It is a pain reliever often used to numb mouth pain caused by teething in infants and toddlers, or from toothaches, braces, dentures, sore throat, or other mouth sores. Benzocaine products are also used to relieve pain associated with earaches, hemorrhoids, and skin disorders.
The US Food and Drug Administration (FDA) issued a warning about a rare blood disorder caused by some over-the-counter (OTC) mouth sore or teething pain relievers. These pain relievers contain the drug benzocaine and are available as sprays, gels, creams, and liquids. The blood disorder is called methemoglobinemia (pronounced met-ˌhē-mə-ˌglō-bə-ˈnēmē-ə). The disorder prevents the blood from carrying oxygen to all parts of the body. People who develop the disorder may have difficulty breathing, feel tired or confused, or have a headache and faster heartbeat, and their skin, lips, and nail beds may become pale, gray, or blue. These symptoms usually appear within minutes or hours after using the product.
Examples of these products (listed by brand names) include: Americaine, Anbesol, Boil Ease, Cepacol Sore Throat, Cetacaine, Dermoplast, Exactacain, Hurricaine, Lanacane, Orabase with Benzocaine, Orajel, and Skeeter Stik. (For a list of more OTC products that contain benzocaine, visit here.) However, labels on these OTC products currently do not contain warnings about the possibility of developing this blood disorder if it is used.
The warning issued by the FDA states that products containing benzocaine, such as Anbesol and Orajel, should no longer be used for children under the age of 2, except under the advice and supervision of a doctor. For older children and adults, directions on the package label should be closely followed. The FDA will continue to evaluate the safety of benzocaine products and update the public as needed. For safer alternatives to relieve teething pain in children younger than 2 and general safety when using benzocaine products, see the next Question and Answer.
Follow these guidelines to reduce the risk of developing methemoglobinemia, a rare blood disorder, when using products containing benzocaine.
Do not use products that contain benzocaine in children less than 2 years old. Instead try these options:
Store products out of reach of children. Benzocaine products as well as all medicines and vitamins should be stored out of reach of children.
Follow directions on the package. Use the products according to the instructions written on the label. For gels and sprays, use sparingly and only when needed. Do not use benzocaine products than four times a day.
Watch for signs and symptoms, which can occur within minutes to hours of using these products. Know the signs and symptoms of methemoglobinemia. These include:
Contact 911 immediately if you suspect methemoglobinemia. Early treatment helps to prevent serious or fatal outcomes.