• Topical pain relief

Numbrino Generic Name & Formulations

General Description

Cocaine HCl 4% (40mg/mL); aqueous nasal soln.

Pharmacological Class

Local anesthetic.

How Supplied

Nasal soln (4mL, 10mL)—1


Generic Availability


Numbrino Indications


Local anesthesia of the mucous membranes for diagnostic procedures and surgeries on or through the nasal cavities.

Numbrino Dosage and Administration


For intranasal use only. Do not apply to damaged nasal mucosa. ≥18yrs: 40–160mg based on the nasal mucosal area and procedure; max 2 pledgets per nasal cavity (total dose of 160mg). Each pledget (recommended size is ½ inch x 3 inch) absorbs 1mL. Do not exceed 3mg/kg for any one procedure/surgery.


<18yrs: not established.

Numbrino Contraindications


Hypersensitivity to other ester-based local anesthetics.

Numbrino Boxed Warnings

Boxed Warning

Abuse and dependence.

Numbrino Warnings/Precautions


High potential for abuse and dependence. History of seizures. Prior EEG abnormalities without seizures. Monitor vital signs (eg, HR and rhythm) and for seizure development. Avoid in patients with history of MI, coronary artery disease, CHF, irregular heart rhythm, abnormal ECG, or uncontrolled hypertension. Pseudocholinesterase deficiency, renal impairment; monitor. Hepatic impairment: avoid. Elderly. Pregnancy. Nursing mothers: not recommended (during and for 48hrs after the last dose).

Numbrino Pharmacokinetics

See Literature

Numbrino Interactions


Avoid concomitant other vasoconstrictor agents (eg, epinephrine, phenylephrine); if unavoidable, prolonged vital sign and ECG may be needed. Avoid use with disulfiram; consider alternative local anesthesia. Concomitant other CNS stimulants may cause excessive stimulation (eg, nervousness, irritability, possibly convulsions). May be potentiated by cholinesterase inhibitors (eg, certain MAOIs, oral contraceptives, glucocorticoids, neostigmine, cyclophosphamide, thiotepa, echothiophate, organophosphate insecticides, certain antineoplastic agents); monitor. May increase risk of hypertension and cardiac arrhythmias with sympathomimetics, postganglionic blocking agents (eg, reserpine), and TCAs. May potentiate MAOIs. May be detected in plasma for up to 1 week and urine toxicology for >1 week after administration.

Numbrino Adverse Reactions

Adverse Reactions

Hypertension, tachycardia, sinus tachycardia.

Numbrino Clinical Trials

See Literature

Numbrino Note

Not Applicable

Numbrino Patient Counseling

See Literature