Hypersensitivity to lidocaine, prilocaine, or any other amide-type local anesthetic;
Hypersensitivity to any other product in the formulation;
Should not be applied to middle ear, mucous membranes, or broken/inflamed skin;
Pedi: Congenital or idiopathic methemoglobinemia;
Infants <1 mo if gestational age is <37 weeks;
Infants <12 mo receiving methemoglobin-inducing agents.Use Cautiously in:
Repeated use or use on large areas of skin (more likely to result in systemic absorption);
Acutely ill, or debilitated patients (↑ risk of absorption and systemic effects);
Severe liver disease;
Any conditions associated with methemoglobinemia (including glucose-6-phosphate dehydrogenase deficiency);
OB: Use only if clearly needed;
Lactation: Usually compatible with breastfeeding (AAP);
Pedi: Area/duration of treatment should be limited in neonates and children <20 kg or 37 weeks gestation (↑ susceptibility to methemoglobinemia);
Geri: May have ↑ absorption and risk of systemic effects.
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