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
Uses:
For the temporary relief of joint pain and muscle pain associated with:
- Arthritis
- Backache
- Discomfort
- Cramps
- Neckache
- Soreness
- Sprains
- Strains
Warnings
For External Use Only
Do Not Use
- On damaged or irritated skin
- With a bandage or heating pad
- If you are allergic to any ingredients in this product
- Other than as directed
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
