Cocaine (Topical)

Cocaine is a local anesthetic. It is put on specific areas of the body (like the nose, mouth, or throat) to create numbness or loss of feeling. This helps perform certain procedures or surgeries without causing pain.

Cocaine can lead to psychological dependence (a strong urge to keep using the medicine because of the "high" feeling it gives). This might result in cocaine abuse (using more frequently and/or in larger amounts of cocaine) and an increased risk of serious side effects. Cocaine abuse has led to deaths from heart or breathing failure.

Using cocaine as a local anesthetic for an exam or surgery is not likely to cause psychological dependence or other serious side effects. However, if cocaine enters the body too quickly, serious side effects can happen. Additionally, some people may be more sensitive to cocaine's effects. Unwanted effects can occur in these individuals even with small doses of the medicine. You should talk to your doctor about using cocaine as a local anesthetic before receiving it.

Cocaine is applied only by or under the close supervision of your doctor.

Cocaine and some of its breakdown products (substances to which cocaine is broken down in the body) will show up in your blood and urine for several days after you receive the medicine. Tests for possible drug use will then be "positive" for cocaine. If you need to take such a test within about 5 days after receiving cocaine, make sure to inform the person in charge that you have recently received cocaine for medical reasons. It may be helpful to have written information from your doctor explaining why the medicine was used, the date you received it, and the amount you received.

In deciding to use a medicine, you and your doctor will weigh the risks against the benefits. Here are important things to consider for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, tell your healthcare professional about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

Cocaine can cause serious side effects in anyone. Therefore, it is very important to discuss with the child's doctor the benefits of this medicine as well as the risks of using it.

Geriatric

Elderly patients may be more likely to experience side effects, including dizziness, lightheadedness, or fast or irregular heartbeats. Older adults are usually more sensitive to the effects of cocaine than younger adults.

Breast Feeding

Studies in breastfeeding women have shown harmful effects on infants. An alternative to this medication should be prescribed, or you should stop breastfeeding while using this medicine.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. In these situations, your doctor may adjust the dose or take other precautions. It is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Dihydroergotamine
• Phenelzine

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Alfentanil
• Almotriptan
• Amifampridine
• Amitriptyline
• Amoxapine
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Bupivacaine
• Bupivacaine Liposome
• Buprenorphine
• Bupropion
• Butorphanol
• Citalopram
• Codeine
• Desvenlafaxine
• Dextroamphetamine
• Dextromethorphan
• Dihydrocodeine
• Dolasetron
• Donepezil
• Duloxetine
• Escitalopram
• Fenfluramine
• Fentanyl
• Fluoxetine
• Fluvoxamine
• Gepirone
• Granisetron
• Hyaluronidase
• Hydrocodone
• Hydromorphone
• Hydroxyamphetamine
• Hydroxytryptophan
• Iobenguane I 123
• Iobenguane I 131
• Lasmiditan
• Levomilnacipran
• Levorphanol
• Lisdexamfetamine
• Lithium
• Lorcaserin
• Meperidine
• Metaxalone
• Methadone
• Methamphetamine
• Methylene Blue
• Milnacipran
• Mirtazapine
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Ondansetron
• Oxycodone
• Oxymorphone
• Palonosetron
• Paroxetine
• Pentazocine
• Remifentanil
• Sertraline
• St John's Wort
• Sufentanil
• Tapentadol
• Tramadol
• Trazodone
• Vilazodone
• Vortioxetine
• Ziprasidone

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Cannabis

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the same time as certain foods, as interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may increase the risk of certain side effects, but it may be unavoidable in some cases. If used together, your doctor may adjust the dose or frequency of this medicine or provide special instructions regarding food, alcohol, or tobacco use.

• Ethanol

Other Medical Problems

Other medical problems may affect how this medicine is used. Make sure to inform your doctor if you have any other medical issues, especially:

• Cancer or
• Chest pain, or history of, or
• Convulsions (seizures), history of, or
• Fast or irregular heartbeat or
• Heart or blood vessel disease or
• High blood pressure or
• Liver disease or
• Myocardial infarction (heart attack), history of, or
• Overactive thyroid—The chance of serious side effects may be increased.

• Tourette's syndrome—May worsen this condition.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may happen, if they do occur, they may need medical attention.

Check with your doctor or nurse right away if any of the following side effects happen:

Less common or Rare

• Abdominal or stomach pain
• chills
• confusion
• dizziness or lightheadedness
• excitement, nervousness, restlessness, or any mood or mental changes
• fast or irregular heartbeat
• general feeling of discomfort or illness
• hallucinations or seeing, hearing, or feeling things that are not there
• headache (sudden)
• increased sweating
• nausea

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Loss of sense of taste or smell (after use in the nose or mouth)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Available Dosage Forms:

• Solution

Therapeutic Class: Anesthetic, Local

Chemical Class: Amino Ester

Your doctor or nurse will apply the smallest amount of medicine that will produce the needed effect before the procedure.