AVALON ACTIV SPRAY THE ORIGINAL 118ML

Indications

Approved Uses

Topical anesthesia of skin and accessible mucous membranes (e.g., oropharyngeal mucosa) for temporary surface anesthesia, including prior to minor procedures/instrumentation where topical lidocaine spray is appropriate.

Dosage & Administration

Dosing by Condition

Dose is product- and actuator-dependent; generally apply 1-2 sprays to the target area, wait ~1 minute, and repeat if needed using the minimum effective amount; for oropharyngeal use, avoid exceeding typical maximum lidocaine exposure of ~3-4.5 mg/kg total from all sources (lower if frail/elderly/hepatic disease) and allow time between sprays to assess effect.

Initial Dose

1 spray to the affected area; may repeat once after a few minutes if needed (use the lowest effective number of sprays).

Maintenance Dose

Repeat sprays as needed up to maximum dose per session; not intended for repeated daily maintenance dosing

Maximum Dose

Apply the minimum effective amount to the affected area. Do not apply more than 3-4 times daily, and avoid use on large areas or on broken/irritated skin to reduce systemic absorption. Do not exceed the maximum number of sprays/applications stated in the SFDA-approved product labeling.

Children's Dosage

Use with caution in children; dose should be calculated based on weight (maximum 3 mg/kg); not recommended in infants under 2 years without specialist supervision

Dose Adjustment Notes

Use the lowest effective dose; reduce total dose and/or frequency in elderly/debilitated patients and in hepatic impairment or reduced cardiac output; avoid excessive dosing on large areas, broken skin, or with occlusion due to increased systemic absorption; renal impairment is not usually a primary driver for topical dose adjustment but severe renal disease may increase metabolite accumulation with high exposure.

How to Take

For topical use only: shake if directed, hold the pressurised container upright, aim the nozzle at the target skin or mucous membrane, and deliver the minimum number of sprays needed; avoid inhalation and contact with eyes; do not apply to large areas, broken/irritated skin, or under occlusive dressings unless directed; wash hands after use (unless treating hands).

Side Effects

Common Side Effects

Application-site burning/stinging, irritation, erythema/redness, and transient numbness; less commonly swelling or blanching/whitening at the site.

Side Effect Frequency

Most common: local application-site effects (burning/stinging, erythema/irritation, transient numbness). Systemic CNS/cardiac adverse effects (dizziness, tinnitus, drowsiness, seizures, arrhythmias, hypotension/bradycardia) are uncommon and usually associated with excessive dose or enhanced absorption. True allergy is uncommon; methemoglobinemia is rare.

Safety & Warnings

Contraindications

Hypersensitivity to lidocaine, other amide-type local anesthetics, or any component of the formulation.

Warnings & Precautions

For topical use only; avoid eyes/mucous membranes and inhalation; do not apply to large areas, broken/irritated/infected skin, or under occlusion; use the minimum effective amount; caution in severe hepatic disease, significant cardiac conduction disease/heart block, shock, and in patients at risk for methemoglobinemia (e.g., G6PD deficiency or concomitant oxidizing drugs); keep out of reach of children.

Age Restriction

Avoid use in infants and young children <3 years unless specifically directed/supervised by a clinician; do not use for teething pain.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Clinically relevant interactions mainly apply if significant systemic absorption occurs: class I antiarrhythmics/other local anesthetics (additive cardiac/CNS toxicity), CYP inhibitors that reduce lidocaine clearance (e.g., cimetidine; strong CYP3A4/1A2 inhibitors), beta-blockers (reduced hepatic blood flow/clearance), and other agents associated with methemoglobinemia (additive risk).

Interaction Severity

MAJOR: Concomitant class I antiarrhythmics (e.g., mexiletine, quinidine, procainamide) or other local anesthetics-additive cardiac/CNS toxicity; MODERATE: CYP inhibitors (e.g., cimetidine, some macrolides/azole antifungals) and beta-blockers-may increase lidocaine exposure/toxicity risk; MODERATE: amiodarone-may increase lidocaine levels and depress conduction; dofetilide is not a typical clinically established major interaction with topical lidocaine at usual doses but caution is warranted with any QT-/arrhythmia-risk regimen if systemic exposure is possible.

Food Interaction

No food interaction; if applied to the mouth/throat, avoid eating, drinking, or chewing gum for at least 60 minutes (or until normal sensation returns) to reduce choking/aspiration risk.

