1- What Ennla cream is and what it is used for:

Lidocaine & prilocaine belong to groups of medicines called common local anesthetic Ennla cream is applied to:
Intact skin prior to minor dermatological procedures (e.g. needle insertion and surgical treatment of localised lesions) and prior to dermal procedures on larger areas e.g. split skin grafting.
- Dermal procedures on newly shaven skin of large body areas e.g. laser hair removal.
- Topical anaesthesia of the genital mucosa, e.g. prior to superficial surgical procedures or prior to infiltration anaesthesia of mucosa.
- Topical anaesthesia of leg ulcers to facilitate mechanical cleansing/de- bridement.

2- Before you use Ennla cream:

Do not take Ennla cream if: You are allergic (hypersensitive) to Ennla or any of the other ingredients in Ennla cream. If you are not sure, talk to your doctor or pharmacist before using Ennla cream.
Take special care with Ennla cream:
Check with your doctor or pharmacist before using Ennla cream if:
- you have a history of local hypersensitivity to Ennla or to any of the excipients in the preparation.
- your baby is pre-term neonate i.e. gestational age less than 37 weeks. - you have abnormal haemoglobin in the blood.
- you are defective glucose-6-phosphate dehydrogenase.
- you have any of the following risk factors that increases systemic effects such as:
- Injured skin, opened wounds, or genital mucosa.
- Impaired tympanic membrane in the ear.
- Application to a large surface area or for long period.
- Atopic dermatitis
- Anemia
- If direct contact to the eye, since cataract and glaucoma might result.
- you have infected skin, since infection might spread.
If you are not sure if the above apply to you, talk to your doctor or pharmacist before using Ennla cream.
Giving other medicines, herbal or dietary supplements.
- Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription and herbal medicines.
This is because Ennla cream can affect the way some medicines work. Also some other medicines can affect the way Ennla cream works. -Inparticular,tellyourdoctor,pharmacistifyouaretakinganyofthe following medicines:
- sulphonamides, acetanilid, aniline dyes, benzocaine, chloroquine, dapsone, metoclopramide, naphthalene, nitrates and nitrites, nitrofuranto- in, nitroglycerin, nitroprusside, pamaquine, para-aminosalicylic acid, phenacetin, phenobarbital, phenytoin, primaquine, quinine.
- other local anaesthetics or agents.
- anti-arrhythmic drugs class III (eg, amiodarone).
- cimetidine or betablockers.
Pregnancy and breast-feeding:
Talk to your doctor or pharmacist before using this medicine if you are pregnant, might become pregnant or are breast feeding.
- Ennla cream during pregnancy/lactation should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus/infant.
- Use the minimum quantity of Ennla cream for the minimum duration.
- Ennla cream should not be applied to the breasts of lactating mothers to avoid accidental ingestion by the infant.
Effects on ability to drive and use machines:
Lidocaine and prilocaine has no influence on driving ability and the ability to operate machines when used at the recommended doses

3- How to use Lidocaine/Prilocaine cream:

Always use Ennla cream exactly as your doctor has told you.
You should check with your doctor or pharmacist if you are not sure.
The dose has been prescribed will depend on the treatment plan.
How to use Ennla cream:
- Adults: A thick layer of Ennla cream is applied on the skin and covered it with occlusive dressing.
- Children: Apply a thick layer of Ennla cream with occlusive dressing for 30- 60 minutes.

If you apply more Ennla cream than you should:
Prilocaine in high doses may cause an increase in the methaemoglobin plasma levels (abnormal haemoglobin of the blood), if this happened, it should be treated with a slow intravenous injection of methylene blue.
If large amount was accidently swallowed, talk to your doctor or go to the hospital immediately.

If you forget to use Ennla cream:

If you forget to apply your cream, apply it after you discuss with your doctor.

If you stop using Ennla cream:

If you are using the cream, do not stop using it without discussing with your doctor. If you have any further question on the use of this product, ask your doctor or pharmacist.

4- Possible side effects:

Like all medicines, Ennla cream can cause side effects, although not everybody gets them.
Allergic reactions:
- Stop the treatment and see the doctor straight away if your skin gets worse or becomes swollen.
Other side effects include:
Very common (affects more than 1 in 10 people).
- None.
Common (affects more than 1 in 100 people and less than 1 in 10 people) - Transient local reactions at the application site such as paleness, erythema (redness) and swelling caused by fluid.
- An initial and usually mild sensation of burning, itching or warmth at the application site.
Uncommon (affects more than 1 in 1000 people and less than 1 in 100 people).
- An initial mild burning, itching sensation or warmth at the application site. - Local tingling or numbness of the hands or feet at the application site, e.g. tingling sensation
- Skin irritation at the application site.
Rare (affects more than 1 in 10000 people and less than 1 in 1,000 people). - Abnormal haemoglobin the blood.
- Unusual bleeding or bruising under the skin.or red or purple, flat, pinhead spots under the skin, especially at longer application time in children with atopic dermatitis or mollusca contagiosa (viral infection of the skin or occasionally of the mucous membranes, sometimes called water warts). - Corneal irritation after accidental eye exposure.
- Allergic reactions (in the most severe cases anaphylactic shock).
Very rare (affects less than 1 in 10,000 people).
- None
Unknown (cannot be estimated from available data).
- None
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please contact your doctor or pharmacist.

5- How to store Lidocaine/Prilocaine cream:

- Keep out of the reach and sight of children.
- Do not use Ennla cream after the expiry date which is stated on the pack after ‘Exp’.
- Store below 30° C.
- To be used within one month after first opening.
- Do not freeze.
- Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.