What is Racser?
Racser and Prilocaine (Racser) topical cream is used on the skin or in the genital area to cause numbness or loss of feeling before certain medical procedures. It is used to prevent pain caused by an injection, the drawing of blood from a vein, or minor surgeries such as removing warts. Racser and Prilocaine (Racser) contains a mixture of two topical local anesthetics (numbing medicines). It deadens the nerve endings in the skin.
Racser and Prilocaine (Racser) is available only with your doctor's prescription.
Racser indications
Racser and Prilocaine (Racser) cream USP, 2.5%/2.5% (a eutectic mixture of Racser 2.5% and Prilocaine (Racser) 2.5%) is indicated as a topical anesthetic for use on:
• normal intact skin for local analgesia.
• genital mucous membranes for superficial minor surgery and as pretreatment for infiltration anesthesia.
Racser and Prilocaine (Racser) cream is not recommended in any clinical situation in which penetration or migration beyond the tympanic membrane into the middle ear is possible because of the ototoxic effects observed in animal studies.
How should I use Racser?
Use Racser cream as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Racser cream. Talk to your pharmacist if you have questions about this information.
- Wash and completely dry the area to be treated. Apply a thick layer of cream to the affected skin. Do not rub Racser cream into the skin.
- Racser cream should only be used on normal, unbroken skin. Do not apply to damaged skin.
- Avoid getting Racser cream in your eyes, nose, or mouth. If you get Racser cream in your eyes, rinse them with plenty of water.
- Wash your hands immediately after using Racser cream.
- Discard unused medicine and packaging in the trash, out of the reach of children and away from pets.
- If you miss a dose of Racser cream, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Racser cream.
Racser description
A local anesthetic of the amide type now generally used for surface anesthesia. It is one of the most potent and toxic of the long-acting local anesthetics and its parenteral use is restricted to spinal anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1006)
Racser dosage
Adult Patients-Intact Skin: A thick layer of Racser and Prilocaine (Racser) cream is applied to intact skin and covered with an occlusive dressing.
Minor Dermal Procedures: For minor procedures such as intravenous cannulation and venipuncture, apply 2.5 grams of Racser and Prilocaine (Racser) cream (1/2 the 5 g tube) over 20 to 25 cm2 of skin surface for at least 1 hour. In controlled clinical trials using Racser and Prilocaine (Racser) cream, two sites were usually prepared in case there was a technical problem with cannulation or venipuncture at the first site.
Major Dermal Procedures: For more painful dermatological procedures involving a larger skin area such as split thickness skin graft harvesting, apply 2 grams of Racser and Prilocaine (Racser) cream per 10 cm2 of skin and allow to remain in contact with the skin for at least 2 hours.
Adult Male Genital Skin: As an adjunct prior to local anesthetic infiltration, apply a thick layer of Racser and Prilocaine (Racser) cream (1 g/10 cm2) to the skin surface for 15 minutes. Local anesthetic infiltration should be performed immediately after removal of Racser and Prilocaine (Racser) cream.
Dermal analgesia can be expected to increase for up to 3 hours under occlusive dressing and persist for 1 to 2 hours after removal of the cream. The amount of Racser and Prilocaine (Racser) absorbed during the period of application can be estimated from the information in TABLE 2, ** footnote, in Individualization of Dose.
Adult Female Patients-Genital Mucous Membranes: For minor procedures on the female external genitalia, such as removal of condylomata acuminata, as well as for use as pretreatment for anesthetic infiltration, apply a thick layer (5 to 10 grams) of Racser and Prilocaine (Racser) cream for 5 to 10 minutes.
Occlusion is not necessary for absorption, but may be helpful to keep the cream in place. Patients should be lying down during the Racser and Prilocaine (Racser) cream application, especially if no occlusion is used. The procedure or the local anesthetic infiltration should be performed immediately after the removal of Racser and Prilocaine (Racser) cream.
Pediatric Patients-Intact Skin: The following are the maximum recommended doses, application areas and application times for Racser and Prilocaine (Racser) cream based on a child's age and weight:
| Age and Body Weight Requirements | Maximum Total Dose of Racser and Prilocaine (Racser) Cream | Maximum Application Area | Maximum Application Time |
| 0 up to 3 months or < 5 kg | 1 g | 10 cm2 | 1 hour |
| 3 up to 12 months and > 5 kg | 2 g | 20 cm2 | 4 hours |
| 1 to 6 years and > 10 kg | 10 g | 100 cm2 | 4 hours |
| 7 to 12 years and > 20 kg | 20 g | 200 cm2 | 4 hours |
Please note: If a patient greater than 3 months old does not meet the minimum weight requirement, the maximum total dose of Racser and Prilocaine (Racser) cream should be restricted to that which corresponds to the patient's weight.
Practitioners should carefully instruct caregivers to avoid application of excessive amounts of Racser and Prilocaine (Racser) cream.
