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Synera
Synera is a topical anesthetic patch containing lidocaine (70 mg) and tetracaine (70 mg) used to numb the skin for pain relief before certain medical procedures such as needle sticks, blood draws, minor skin surgeries, and laser treatments. Synera works by blocking nerve signals in the skin, providing localized pain relief. The patch contains a warming element to help increase the effectiveness of the anesthetic agents.
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Frequently Asked Questions
How long does Synera take to work?
Synera should be applied 30 minutes before the procedure for the best effect. The patch provides local anesthesia for up to 60 minutes.
Can I use Synera on broken skin?
No, Synera should only be applied to intact skin. Applying it to broken skin can lead to increased absorption of the drug and a higher risk of side effects.
What should I do if the patch causes irritation?
If you experience significant irritation or an allergic reaction (such as swelling or rash), remove the patch immediately and wash the area with mild soap and water. Contact your healthcare provider if the irritation persists.
Can I use more than one Synera patch at a time?
Using more than one patch at a time is not recommended, as this can increase the risk of systemic side effects. Always follow your healthcare provider’s instructions on the correct number of patches to use.
Can I use Synera for chronic pain?
Synera is primarily used for procedural pain relief before minor medical or cosmetic procedures. It is not typically used for managing chronic pain conditions.
Comprehensive Drug Guide
How Does Synera Work?
Lidocaine and tetracaine work by blocking sodium channels in the nerve cells, which prevents nerve impulses from being transmitted, thus providing localized numbness and pain relief. The patch also contains a warming component that helps enhance drug penetration through the skin, improving the efficacy of the anesthetics.
Common Dosages
- 70 mg lidocaine and 70 mg tetracaine.
Typical Dosing
- For local anesthesia: Apply one Synera patch to intact skin 30 minutes before the procedure. The patch should remain in place for the entire duration, which is typically up to 60 minutes, depending on the procedure.
Typical Dosing
FDA Approved Indications
- Topical local anesthesia for intact skin before minor medical procedures such as needle sticks (e.g., blood draws, IV cannulation) and superficial surgical or cosmetic procedures.
Who Shouldn't Take Synera?
- Hypersensitivity to lidocaine, tetracaine, or any other local anesthetics.
- Known allergic reactions to amide or ester-type local anesthetics.
- Severe liver disease, as local anesthetics are metabolized by the liver.
Advice From The Pharmacist
- Apply Synera 30 minutes before the procedure for maximum effect, and do not leave the patch on for longer than 60 minutes.
- Do not apply to broken skin or open wounds, as this can increase the risk of systemic absorption and potential side effects.
- The patch contains a warming component that may feel slightly warm or cause mild skin redness; this is normal.
- Avoid contact with eyes and mucous membranes, as this can cause irritation.
- Dispose of the patch safely after use, as it still contains residual anesthetic agents that could be harmful if accidentally ingested by children or pets.
Side Effects of Synera
Common Side Effects
- Skin redness or irritation at the application site
- Temporary numbness or tingling sensation
- Mild warmth or burning sensation
Uncommon/Severe Side Effects
- Allergic reactions, such as rash, itching, swelling, or difficulty breathing.
- Methemoglobinemia: A rare condition where the oxygen-carrying capacity of the blood is reduced, leading to symptoms like blue-colored skin, shortness of breath, or fatigue
Risks and Warnings of Synera
- Methemoglobinemia: Though rare, tetracaine can increase the risk of methemoglobinemia, especially in infants, elderly patients, or those with pre-existing blood disorders. Seek immediate medical attention if symptoms of methemoglobinemia occur.
- Systemic Absorption: The risk of systemic toxicity increases if the patch is applied to broken skin or left on for longer than recommended. Signs of toxicity include dizziness, irregular heartbeat, and seizures.
- Allergic Reactions: Some patients may be allergic to local anesthetics, particularly ester-type anesthetics like tetracaine. Discontinue use if signs of an allergic reaction develop.
Interactions with Synera
Common Drug Interactions
- Other local anesthetics: Using other local anesthetics (such as lidocaine ointment or injections) in combination with Synera can increase the risk of systemic side effects such as heart arrhythmias or seizures.
- Antiarrhythmic drugs: Lidocaine is also used as an antiarrhythmic drug. Combining it with other antiarrhythmic agents (such as amiodarone) may increase the risk of side effects.
- Sulfa drugs: Some sulfa-containing drugs may increase the risk of methemoglobinemia when used with tetracaine.
Alternatives to Synera
- EMLA cream (lidocaine/prilocaine): A topical anesthetic cream used for similar purposes before minor skin procedures.
- Lidocaine patches (Lidoderm): These patches are used to relieve pain in specific areas of the body, often for post-shingles pain (postherpetic neuralgia).
- Ethyl chloride spray: A topical anesthetic spray used for quick numbing of the skin before injections or minor procedures.
