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Benzocaine, sold under the brand name Orajel amongst others,
is an ester local anesthetic commonly used as a topical pain reliever or in cough drops.
It is the active ingredient in many over-the-counter anesthetic ointments such as products for oral ulcers.
It also combined with antipyrine to form A/B otic drops to relieve ear pain and remove earwax.
In European Union, the contraindication applies to children under 12 years of age.
It was first synthesised in 1890 in Germany and approved for medical use in 1902.
Medical uses
Benzocaine is indicated to treat a variety of pain-related conditions.
- Local anesthesia of oral and pharyngeal mucous membranes
- (sore throat, cold sores, mouth ulcers, toothache, sore gums, denture irritation)
- Otic pain (earache)
- Surgical or procedural local anesthesia
Other uses
- glycerol-based ear medications for use in removing excess wax as well as relieving ear conditions such as otitis media and swimmers ear.
- Some previous diet products such as Ayds.
- Some condoms designed to prevent premature ejaculation.
- Benzocaine largely inhibits sensitivity on the penis,
- and can allow for an erection to be maintained longer (in a continuous act) by delaying ejaculation.
- (not to be confused with the liquid face powder) used mainly after mosquito bites.
- Today’s ready made Pudroderm was once used there as pharmaceutical compound.
Medical uses
A systematic review investigated tetracaine for use in emergency departments,
Tetracaine is the T in TAC, a mixture of 5 to 12% tetracaine, 0.05% adrenaline,
and 4 or 10% cocaine hydrochloride used in ear, nose, and throat surgery and
Available forms
Benzocaine can come in a variety of preparations including:
Oral preparations:
- Lozenges (ex. Cepacol, Mycinettes)
- Throat Spray (ex. Ultra Chloraseptic)
Topical preparations:
- Aerosol (ex. Topex)
- Gel (ex. Orajel)
- Paste (ex. Orabase)
- Cream (ex. Lanacane – active ingredient 3% Benzocaine)
Otic preparations:
- Solution (ex. Allergen)
Side effects
Overapplication of oral anesthetics such as benzocaine can increase the risk of pulmonary aspiration
by relaxing the gag-reflex and allowing regurgitated stomach contents or oral secretions to enter the airway.
The topical use of higher concentration (10–20%)
benzocaine products applied to the mouth or mucous membranes has been found to be a cause of methemoglobinemia,
This side effect is most common in children under two years of age.
As a result, the FDA has stated that benzocaine products should not be used in children under two years of age,
In European countries, the contraindication applies to children under 12 years of age.
Symptoms of methemoglobinemia usually occur within minutes to hours of applying benzocaine,
and can occur upon the first-time use or after additional use.
Benzocaine may cause allergic reactions. These include:
- Contact dermatitis (redness and itchiness)
- Anaphylaxis (rare)
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