When applying Racser and Prilocaine (Racser) cream to the skin of young children, care must be taken to maintain careful observation of the child to prevent accidental ingestion of Racser and Prilocaine (Racser) cream, or the occlusive dressing. A secondary protective covering to prevent inadvertent disruption of the application site may be useful.
Racser and Prilocaine (Racser) cream should not be used in neonates with a gestational age less than 37 weeks nor in infants under the age of twelve months who are receiving treatment with methemoglobin-inducing agents.
When Racser and Prilocaine (Racser) cream is used concomitantly with other products containing local anesthetic agents, the amount absorbed from all formulations must be considered. The amount absorbed in the case of Racser and Prilocaine (Racser) cream is determined by the area over which it is applied and the duration of application under occlusion.
Although the incidence of systemic adverse reactions with Racser and Prilocaine (Racser) cream is very low, caution should be exercised, particularly when applying it over large areas and leaving it on for longer than 2 hours. The incidence of systemic adverse reactions can be expected to be directly proportional to the area and time of exposure.
INSTRUCTIONS FOR APPLICATION
To measure 1 gram of Racser and Prilocaine (Racser) cream, the cream should be gently squeezed out of the tube as a narrow strip that is 1.5 inches (3.8 cm) long and 0.2 inches (5 mm) wide. The strip of Racser and Prilocaine (Racser) cream should be contained within the lines of the diagram shown below.
| ≈ 1 g strip |
1.5 x 0.2 inches
Use the number of strips that equals your dose, like the examples in the table below.
| Dosing Information | |
| 1 gram = | 1 strip |
| 2 grams = | 2 strips |
| 2.5 grams = | 2.5 strips |
For adult and pediatric patients, apply ONLY as prescribed by your physician.
If your child is below the age of 3 months or small for their age, please inform your doctor before applying Racser and Prilocaine (Racser) cream, which can be harmful, if applied over too much skin at one time in young children.
When applying Racser and Prilocaine (Racser) cream to the intact skin of young children, it is important that they be carefully observed by an adult in order to prevent the accidental ingestion of or eye contact with Racser and Prilocaine (Racser) cream.
Racser and Prilocaine (Racser) cream must be applied to intact skin at least 1 hour before the start of a routine procedure and for 2 hours before the start of a painful procedure. A protective covering of the cream is not necessary for absorption but may be helpful to keep the cream in place. If using a protective covering, your doctor will remove it, wipe off the Racser and Prilocaine (Racser) cream, and clean the entire area with an antiseptic solution before the procedure.
The duration of effective skin anesthesia will be at least 1 hour after removal of the protective covering.
PRECAUTIONS:
1. Do not apply near eyes or on open wounds.
2. Keep out of reach of children.
3. If your child becomes very dizzy, excessively sleepy, or develops duskiness of the face or lips after applying Racser and Prilocaine (Racser) cream, remove the cream and contact your physician at once.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Racser interactions
Patients receiving class I antiarrhythmic agents eg tocainide & mexiletine; Methemoglobinemia-inducing agents eg sulfonamide, phenacetine, phenobarb, primaquin.
Racser side effects
See also:
What are the possible side effects of Racser?
Localized Reactions: During or immediately after treatment with Racser and Prilocaine (Racser) cream on intact skin, the skin at the site of treatment may develop erythema or edema or may be the locus of abnormal sensation. Rare cases of discrete purpuric or petechial reactions at the application site have been reported. Rare cases of hyperpigmentation following the use of Racser and Prilocaine (Racser) cream have been reported. The relationship to Racser and Prilocaine (Racser) cream or the underlying procedure has not been established. In clinical studies on intact skin involving over 1,300 Racser and Prilocaine (Racser) cream-treated subjects, one or more such local reactions were noted in 56% of patients, and were generally mild and transient, resolving spontaneously within 1 or 2 hours. There were no serious reactions which were ascribed to Racser and Prilocaine (Racser) cream.
Two recent reports describe blistering on the foreskin in neonates about to undergo circumcision. Both neonates received 1.0 g of Racser and Prilocaine (Racser) cream.
In patients treated with Racser and Prilocaine (Racser) cream on intact skin, local effects observed in the trials included: paleness (pallor or blanching) 37%, redness (erythema) 30%, alterations in temperature sensations 7%, edema 6%, itching 2% and rash, less than 1%.
In clinical studies on genital mucous membranes involving 378 Racser and Prilocaine (Racser) cream-treated patients, one or more application site reactions, usually mild and transient, were noted in 41% of patients. The most common application site reactions were redness (21%), burning sensation (17%) and edema (10%).
Allergic Reactions: Allergic and anaphylactoid reactions associated with Racser or Prilocaine (Racser) can occur. They are characterized by urticaria, angioedema, bronchospasm, and shock. If they occur they should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value.
