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Drug overview for DIBUCAINE (dibucaine):
Generic name: DIBUCAINE (DYE-bue-kane)
Drug class: Topical Local Anesthetics
Therapeutic class: Dermatological
Dibucaine is a local anesthetic with a long duration of action.
Dibucaine is used topically for the temporary relief of pain and itching associated with minor burns, sunburn, minor cuts or scrapes, insect bites, or minor skin irritations. Dibucaine ointment is also used topically for the temporary relief of pain, itching, and burning caused by hemorrhoids.
Generic name: DIBUCAINE (DYE-bue-kane)
Drug class: Topical Local Anesthetics
Therapeutic class: Dermatological
Dibucaine is a local anesthetic with a long duration of action.
Dibucaine is used topically for the temporary relief of pain and itching associated with minor burns, sunburn, minor cuts or scrapes, insect bites, or minor skin irritations. Dibucaine ointment is also used topically for the temporary relief of pain, itching, and burning caused by hemorrhoids.
DRUG IMAGES
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The following indications for DIBUCAINE (dibucaine) have been approved by the FDA:
Indications:
Hemorrhoids
Minor skin wound pain
Pruritus of skin
Skin irritation
Professional Synonyms:
Itchy skin eruption
Pruritic dermatitis
Indications:
Hemorrhoids
Minor skin wound pain
Pruritus of skin
Skin irritation
Professional Synonyms:
Itchy skin eruption
Pruritic dermatitis
The following dosing information is available for DIBUCAINE (dibucaine):
Dibucaine is applied topically in the form of a cream or ointment. Dibucaine ointment may also be administered rectally using a rectal applicator.
For the temporary relief of pain and itching associated with various skin conditions, dibucaine 1% ointment is applied to affected areas gently and if necessary, covered with a light dressing. No more than 30 or 7.5 g of the ointment should be used by adults or children, respectively, in any 24-hour period.
When dibucaine 0.5% cream is used for the temporary relief of pain and itching associated with various skin conditions, the cream is applied liberally to affected areas and rubbed in gently.
For the temporary relief of pain, itching, and burning caused by hemorrhoids, dibucaine 1% ointment may be instilled into the rectum using a rectal applicator. The ointment may be administered each morning and evening and after each bowel movement. Additional ointment may be applied topically to anal tissues. No more than 30 g of the ointment should be used by adults in any 24-hour period.
For the temporary relief of pain and itching associated with various skin conditions, dibucaine 1% ointment is applied to affected areas gently and if necessary, covered with a light dressing. No more than 30 or 7.5 g of the ointment should be used by adults or children, respectively, in any 24-hour period.
When dibucaine 0.5% cream is used for the temporary relief of pain and itching associated with various skin conditions, the cream is applied liberally to affected areas and rubbed in gently.
For the temporary relief of pain, itching, and burning caused by hemorrhoids, dibucaine 1% ointment may be instilled into the rectum using a rectal applicator. The ointment may be administered each morning and evening and after each bowel movement. Additional ointment may be applied topically to anal tissues. No more than 30 g of the ointment should be used by adults in any 24-hour period.
No enhanced Administration information available for this drug.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for DIBUCAINE (dibucaine):
There are 0 contraindications.
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Long-acting Bupivacaine/Local Anesthetics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) CLINICAL EFFECTS: Concurrent or use of local anesthetics with 96 hours of use of long-acting bupivacaine may result in neurologic and cardiovascular toxicity. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also result in methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) PREDISPOSING FACTORS: Use of additional agents that are associated with methemoglobinemia may further increase the risk of methemoglobinemia.(1) Patients who are at increased risk of developing methemoglobinemia include those with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended.(1) PATIENT MANAGEMENT: Avoid the use of other local anesthetics within 96 hours following the administration of long-acting bupivacaine. In patients for whom use is required, monitor for neurologic and cardiovascular effects. Also monitor for methemoglobinemia with use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine.(1,2) Non-liposomal bupivacaine may be administered in the same syringe as bupivacaine liposomal or injected immediately before bupivacaine liposomal as long as the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) DISCUSSION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposome bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally. Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) |
BUPIVACAINE LIPOSOME, EXPAREL, XARACOLL, ZYNRELEF |
There are 0 moderate interactions.
