SUPER T- lidocaine hcl, tetracaine hcl, benzocaine cream 
Dermal Source, Inc.

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Drug Facts - For use by licensed professionals only.


Active Ingredient  (in each cc) Purpose
Lidocaine HCl   5% Topical Anesthetic
Tetracaine HCl   1% Topical Anesthetic
Benzocaine 12% Topical Anesthetic

Uses: External Use Only on Intact Skin. Temporarily relives pain due to tattooing, makeup or other pain sensitive procedures.

WARNINGS:Keep out of children's reach.
Keep out of eyes and mouth. In case of accidental contact with eyes, rinse immediately with copious amounts of eyewash. Seek care by an eye care physician. If accidently swallowed, get medical help immediately.

Do not use:

Directions:  Sensitivity test advised prior to use.

Apply sparingly to affected area for 15-30 minutes. Remove and cleanse skin. Repeat as needed up to three times a day. Remove product before continuing with procedure.

Inactive Ingredients: Purified Water, Propylene Glycol, Ethyoxydiglycol, NF Emulsifying Wax, Polyacrylamide, Hydroxyethylcellulose, Diazolidinyl Urea, Methylparaben, Propylparaben, and EDTA.

Other information: Discard after expiration date. Store in cool, dark place.

Questions? Contact distributor on product label.

PRINCIPAL DISPLAY PANEL

TOP SHELF

SUPER
T

7/8 oz. 

topical anesthetic for use before
a pain sensitive procedure

Distributed by: DERMAL SOURCE
Portland, OR 97232

www.dermalsource.com
1-866-568-3223

label
SUPER T 
lidocaine hcl, tetracaine hcl, benzocaine cream
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:80069-010
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Lidocaine Hydrochloride (UNII: V13007Z41A) (Lidocaine - UNII:98PI200987) Lidocaine Hydrochloride Anhydrous50 mg  in 1 g
Tetracaine Hydrochloride (UNII: 5NF5D4OPCI) (Tetracaine - UNII:0619F35CGV) Tetracaine Hydrochloride10 mg  in 1 g
Benzocaine (UNII: U3RSY48JW5) (Benzocaine - UNII:U3RSY48JW5) Benzocaine120 mg  in 1 g
Inactive Ingredients
Ingredient NameStrength
Water (UNII: 059QF0KO0R)  
Propylene Glycol (UNII: 6DC9Q167V3)  
Diethylene Glycol Monoethyl Ether (UNII: A1A1I8X02B)  
White Wax (UNII: 7G1J5DA97F)  
Diazolidinyl Urea (UNII: H5RIZ3MPW4)  
Methylparaben (UNII: A2I8C7HI9T)  
Propylparaben (UNII: Z8IX2SC1OH)  
Edetic Acid (UNII: 9G34HU7RV0)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:80069-010-0124.805833 g in 1 BOTTLE, PUMP; Type 0: Not a Combination Product08/15/2021
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
OTC Monograph DrugM01708/15/2021
Labeler - Dermal Source, Inc. (183535629)
Establishment
NameAddressID/FEIBusiness Operations
HTO Nevada, Inc. (dba Kirkman)117115846manufacture(80069-010)

Revised: 10/2023
Document Id: b1e0401b-d425-4be0-92d3-bdd31fc8eb1a
Set id: be7fc3d4-bc48-44b9-abf3-68024654aed9
Version: 3
Effective Time: 20231013
 
Dermal Source, Inc.