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Oral lidocaine-containing products for infant teething becoming pharmacy medicines

Tuesday, December 18, 2018


The MHRA have issued new advice for the use of oral lidocaine-containing products for teething in children. After a significant number of administration errors being reported through yellow card, a review by the Commission on Human Medicines recommended a few changes to the availability of these medicines and their packaging.

As a result, from early 2019 oral lidocaine-containing products for infant teething are to be reclassed as ‘P’ medicines, only available under the supervision of a pharmacist so that parents and caregivers can receive guidance about managing infant teething symptoms. Non-medicinal options such as a teething ring or massaging the gum should be the first line for relieving infant teething symptoms, and lidocaine-containing products should only be used when simple measures have failed to provide sufficient relief.

We recommend that you read the Quick Reference Guide for Pharmacists which gives you information on the recommendations, the background to why these changes have been introduced, the affected products and advice to support you when you have conversations with parents or carers.

The MHRA have released the following advice for healthcare professionals:

  • pharmacists should only recommend use of these products when local non-medicinal treatments such as a teething ring or massaging the gum have failed to provide sufficient relief
  • if oral lidocaine-containing products are to be used, remind parents and caregivers to read the advice in the Patient Information Leaflet carefully, especially for dose and administration, and to seek medical attention if their child’s condition does not improve
  • advise parents and caregivers that other lidocaine products authorised in adults or for other conditions such as mouth ulcers should not be used for treatment of infant teething pain
  • sugar-free paracetamol or ibuprofen suspensions, administered according to the approved indication and dose for weight and age, may also be considered for the relief of teething symptoms
  • report any suspected adverse drug reactions to lidocaine products via the Yellow Card Scheme

If you have any questions about this, please get in touch with Adam in the Policy Team.