The following contraindication information is available for DIBUCAINE (dibucaine):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Large open wound |
| Methemoglobinemia |
There are 3 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Cardiac arrhythmia |
| Glucose-6-phosphate dehydrogenase (g6Pd) deficiency |
| Hemolytic anemia from pyruvate kinase and g6PD deficiencies |
There are 2 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Respiratory depression |
| Seizure disorder |
The following adverse reaction information is available for DIBUCAINE (dibucaine):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 16 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Dermatitis due to topical drug |
| Rare/Very Rare |
|---|
|
Acute respiratory failure Anaphylaxis Angioedema Bradycardia Bronchospastic pulmonary disease Cardiac arrhythmia CNS toxicity Cyanosis Eyelid edema Headache disorder Hypotension Methemoglobinemia Respiratory depression Seizure disorder Unconsciousness |
There are 20 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Blanching of skin Edema Erythema Pruritus of skin Skin rash Stinging of skin Urticaria |
| Rare/Very Rare |
|---|
|
Acute cognitive impairment Apprehension Blurred vision Dizziness Drowsy Euphoria Muscle fasciculation Nervousness Sensation of cold Sensation of warmth Tinnitus Tremor Vomiting |
The following precautions are available for DIBUCAINE (dibucaine):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for DIBUCAINE (dibucaine):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for DIBUCAINE (dibucaine)'s list of indications:
| Hemorrhoids | |
| K64.0 | First degree hemorrhoids |
| K64.8 | Other hemorrhoids |
| K64.9 | Unspecified hemorrhoids |
| O22.4 | Hemorrhoids in pregnancy |
| O22.40 | Hemorrhoids in pregnancy, unspecified trimester |
| O22.41 | Hemorrhoids in pregnancy, first trimester |
| O22.42 | Hemorrhoids in pregnancy, second trimester |
| O22.43 | Hemorrhoids in pregnancy, third trimester |
| O87.2 | Hemorrhoids in the puerperium |
| Pruritus of skin | |
| L29.8 | Other pruritus |
| L29.81 | Cholestatic pruritus |
| L29.89 | Other pruritus |
| L29.9 | Pruritus, unspecified |
| Skin irritation | |
| L24 | Irritant contact dermatitis |
| L24.0 | Irritant contact dermatitis due to detergents |
| L24.1 | Irritant contact dermatitis due to oils and greases |
| L24.2 | Irritant contact dermatitis due to solvents |
| L24.3 | Irritant contact dermatitis due to cosmetics |
| L24.4 | Irritant contact dermatitis due to drugs in contact with skin |
| L24.5 | Irritant contact dermatitis due to other chemical products |
| L24.6 | Irritant contact dermatitis due to food in contact with skin |
| L24.7 | Irritant contact dermatitis due to plants, except food |
| L24.8 | Irritant contact dermatitis due to other agents |
| L24.81 | Irritant contact dermatitis due to metals |
| L24.89 | Irritant contact dermatitis due to other agents |
| L24.9 | Irritant contact dermatitis, unspecified cause |
| L24.A | Irritant contact dermatitis due to friction or contact with body fluids |
| L24.A0 | Irritant contact dermatitis due to friction or contact with body fluids, unspecified |
| L24.A1 | Irritant contact dermatitis due to saliva |
| L24.A2 | Irritant contact dermatitis due to fecal, urinary or dual incontinence |
| L24.A9 | Irritant contact dermatitis due friction or contact with other specified body fluids |
| L24.B | Irritant contact dermatitis related to stoma or fistula |
| L24.B0 | Irritant contact dermatitis related to unspecified stoma or fistula |
| L24.B1 | Irritant contact dermatitis related to digestive stoma or fistula |
| L24.B2 | Irritant contact dermatitis related to respiratory stoma or fistula |
| L24.B3 | Irritant contact dermatitis related to fecal or urinary stoma or fistula |
| L25 | Unspecified contact dermatitis |
| L25.0 | Unspecified contact dermatitis due to cosmetics |
| L25.1 | Unspecified contact dermatitis due to drugs in contact with skin |
| L25.2 | Unspecified contact dermatitis due to dyes |
| L25.3 | Unspecified contact dermatitis due to other chemical products |
| L25.4 | Unspecified contact dermatitis due to food in contact with skin |
| L25.5 | Unspecified contact dermatitis due to plants, except food |
| L25.8 | Unspecified contact dermatitis due to other agents |
| L25.9 | Unspecified contact dermatitis, unspecified cause |
| L30.9 | Dermatitis, unspecified |
| R21 | Rash and other nonspecific skin eruption |
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