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Medical Forum / General / Dentistry / February 2008

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ingredients of lidocaine spray mucous membrane (MM dental Altaseptic     Xylocaine)

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jhutchence@gmail.com - 04 Feb 2008 06:08 GMT
I have had some form of lidocaine spray on my throat, for a surgical
procedure. I do not have any specific information on what was
administered to me, but I think many on this group know. I believe it
was in a small aerosol canister with an attached tube.

Speficically, I would like to know the ingredients of this drug. Hours
of searching has not produced any specific manufacturer's information
on the ingredients, etc, and how it differs from a seemingly similar
OTC product.

The second question is then, how does it differ from "not for internal
use" sunburn/bite numbing sprays. For instance Lanacane anesthetic
spray containing 20% Benzocaine, 0.2% Benzothonium Chloride, ethanol
36%, aloe extract, isobutane propellant, etc..

Is this "dental" or "MM" lidocaine spray essentially the same product?
Is it specifically reformulated to be safe for this semi-internal use?
I have read that Altaseptic MM is "do not swallow" which is the same
warning given on the Lanacane product.

Curious to know, thank you.
Newbie@bix.nex - 04 Feb 2008 06:39 GMT
>I have had some form of lidocaine spray on my throat, for a surgical
>procedure. I do not have any specific information on what was
[quoted text clipped - 10 lines]
>spray containing 20% Benzocaine, 0.2% Benzothonium Chloride, ethanol
>36%, aloe extract, isobutane propellant, etc..

>Curious to know, thank you.

Lidocaine has a common trade name: Xylocaine
http://www.rxlist.com/cgi/generic/xylocaineinj.htm
Can be used topically, or parenterally.

Benzocaine is also known as:  Benzocaine.
http://www.rxlist.com/cgi/generic/americaine.htm
Used topically only, not for parenteral use.

>Is this "dental" or "MM" lidocaine spray essentially the same product?
>Is it specifically reformulated to be safe for this semi-internal use?
>I have read that Altaseptic MM is "do not swallow" which is the same
>warning given on the Lanacane product.

Not sure what you are asking here.
There are many local anesthetics and there are
two major classes: amides and esters (IIRC)
They are all somewhat related; but not all are suitable
for parenteral use.

WTF is semi-internal ? ITYM 'enteral'.
http://en.wikipedia.org/wiki/Route_of_administration

Have no idea what Lanacane or Altaseptic MM are,
and am not willing to look it up for you.
Mark & Steven Bornfeld - 04 Feb 2008 14:24 GMT
> I have had some form of lidocaine spray on my throat, for a surgical
> procedure. I do not have any specific information on what was
[quoted text clipped - 17 lines]
>
> Curious to know, thank you.

    I don't know what might have been the inactive ingredients in the
preparations.  I believe lidocaine viscous is mixed in glycerine.  There
may be preservatives.  Amide-type anesthetics such as lidocaine and
prilocaine are thought to have a lower allergic potential than
ester-form anesthetics such as benzocaine and procaine.  I would think
sprays for intraoral use are more likely to use a pump aerosol bottle
rather than a propellent like isobutant.  Benzothonium chloride is a
preservative--some people have reacted to these as well.
    Of course people also use things like Oraseptic which IS intended for
intraoral use, which contains phenolics, and certainly not good for you.
 While I don't see anything in the ingredients you list that seem
likely to be dangerous in small quantities, it's likely to be rather
unpleasant-tasting.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

jhutchence@gmail.com - 04 Feb 2008 18:38 GMT
On Feb 4, 6:24 am, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:
>         I don't know what might have been the inactiveingredientsin the
> preparations.  I believelidocaineviscous is mixed in glycerine.  There
[quoted text clipped - 16 lines]
> Brooklyn, NY
> 718-258-5001

The difference between benzocaine and lidocaine is a point I missed.
On second thought you are right about it being a pump rather than a
pressurized canister.

Not having training in Otolaryngology, I don't know whether
application in the throat counts as internal or not, I was just a
little surprised that the MM formulation also has a "do not swallow"
warning. It strikes me that quite a few people would end up swallowing
some of it. What are the risks?

I don't think I'll be trying it to see what it tastes like anyway.

I was curious that a small canister of Altaseptic MM apparently sells
for about $40 while the Lanacane was about $5.

Thank you for the information. Those two paragraphs contain more
relevant information on the subject than I could find in 4 hours of
googling. They should put that in the brochure.
Mark & Steven Bornfeld - 04 Feb 2008 19:38 GMT
> On Feb 4, 6:24 am, Mark & Steven Bornfeld
> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 37 lines]
> relevant information on the subject than I could find in 4 hours of
> googling. They should put that in the brochure.

