topical Anesthetic Support Group
  • 0 Reviews · Be the first to review/rate this drug

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