The properties

The properties listed below are those particular to the combination only. For the properties of the components please consider, lidocaine hydrochloride p. 1392, prilocaine hydrochloride p. 1396.

l INDICATIONS AND DOSE

Anaesthesia before minor skin procedures including venepuncture

 TO THE SKIN

 Child 1–2 months: Apply up to 1 g for maximum 1 hour before procedure, to be applied under occlusive dressing, shorter application time of 15–30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 1 dose per day  Child 3–11 months: Apply up to 2 g for maximum 1 hour before procedure, to be applied under occlusive dressing, shorter application time of 15–30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 2 doses per day  Child 1–11 years: Apply 1–5 hours before procedure, a thick layer should be applied under occlusive dressing, shorter application time of 15–30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 2 doses per day  Child 12–17 years: Apply 1–5 hours before procedure (2–5 hours before procedures on large areas e.g. split skin grafting), a thick layer should be applied under occlusive dressing, shorter application time of 15–30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca) ? Adult: Apply 1–5 hours before procedure (2–5 hours before procedures on large areas e.g. split skin grafting), a thick layer should be applied under occlusive dressing Anaesthesia on genital skin before injection of local anaesthetics

 TO THE SKIN

 Adult: Apply under occlusive dressing for 15 minutes (males) or 60 minutes (females) before procedure Anaesthesia before surgical treatment of lesions on genital mucosa

 TO THE SKIN

 Adult: Apply up to 10 g, to be applied 5–10 minutes before procedure Anaesthesia before cervical curettage

 TO THE SKIN

 Adult: Apply 10 g in lateral vaginal fornices for 10 minutes Anaesthesia before mechanical cleansing or debridement of leg ulcer

 TO THE SKIN

 Adult: Apply up to 10 g for 30–60 minutes, to be applied under occlusive dressing FORTACIN ® Primary premature ejaculation

 TO THE SKIN

 Adult: 3 sprays every 4 hours as required, to be applied to cover the glans penis (excess spray should be removed after 5 minutes and before intercourse); maximum 9 sprays per day

DOSE EQUIVALENCE AND CONVERSION

 For Forticin ® each dose of 3 sprays is equivalent to lidocaine 22.5 mg and prilocaine 7.5 mg.

l CONTRA-INDICATIONS 

Use in child less than 37 weeks corrected gestational age

l CAUTIONS FORTACIN

® Acquired methaemoglobinaemia . anaemia . congenital methaemoglobinaemia

l INTERACTIONS → Appendix 1:

anaesthetics, local . antiarrhythmics

l SIDE-EFFECTS

 Common or very common Sexual dysfunction (in adults)  Uncommon Fever (in adults). headache (in adults). penis disorder  Rare or very rare Methaemoglobinaemia . skin reactions

SIDE-EFFECTS, FURTHER INFORMATION

When applied to the glans penis, side-effects for sexual partners should be considered. Side-effects reported in female partners include vaginal candidiasis and dysuria.

l CONCEPTION AND CONTRACEPTION FORTACIN

Deterioration of polyurethane-based female and male condoms has been observed. Manufacturer advises avoid in patients planning to conceive, or if it is essential to achieve penetration, then the glans penis should be washed thoroughly 5 minutes after application but before intercourse.

l PREGNANCY FORTACIN

 Manufacturer advises preferably avoid unless an effective male barrier contraceptive is used—limited information available.

l HEPATIC IMPAIRMENT FORTACIN

 Manufacturer advises caution in severe impairment (no information available).

l DIRECTIONS FOR ADMINISTRATION FORTACIN

 Manufacturer advises when using the spray for the first time, shake and prime the unit with 3 sprays, and before each subsequent use, shake and prime the unit with 1 spray.

l PATIENT AND CARER ADVICE

Medicines for Children leaflet: EMLA cream for local anaesthesia www.medicinesforchildren.org.uk/emla-cream-localanaesthesia