Magic mouthwash: Difference between revisions
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Revision as of 16:00, 22 March 2016
- In infants, do NOT use oral lidocaine due to risk of methemoglobinemia and FDA black box warning[1][2]
Background
- Some experts recommend Magic Mouthwash / oral Lidocaine in children if not tolerating PO intake, although evidence suggests no better than placebo[3]
Warnings
- DO NOT EXCEED dosing limits especially for lidocaine.
- DO NOT use under 2 years old
- Never give a family an amount that can be toxic if unintentionally swallowed in its entirety
Lidocaine
- 1 cc Viscous 2% lidocaine = 20 mg lidocaine
- Max dose = 5mg/kg
- For a 10 kg child = 50 mg lidocaine = 2.5 cc
Diphenhydramine
- Diphenhydramine 6.25mg/5cc or 12.5mg/5cc
- Max dose = 5mg/kg/day
- For a 10 kg child = 50 mg benadryl =20 cc of 12.5mg/5cc
Makeup
Equal parts:
- Viscous lidocaine 2%
- Diphenhydramine
- Maalox
Treatment
0.5-1mL before feeds
See Also
References
- ↑ FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
- ↑ Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39
- ↑ Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9