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# Mylot%20at ## Overview Mylot%20at is a combination medication containing lidocaine and prilocaine, a eutectic mixture of local anesthetics. It works by reversibly blocking nerve conduction, thereby producing local anesthesia. ## Primary Indications * Topical anesthetic for intact skin prior to needle insertion (e.g., venous access, blood draws). * Topical anesthetic for superficial dermatological procedures. ## Adult Dosing * **For intact skin prior to needle insertion:** Apply 1 to 2.5 grams per 10 cm² of skin. Allow to remain on the skin for at least 1 hour. Do not exceed a total application of 60 grams. * **For superficial dermatological procedures:** Apply 0.5 to 1 gram per 10 cm² of skin. Allow to remain on the skin for 5 minutes for hair removal or up to 20 minutes for other procedures. ## Pediatric Dosing Dosing in pediatric patients varies significantly by age and weight. Local protocols or specific product labeling should be consulted. Generally, the amount applied and duration of contact should be reduced in younger children and those with lower body weight. * **Infants 0-3 months or weighing up to 5 kg:** Maximum application area is 10 cm². * **Infants 3-12 months or weighing 5-10 kg:** Maximum application area is 20 cm². * **Children 1-2 years or weighing 10-20 kg:** Maximum application area is 30 cm². * **Children 2-5 years or weighing 20-30 kg:** Maximum application area is 40 cm². * **Children 5-10 years or weighing 30-60 kg:** Maximum application area is 100 cm². * **Adolescents 10-12 years or weighing 60-80 kg:** Maximum application area is 150 cm². For any pediatric patient, ensure the total dose does not exceed recommended limits based on body weight and application site. ## Dose Adjustments No dose adjustments are typically required based on renal or hepatic impairment for topical application, provided recommended doses and application areas are not exceeded. ## Contraindications * Hypersensitivity to lidocaine, prilocaine, or any component of the formulation. * Infants younger than 12 months of age undergoing treatment with methemoglobinemia-inducing agents. ## Adverse Effects Common adverse effects include local skin reactions such as transient blanching, redness, or edema. Systemic absorption can lead to methemoglobinemia (especially in infants), central nervous system effects (e.g., dizziness, confusion), or cardiovascular effects. Allergic reactions are rare. ## Key Drug Interactions * **Methemoglobinemia-inducing agents:** Increased risk of methemoglobinemia with concurrent use, particularly in infants. * **Antiarrhythmics (Class Ib):** Additive effects with systemic lidocaine or prilocaine. ## Monitoring * Monitor for signs of local irritation or allergic reaction. * In pediatric patients, especially infants, monitor for signs of methemoglobinemia (e.g., cyanosis, shortness of breath, headache). ## Clinical Pearls * Ensure the product is not applied to broken or irritated skin to avoid increased systemic absorption and potential adverse effects. * For topical anesthesia, adequate occlusion with a dressing is often required to enhance penetration and efficacy. * Systemic absorption is generally low with recommended doses but can increase with prolonged contact, large application areas, or compromised skin. *** **Disclaimer:** This information is intended for clinical use and does not substitute for professional medical advice. Always consult the most current prescribing information and local institutional protocols for definitive guidance.