Benzalkonium chloride/benzocaine is a topical solution used to treat cold sores and fever blisters.

Benzalkonium chloride/benzocaine is a combination of an antiseptic and a local anesthetic that work together to prevent infection and relieve pain temporarily. The combo medication is available as a single dose solution, over the counter (OTC) in the U.S.

Benzalkonium chloride/benzocaine work in the following ways:

• Benzalkonium: An antiseptic and disinfectant agent that kills microorganisms and prevents infection
• Benzocaine: An ester local anesthetic that numbs the region it is applied on by blocking initiation and conduction of pain signals from the application area to the brain

• Do not use benzalkonium chloride/benzocaine if you are hypersensitive to benzalkonium chloride, benzocaine, other ester-type anesthetics, or any other component of the formulation.
• Do not apply benzalkonium chloride/benzocaine over large areas of the body and avoid contact with eyes.
• Do not apply more than 3 times per day.
• Do not use it for teething or in children under 2 years of age.
• There have been reports of methemoglobinemia associated with the use of local anesthetics. Methemoglobinemia is a condition with high blood levels of methemoglobin, a type of hemoglobin that does not deliver oxygen to the tissues. Individuals at higher risk for methemoglobinemia include:
  • Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Congenital or idiopathic methemoglobinemia
  • Cardiac or pulmonary compromise
  • Exposure to oxidizing agents or their metabolites
  • Infants younger than 6 months of age
• Check with your physician before using benzalkonium chloride/benzocaine to treat deep or puncture wounds, animal bites, or serious burns.

Common side effects of benzalkonium chloride/benzocaine include:

• Transient stinging sensation at the application site

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

• Benzalkonium Chloride(Dodecyl Dimethyl Benzyl ammonium Chloride)

• 

• What are the dosages of benzalkonium chloride/benzocaine?

   

  Topical solution (touch-free applicator)

  • 0.13%/5%

  Adult and Pediatric:

  Cold Sores

  Children below 2 years:

  • Safety and efficacy not established

  Adults and children 2 years and above:

  • Orajel Single Dose: Apply single dose topically to cold sore

  Administration

  Orajel Single Dose

  • Clean lip area using only warm water or alcohol of any lip preparations, lotions, ointments, residual beverages, or cosmetics, including lipstick
  • Follow directions on applicator to allow medication to saturate the tip
  • Gently touch the site of the cold sore with the saturated applicator tip; once the area is numb, rub the site of the cold sore and the surrounding area
  • Rub firmly to allow the treatment to deeply penetrate the skin
  • To treat most cold sores, 1 treatment is typically enough, if symptoms go away and then return, apply another dose for the second cold sore
  • Do not exceed 3 applications per day
  • Discard after use

  Overdose

  • Benzalkonium chloride/benzocaine overdose can have serious, and sometimes, fatal effects.
  • Overdose symptoms may include central nervous system depression, fainting, seizure, reduced cardiovascular function, low blood pressure (hypotension), slow heart rate (bradycardia), irregular heart rhythm (arrhythmia), and cardiac arrest.
  • Overdose is treated with symptomatic and supportive care.

  • What drugs interact with benzalkonium chloride/benzocaine?

     

    Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

    • Benzalkonium chloride/benzocaine has no listed severe or serious interactions with other drugs.
    • Moderate interactions of benzalkonium chloride/benzocaine include:
      • dapsone topical
      • local anesthetics
      • methemoglobinemia associated agents
      • nitric oxide
      • prilocaine
      • sodium nitrite
    • Benzalkonium chloride/benzocaine has no listed mild interactions with other drugs.

    The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

    It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

     

    Pregnancy and breastfeeding

     

    • Use benzalkonium chloride/benzocaine with caution during pregnancy only if clearly needed and maternal benefits outweigh risks to the fetus.
    • It is not known if benzalkonium chloride/benzocaine is distributed in breastmilk. Check with your physician before use.
    • Check with your physician before using any OTC product, including benzalkonium chloride/benzocaine, if you are pregnant or breastfeeding.

    What else should I know about benzalkonium chloride/benzocaine?

     

    • Use benzalkonium chloride/benzocaine topical solution exactly as prescribed or as per label instructions. Do not use extra doses or more frequently than recommended.
    • Benzalkonium chloride/benzocaine is for external use only.
    • Ensure that the lip area is free of lip preparations, lotions, ointments, residual beverages, or cosmetics, including lipstick, for the best results from the medication.
    • Discontinue use and consult with your dentist or physician if your condition persists for longer than a week, or symptoms worsen.
    • Benzalkonium chloride/benzocaine is flammable, keep away from fire or flame.
    • Store safely out of reach of children.
    • In case of oral ingestion and overdose, seek medical help or contact Poison Control.

    • Summary

      Benzalkonium chloride/benzocaine is a topical solution used to treat cold sores and fever blisters. Benzalkonium chloride/benzocaine is a combination of an antiseptic and a local anesthetic that work together to prevent infection and relieve pain temporarily. Common side effects of benzalkonium chloride/benzocaine include transient stinging sensation at the application site. Check with your physician before using benzalkonium chloride/benzocaine, if you are pregnant or breastfeeding.