    I can't say for sure that there's anything significantly toxic about
the Lanacaine.  Anything intraoral should be considered internal use
unless you're sure there is no absorbtion from the GI tract of any of
the components.
    Not for internal use is a generic warning for anything not designed to
be taken internally.  It's a good idea not to use any medicament for an
off-label use unless advised to by your doctor.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Newbie@bix.nex - 05 Feb 2008 00:02 GMT
>> On Feb 4, 6:24 am, Mark & Steven Bornfeld
>> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 47 lines]
>
>Steve

From Wikipedia:

Classification

Routes of administration can broadly be divided into:

   * topical: local effect, substance is applied directly where its
action is desired
   * enteral: desired effect is systemic (non-local), substance is
given via the digestive tract
   * parenteral: desired effect is systemic, substance is given by
other routes than the digestive tract

The U.S. Food and Drug Administration recognizes 111 distinct routes
of administration. The following is a brief list of some routes of
administration.

[edit] Topical

   * epicutaneous (application onto the skin), e.g. allergy testing,
typical local anesthesia
   * inhalational, e.g. asthma medications
   * enema, e.g. contrast media for imaging of the bowel
   * eye drops (onto the conjunctiva), e.g. antibiotics for
conjunctivitis
   * ear drops - such as antibiotics and corticosteroids for otitis
externa
   * intranasal route (into the nose), e.g. decongestant nasal sprays
   * vaginal, e.g. topical estrogens, antibacterials

[edit] Enteral

   * by mouth (orally), many drugs as tablets, capsules, or drops
   * by gastric feeding tube, duodenal feeding tube, or gastrostomy,
many drugs and enteral nutrition
   * rectally, various drugs in suppository or enema form

[edit] Parenteral by injection or infusion

   * intravenous (into a vein), e.g. many drugs, total parenteral
nutrition
   * intraarterial (into an artery), e.g. vasodilator drugs in the
treatment of vasospasm and thrombolytic drugs for treatment of
embolism
   * intramuscular (into a muscle), e.g. many vaccines, antibiotics,
and long-term psychoactive agents
   * intracardiac (into the heart), e.g. adrenaline during
cardiopulmonary resuscitation (no longer commonly performed)
   * subcutaneous (under the skin), e.g. insulin
   * intraosseous infusion (into the bone marrow) is, in effect, an
indirect intravenous access because the bone marrow drains directly
into the venous system. This route is occasionally used for drugs and
fluids in emergency medicine and paediatrics when intravenous access
is difficult.
   * intradermal, (into the skin itself) is used for skin testing
some allergens, and also for tattoos
   * intrathecal (into the spinal canal) is most commonly used for
spinal anesthesia and chemotherapy
   * intraperitoneal, (infusion or injection into the peritoneum)
e.g. peritoneal dialysis is predominantly used in veterinary medicine
and animal testing for the administration of systemic drugs and fluids
due to the ease of administration compared with other parenteral
methods

[edit] Other parenteral

   * transdermal (diffusion through the intact skin), e.g.
transdermal opioid patches in pain therapy, nicotine patches for
treatment of addiction
   * transmucosal (diffusion through a mucous membrane), e.g.
insufflation (snorting) of cocaine, sublingual nitroglycerine, buccal
(absorbed through cheek near gumline)
   * inhalational, e.g. inhalational anesthetics

[edit] Other

   * epidural (synonym: peridural) (injection or infusion into the
epidural space), e.g. epidural anesthesia
   * intravitreal
Mark & Steven Bornfeld - 05 Feb 2008 00:24 GMT
> From Wikipedia:
>
[quoted text clipped - 75 lines]
> epidural space), e.g. epidural anesthesia
>     * intravitreal

    Thank you Mr. Answer Man!  Don't know if you're in a Super-Tuesday
state, but you know what they say--
"Vote early and often!"

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Amatus Cremona - 05 Feb 2008 13:26 GMT
Different process of getting FDA approval if the label says internal use vs.
external use.

Signature

/

Amatus

/

>> On Feb 4, 6:24 am, Mark & Steven Bornfeld
>> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 48 lines]
>
> Steve
Mark & Steven Bornfeld - 05 Feb 2008 14:46 GMT
> Different process of getting FDA approval if the label says internal use vs.
> external use.

Lawyers, lots of paperwork and time--sure.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Amatus Cremona - 05 Feb 2008 15:12 GMT
Some medications designed to be placed on skin are processed with cosmetics
rather than drugs.  Weird.

Signature

/

Amatus

/

>> Different process of getting FDA approval if the label says internal use
>> vs. external use.
>
> Lawyers, lots of paperwork and time--sure.
>
> Steve
George - 04 Feb 2008 18:40 GMT
Small aerosol canister with a long flexible tube attached to it? If it
was yellow, there is a good chance it might have been xylonor spray,
manufactured by Septodont. You can check their site for more info and
a picture of the canister.

Regards,
George
 
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