<< Back to News

System Formulary Update
Topical Anesthetics and Analgesics

Situation
The topical anesthetics and analgesics class review and formulary standardization was approved at the August 2020 System Pharmacy and Therapeutics Committee meeting.

Background
The following topical medications were reviewed: benzocaine, benzocaine-butamben-tetracaine, capsaicin, cocaine, dibucaine, ethyl chloride, lidocaine, lidocaine-prilocaine, lidocaine-tetracaine, pramoxine, tetracaine

Assessment/Recommendation
Changes Effective: Tuesday, November 3, 2020

System P&T voted to include the following products on the UNC Health Medication Formulary: 

• Benzocaine mucosal gel 20% (5.25 g)
• Benzocaine mucosal spray 20% (2 oz)
• Benzocaine-menthol topical spray 20%-0.5% (2 oz)
• Capsaicin cream 0.025% (60 g)
• Cocaine topical solution 4% (4 mL)
• Dibucaine ointment 1% (28 g)
• Lidocaine mucosal jelly 2% (5 mL, 30 mL)
• Lidocaine mucosal jelly with applicator 2% (6 mL, 11 mL, 20 mL)
• Lidocaine mucosal solution (viscous) 2% (20 mL, 100 mL)
• Lidocaine solution 4% (50 mL)
• Lidocaine laryngotracheal solution 4% (4 mL)

Note: Stock of these products may vary at individual entities

As a result, the following products will be removed from the UNC Health Medication Formulary: 

• Benzocaine cream, gel (7.5%, 10%), oral solution, ointment
• Butamben-tetracaine-benzocaine
• Capsaicin cream (0.075%, 0.1%), patch
• Ethyl chloride spray
• Lidocaine lotion, swab
• Lidocaine-tetracaine patch
• Pramoxine foam
• Pramoxine-calamine
• Pramoxine-hydrocortisone lotion

Non-formulary orders for lidocaine patch 4% will be converted to lidocaine patch 5% via a therapeutic interchange.