Systemic (Dose Related) Reactions: Systemic adverse reactions following appropriate use of Racser and Prilocaine (Racser) cream are unlikely due to the small dose absorbed. Systemic adverse effects of Racser and/or Prilocaine (Racser) are similar in nature to those observed with other amide local anesthetic agents including CNS excitation and/or depression (light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest). Excitatory CNS reactions may be brief or not occur at all, in which case the first manifestation may be drowsiness merging into unconsciousness. Cardiovascular manifestations may include bradycardia, hypotension and cardiovascular collapse leading to arrest.
Racser contraindications
See also:
What is the most important information I should know about Racser?
Racser and Prilocaine (Racser) cream is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type or to any other component of the product.
Active ingredient matches for Racser:
Lidocaine/Prilocaine in Malaysia.
| Unit description / dosage (Manufacturer) | Price, USD |
| Racser 5 g x 5's | |
| Racser 30 g | |
| Racser cream 5 g x 5 x 1's (Galentic) | |
| Racser cream 30 g x 1's (Galentic) | |
List of Racser substitutes (brand and generic names): | |
| Prilovix Ultralite | |
| Prilovix Ultralite Plus | |
| Prilovixil Cream | |
| Prilovixil Plus Cream | |
| PRILOX | |
| PRILOX Cream/ Gel/ Ointment / 25mg - 25mg / 5gm units (Neon Labs) | $ 1.52 |
| PRILOX Cream/ Gel/ Ointment / 25mg - 25mg / 30gm units (Neon Labs) | $ 6.51 |
| Prilox 200mg TAB / 10 (Neon Labs) | $ 0.60 |
| Prilox Lidocaine 25 mg, Prilocaine 25mg/1 g. CRM / 30g (Neon Labs) | $ 7.16 |
| Prilox Lidocaine 25 mg, Prilocaine 25mg/1 g. CRM / 5g (Neon Labs) | $ 1.73 |
| 30g (Neon Labs) | $ 7.16 |
| 5g (Neon Labs) | $ 1.73 |
| PRILOX 200 MG TABLET 1 strip / 10 tablets each (Neon Labs) | $ 0.73 |
| PRILOX OINTMENT 1 tube / 30 GM ointment each (Neon Labs) | $ 7.19 |
| PRILOX OINTMENT 1 tube / 5 GM ointment each (Neon Labs) | $ 1.37 |
| PRILOX cream 30g (Neon Labs) | $ 7.87 |
| PRILOX cream 5g (Neon Labs) | $ 1.90 |
| Prilox 200mg TAB / 10 (Neon Labs) | $ 0.60 |
| Prilox Lidocaine 25 mg, Prilocaine 25mg/1 g. CRM / 30g (Neon Labs) | $ 7.16 |
| Prilox Lidocaine 25 mg, Prilocaine 25mg/1 g. CRM / 5g (Neon Labs) | $ 1.73 |
| Prilox 200mg Tablet (Neon Labs) | $ 0.07 |
| Prilox Cream (Neon Labs) | $ 8.30 |
| Priloxx LP External Kit | |
| Prinex (Greece) | |
| RE NOPAIN | |
| RE-NOPAIN | |
| RE-NOPAIN CREAM 1 tube / 30 GM cream each (La Renon Healthcare Pvt Ltd) | $ 6.84 |
| Romla (Bulgaria, Romania) | |
| Senatec Topical | |
| Solarcaine Cool Aloe Topical | |
| Solarcaine First Aid Lidocaine Spray Topical | |
| Solarcaine Lidocaine First Aid Spray Topical | |
| Tapin (Denmark, Sweden) | |
| Topicaine Topical | |
| Topla (South Africa) | |
| Topsy (Indonesia) | |
| Topsy 3 g x 1's (Galenium) | |
| Topsy 5 g x 1's (Galenium) | $ 5.77 |
| XYLAP (India) | |
| XYLAP cream 30g (Spitze Pharma) | $ 6.33 |
| Xylocream (Greece) | |
| Xylone Plus (Bangladesh) | |
| XYNOVA P | |
| XYNOVA P CREAM 1 tube / 5 GM cream each (Troikaa Pharmaceuticals Ltd) | $ 1.73 |
| XYNOVA P GEL 1 tube / 30 GM gel each (Troikaa Pharmaceuticals Ltd) | $ 7.16 |
| Xynova P Gel (Troikaa Pharmaceuticals Ltd) | $ 7.16 |
See 140 substitutes for Racser | |
References
- DailyMed. "PRILOCAINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DailyMed. "LIDOCAINE; TETRACAINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "prilocaine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Racser are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Racser. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
No survey data has been collected yet1 consumer reported age
| Users | % | ||
|---|---|---|---|
| 30-45 | 1 | 100.0% | |
Consumer reviews
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Information checked by Dr. Sachin Kumar, MD Pharmacology
