DRUG FACTS

Methemoglobinemia

Cases of methemoglobinemia have been reported in association with local anesthetic use. Although all patients are at risk for methemoglobinemia, patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended.

Signs and symptoms of methemoglobinemia may occur immediately or may be delayed some hours after exposure and are characterized by a cyanotic skin discoloration and abnormal coloration of the blood. Methemoglobin levels may continue to rise; therefore, immediate treatment is required to avert more serious central nervous system and cardiovascular adverse effects, including seizures, coma, arrhythmias, and death. Discontinue lidocaine-containing products and any other oxidizing agents. Depending on the severity of the symptoms, patients may respond to supportive care, i.e., oxygen therapy, hydration. More severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen.

Active Ingredient

Lidocaine 4%

Purpose

Topical Anesthetic

Active Ingredient

Menthol 1%

Purpose

Topical Analgesic

Active Ingredient

Camphor 3%

Purpose

Topical Analgesic

Active Ingredient

Dimethicone 3%

Purpose

Skin Conditioner

Uses:

For the temporary relief of joint pain and muscle pain associated with:

• Arthritis
• Backache
• Cramps
• Discomfort
• Neckache
• Soreness
• Sprains
• Strains

Warnings

For External Use Only

Directions

Adults and Children 12 years of Age and Older:

• Clean and dry the affected area
• Apply product directly to your skin, up to 4 times daily

Other Information

• Store in a cool, dry place with lid tightly closed

Inactive Ingredients

Aloe Barbadensls Leaf Extract, Alcohol, Arnlca Montana Flower Extract, Boswellia Serrata Extracl Butylene Glycol Cellulose Gum Dihydroxyaluminum Aminoecstete, Blycerin, lsopropyl Myristate, Msttwlsulfonylmethene, Partially Neutralized Polyacrylate, Phenoxvethanol, Polvsorbate 80, Porvvinyl Pyrrolidone, Propylene Glycol, Tartaric Acid, Tetrasodium EDTA, Water.

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