Topical Lidocaine - L.M.X.4
The health care staff at AFCH and UWHC wants you and your child to have the best possible experience when visiting the doctor’s office. Many parents and children fear the pain and anxiety related to a shot or needle stick. Topical lidocaine is a cream that can be applied to numb the skin. L.M.X.4 is one of these creams. This handout will teach you how to use L.M.X.4 to reduce or prevent the pain that goes with needle sticks.
Tips for using L.M.X.4
- Apply L.M.X.4 to the area that your child will receive a needle stick just before leaving home for doctor or hospital visits. If you live more than one hour away, you may want to wait and apply the cream when you arrive for your visit.
- Do NOT clean the site before you apply the cream. L.M.X.4 works withy the oils in the skin. If the skin is very dirty, you can wash the area with soap and water.
- For the best pain relief, it should be on the skin at least 20-30 minutes.
- The cream can remain on the skin for up to 60 minutes.
- The numb feeling will last for up to 90 minutes after the cream has been wiped away.
- L.M.X.4 should be stored at room temperature. Keep it out of the reach of small children.
- Each small tube (15 gram) contains enough medicine for 2 – 4 uses. Throw it away when it has expired.
- Use only on skin that is intact and without wounds or rashes. Intact skin means that the skin has no open spots, redness, or wounds. Do not use L,M.X.4 on lips, mouth or diaper areas. How much does L.M.X. 4 cost and where can I buy it?
How much does L.M.X. 4 cost and where can I buy it?
As with any over the counter drug purchased at a pharmacy, it varies by pharmacy. The UWHC Pharmacies have priced this product competitively and keep the product on hand for patient convenience. You may inquire about current prices from any UWHC Health Pharmacy.
Will Insurance Companies pay for L.M.X.4?
A few insurance companies will cover it. It depends on the plan. You can call your plan in advance to ask if they will cover it.
How do you apply the cream?
- While wearing gloves, rub a small amount of cream to the area the needle will go in. Rub into the skin for about 30 seconds. If you do not have gloves, rinse your hands under running water. Do not use soap or alcohol gels. This may increase the amount you absorb. If you are not sure which site will be used, you can call and ask the nurse which site or sites will be used. You can ask when you arrive for your visit and apply the cream at that time.
- Most likely places for a needle stick:
Infant up to 5 years 2 year old and older
- Apply more L.M.X.4 to cover an area about the size of a nickel. This layer should be thick like frosting on a cake.
- The cream does not need to be covered in order for it to work. You can use “press and seal” clear plastic wrap to keep the cream in place if a dressing did not come with the cream. If you do not have “press and seal”, use any brand of clear plastic wrap. Wrap it loosely around the arm or leg and secure with some clear tape. Do not apply the clear wrap too tightly or it will decrease the flow of blood to fingers or toes. Do not use heat or cold on the site as this can change how much medicine is absorbed.
Are there side effects with L.M.X. 4?
All medicines have side effects. Some are mild and do not need to be reported to your doctor, such as:
- Short-term blanching (whitening) of the skin where the cream was put. Later the blanching may change to redness.
- Itching at the site is another side effect you do not need to report.
If you notice any changes in behavior or have any concerns, remove the cream from the skin right away. Then, call the doctor’s office and ask to speak to your child’s doctor or nurse. After hours, ask for the doctor on call.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/17/2012
Copyright © 10/17/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6836
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