Cetacaine

General Information

Cetacaine is the brand name of a commonly available topical mucosal anesthetic, which is a combination of 14% benzocaine, 2% tetracaine hydrochloride, and 2% butamben. This is slightly different from another readily available topical anesthetic, HurriCaine spray, which is composed of 20% benzocaine.

Administration

• Type: Topical anesthetic
• Dosage Forms: Spray, gel, solution
• Routes of Administration: Mucosal
• Common Trade Names: Cetacaine; Exactacain

Adult Dosing

Spray form

• Apply maximum 2 second spray

Gel form

• Apply a maximum of 1 inch of gel

Solution form

• Apply a maximum of 0.4cc

Pediatric Dosing

No pediatric dosing established

Special Populations

• Pregnancy Rating: Category C
• Lactation risk: Safety unknown

Renal Dosing

• Adult: N/A
• Pediatric: N/A

Hepatic Dosing

• Adult: N/A
• Pediatric: N/A

Contraindications

• Allergy to class/drug
• Cholinesterase deficincies
• Use caution in G6PD and Hgb-M patients
• Avoid using on significantly inflamed or macerated tissue

Adverse Reactions

Serious

• Methemoglobinemia
• Anaphylaxis

Common

• Contact dermatitis
• Xeroderma

Pharmacology

• Half-life: Unknown
• Metabolism: Plasma cholinesterase, liver
• Excretion: Urine (minimal systemic absorption)

Mechanism of Action

• Ester anesthetic, inhibits Na ion channels and nerve impulse/conduction

References

Micromedex

US FDA benzocaine warning. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250264.htm