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LMX4 is a pharmacy (P) medicine containing lidocaine 4% w/w in a liposomal cream base, used as a topical anaesthetic to numb intact skin before needle insertion, cannulation, blood sampling or painful topical procedures. Sold by Ways Pharmacy (UK) under pharmacist consultation in 5g and 30g pack sizes.
How to access this medicine
- Select the pack size (5g or 30g) on this page and complete payment.
- You will be sent a brief consultation questionnaire — please confirm the intended use, the person who will use the cream (adult or child, with age), any known allergies to local anaesthetics and any broken or inflamed skin in the area.
- Our GPhC-registered pharmacist reviews your responses.
- If supply is clinically appropriate, the cream is dispensed and dispatched.
- If supply is not appropriate, you will receive a full refund and a brief written explanation.
About this medicine
| Active ingredient | Lidocaine 4% w/w (利多卡因) in a liposomal cream base |
|---|---|
| Drug class | Topical amide local anaesthetic |
| Licensed indications | Surface anaesthesia of intact skin before venepuncture, cannulation and minor superficial procedures; symptomatic relief of minor skin pain |
| Legal classification | P — Pharmacy medicine (supplied under pharmacist consultation) |
| Pack sizes | 5g tube · 30g tube |
| Typical onset | Approximately 30 minutes after application under occlusion (e.g. a cling film cover) |
| Patient leaflet | LMX4 PIL via emc — read before use |
How to use
- Wash and dry the area of skin to be numbed.
- Apply a thick layer of cream (do not rub in) to the area, covering only intact, undamaged skin.
- Cover with an occlusive dressing (e.g. cling film or a transparent adhesive dressing) for at least 30 minutes for an adult, or as advised by the procedure clinician.
- Remove the dressing and wipe off the cream just before the procedure.
- The numbing effect lasts approximately 1 to 2 hours after the cream is removed.
Maximum dosing (from the Summary of Product Characteristics)
- Adults: do not apply to more than 100 cm2 of skin at one time (approximately the area covered by the 5g tube).
- Children: lower maximums apply by age and weight — confirm with the pharmacist before use in a child.
- Do not leave under occlusion for longer than 5 hours.
- Do not apply to broken, inflamed or infected skin.
Common use cases
- Before a planned blood test, cannula insertion or injection
- Before minor dermatological procedures on intact skin
- Before aesthetic procedures such as dermal filler injection, microneedling, laser hair removal, tattoo work or piercing (under appropriate clinician supervision)
- Before paediatric venepuncture (under the dosing limits set out in the PIL)
Not suitable for: people with a known hypersensitivity to lidocaine or other amide local anaesthetics; application to broken, inflamed or infected skin, mucous membranes or the eye; application to large areas in young infants; people with known methaemoglobinaemia or significant cardiac, hepatic or renal impairment without medical advice.
Side effects and what to watch for
Common local side effects include transient redness, paleness (blanching), itching or a mild burning sensation at the application site. Stop using the cream and seek medical advice if you develop signs of an allergic reaction (widespread rash, swelling of the face or tongue, difficulty breathing), if a child becomes drowsy or develops bluish lips after use, or if numbness lasts substantially longer than expected.
Frequently asked questions
How long before a procedure should I apply LMX4?
Apply a thick layer to intact skin under an occlusive cover at least 30 minutes before the planned procedure. The numbing effect peaks at around 30 to 60 minutes and lasts approximately 1 to 2 hours after the cream is removed.
Can LMX4 be used on children?
LMX4 can be used in children, including for paediatric blood tests and cannulation, but the maximum amount and the maximum application time vary by age and weight. Confirm the appropriate dose with the pharmacist before use in a child, particularly in infants.
Can LMX4 be used before aesthetic procedures such as lip filler or microneedling?
Lidocaine 4% creams are commonly used as a pre-procedure topical anaesthetic before minor aesthetic procedures on intact skin. The cream should be applied as directed and washed off cleanly before the procedure begins. Your clinician will confirm the exact protocol they use.
Can LMX4 be used on broken skin or open wounds?
No. LMX4 should only be applied to intact, healthy skin. Application to broken, inflamed or infected skin can increase systemic absorption and the risk of side effects.
How does LMX4 compare with EMLA cream?
Both are topical local anaesthetics used to numb intact skin before needles or minor procedures. LMX4 contains lidocaine 4% in a liposomal base and typically reaches surgical-strength anaesthesia in about 30 minutes; EMLA contains a lidocaine + prilocaine mixture and usually needs around 60 minutes under occlusion. The pharmacist or your clinician will advise which is more appropriate for your situation.
How should LMX4 be stored?
Store below 25 degrees Celsius, in the original tube, with the cap firmly closed. Do not freeze. Keep out of reach of children.
Regulatory information
- Legal status: P (Pharmacy medicine)
- Marketing authorisation holder: Ferndale Pharmaceuticals Ltd
- Supplied by: Ways Pharmacy, UK — GPhC-registered (registration number on the storefront footer)
- Patient Information Leaflet: LMX4 PIL via emc
- Suspected side effect? Report via the MHRA Yellow Card Scheme
This page provides factual information about a pharmacy (P) medicine and is not an advertisement to the public. Supply is dependent on satisfactory completion of a clinical consultation reviewed by a GPhC-registered pharmacist. Always read the Patient Information Leaflet before use.
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