Benzocaine Side Effects. Benzocaine, a topical pain reliever usually applied to the gums or the mouth to soothe pain, can be dangerous to your health. According to the U.S. Food and Drug Administration, use of Benzocaine — which is found in over-the-counter drugs such as Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase, Americaine, and many others — can lead “to a rare but serious—and sometimes fatal—condition called methemoglobinemia”.
Metheglobinemia leads to a reduction in the amount of oxygen being carried through the bloodstream; this condition could result in death.
Signs and symptoms. So how do you know if a person who used Benzocaine has developed methemoglobinemia? Here are some symptoms you should watch out for: pale, gray or blue colored skin, lips, and nail beds; shortness of breath; fatigue; confusion; headache; lightheadedness; and rapid heart rate.
Sometimes these symptoms are not present even if one has methemoglobinemia. On the other hand, the presence of any of these symptoms does not always mean that one has metheglobinemia. Said symptoms usually appear within a few minutes to two hours of using benzocaine gels or liquids. These may occur during the first application of the drug or after multiple usage.
What should you do if you recognize any of the above signs and symptoms in someone using benzocaine? Here’s the answer from the FDA:
Answer: Stop using the product and seek medical help immediately by calling 911.
Methemoglobinemia caused by benzocaine may require treatment with medications and may require admission to a hospital. Serious cases of methemoglobinemia should be treated promptly. If left untreated or if treatment is delayed, serious cases of methemoglobinemia may cause permanent injury to the brain and body tissues, and even death, due to an inadequate supply of oxygen.
Babies and toddlers particularly at risk. The FDA warned that children ages two years old and below are at particular risk and is thus advising parents and health care givers to NOT use Benzocaine for these children except upon the advice and supervision of medical professionals.
The agency revealed that it has received 29 reports of benzocaine gel-related cases of methemoglobinemia. More than a majority of said cases (19 out of 29) occurred in children most of whom are under two years old (15 of 19 cases).
Other over-the-counter Benzocaine products. Here’s a list of over-the-counter drugs that use benzocaine as its main ingredient. Please note that this is only a partial list and there are other products out there not included in this list:
Anbesol Cold Sore Therapy
Anbesol Maximum Strength
Benzocaine Burn Spray
Boil Ease Maximum Strength
Cepacol Sore Throat
Dent’s Extra Strength Toothache
Dent’s Maxi-Strength Toothache
Dry Socket Remedy
Kanka Soft Brush
Lanacane Maximum Strength
Orabase with Benzocaine
Orajel Denture Plus
Orajel Maximum Strength
Orajel Medicated Toothache
Orajel Mouth Sore
Orajel Multi-Action Cold Sore
Orajel Ultra Mouth Sore
Red Cross Canker Sore
Rid-A-Pain Dental Drops
Walgreens Oral Anesthetic Paste
Zilactin Toothache and Gum Pain
UPDATE on Benzocaine Side Effects: In a 07 April 2011 advisory, the FDA reveals that its total of methemoglbinemia cases associated with benzocaine use adds up to 319 cases seven of whom ended in death. From FDA:
Of the 319 total cases, there were seven cases of death and 32 cases that were categorized as life-threatening, defined as those patients with a reported methemoglobin level greater than 55%. Two hundred and sixteen cases were categorized as serious, defined as those patients with a reported methemoglobin level of 30% to 55% or who were administered methylene blue regardless of the level of methemoglobin. Methemoglobin levels were reported in 227 cases. The values range from 0.3% to 77% (average 35.2%, median 34.5%).
In the cases, topical benzocaine spray was used for medical procedures such as transesophageal echocardiogram, endoscopy, bronchoscopy, intubation, and feeding tube placements.
Benzocaine Side Effects & Health Risks on Children posted 24 June 2012. Updated 27 April 2017.