Special Populations

Breastfeeding

Caution

Children

Use with caution in children; dose should be calculated based on weight (maximum 3 mg/kg); not recommended in infants under 2 years without specialist supervision

Elderly

Use minimum effective dose; elderly patients are more susceptible to systemic toxicity due to reduced hepatic clearance and cardiac reserve

Kidney Impairment

No routine adjustment for topical use as directed; use caution in severe renal impairment if prolonged/excessive use could lead to systemic exposure (metabolite accumulation).

Liver Impairment

Use with caution in hepatic impairment; in severe liver disease use the minimum effective amount and avoid repeated/large-area application (dose reduction may be needed if systemic exposure is likely).

Storage & Patient Advice

Storage Conditions

Store below 30°C. Keep away from heat and open flame. Do not puncture or incinerate the pressurised container. Keep out of reach of children.

Missed Dose

Not applicable (used as needed); if you were instructed to use it on a schedule, apply when remembered unless it is close to the next dose-do not double.

Stopping the Medicine

Safe to stop anytime; no tapering required.

Overdose

Systemic lidocaine toxicity may cause perioral numbness, tinnitus, dizziness, confusion, tremor/seizures, respiratory depression, hypotension/bradycardia/arrhythmias and cardiac arrest; stop exposure, provide airway/oxygen/ventilation, treat seizures with benzodiazepines, provide ACLS-level cardiovascular support, and consider IV lipid emulsion for severe cardiotoxicity; seek emergency care.

Patient Counseling

Use only as prescribed; avoid exceeding the recommended number of sprays. If used in the mouth/throat, avoid eating or drinking until numbness resolves (often ~1 hour) to reduce choking/aspiration risk. Avoid eyes and do not apply to large areas, broken/inflamed skin, or under occlusion; wash hands after use. Stop and seek urgent care if symptoms of systemic toxicity occur (e.g., dizziness, tinnitus, perioral numbness, metallic taste, confusion, seizures, palpitations/arrhythmia). Pressurised container: keep below 30°C, away from heat/flames; do not puncture or incinerate.

Monitoring Requirements

No routine monitoring for small-area intact-skin use; monitor for local irritation/allergy and for systemic toxicity (perioral numbness, tinnitus, metallic taste, dizziness, seizures, bradycardia/arrhythmias) when used on mucosa, large areas, broken skin, under occlusion, or for procedural anesthesia-consider vital sign monitoring in procedural settings.

Pharmacology

Mechanism of Action

Reversibly blocks voltage-gated sodium channels, decreasing neuronal membrane permeability to sodium and preventing initiation/propagation of nerve impulses to produce local anesthesia.

Onset of Action

Usually within 1-5 minutes (often ~1-3 minutes on mucous membranes).

Duration of Effect

Typically about 10-30 minutes on mucous membranes (often shorter on very vascular/wet surfaces), and may last up to ~30-60 minutes on some skin applications depending on site and dose.

Half-Life

1.5-2 hours (systemic, following absorption)

Bioavailability

No single fixed bioavailability value; systemic absorption after topical lidocaine is variable and depends on dose, application site (mucosa >> intact skin), surface area, duration, and skin integrity.

Metabolism

Extensive hepatic metabolism mainly via CYP1A2 and CYP3A4 to active metabolites (e.g., monoethylglycinexylidide [MEGX] and glycinexylidide [GX]).

Excretion

Primarily renal excretion as metabolites; only a small fraction is excreted unchanged (typically <10%).

Protein Binding

Approximately 60-80% protein bound, mainly to alpha-1-acid glycoprotein.

Product Information

Available Dosage Forms

Spray (topical) in a pressurised container.

Composition per Dose

Each metered spray (approximately 0.1 ml): 10 mg lidocaine hydrochloride (10% w/v solution)

Generic Availability

Yes

OTC Alternatives

Possible OTC alternatives depend on local regulations; in many markets, lower-strength topical local anesthetics such as lidocaine 2-5% (e.g., 4% cream/gel/patch) or benzocaine oral/topical products may be OTC, but this specific product (lidocaine 10% spray) is SFDA Prescription-only and should not be substituted without clinician/pharmacist guidance.

Pain Type

General

Nsaid

No

Opioid

No

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