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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Benzocaine (incl. topical)

4

XIV.a Methemoglobinemia

4
Last update : 29/10/2023
 
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1
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3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
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See also under
Anesthetic agents (local, topical)
3

Publications

Silent Hypoxia From Benzocaine-Induced Methemoglobinemia Following Transesophageal Echocardiogram.
Cureus 2025 Jul;17;e87109 2025 Jul
Occult Methemoglobinemia in a Medically-Complex 7-Year-Old Child and the Opportunity for Pharmacist Intervention in Pediatric Emergency Medicine.
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG 2024 Dec;29;650-653 2024 Dec
Case Report: An Uncommon Etiology of Vulvar Irritation and Swelling in an Adolescent Patient.
Journal of pediatric and adolescent gynecology 2022 Dec;35;715-717 2022 Dec
Benzocaine-related methaemoglobinemia after transoesophageal echocardiography: a rare, life-threatening complication.
BMJ case reports 2021 Apr 23;14; 2021 Apr 23
Topical Benzocaine and Methemoglobinemia.
American journal of therapeutics 2017;24;e596-e598 2017
An Uncommon Complication With Use of Topical Local Anesthetic Agents: Methemoglobinemia.
American journal of therapeutics 2016;23;e1968-e1969 2016
An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine.
Case reports in emergency medicine 2015;2015;670979 2015
Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray.
Case reports in anesthesiology 2015;2015;685304 2015
Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital.
Thorax 2014 Dec;69;1157-8 2014 Dec
Methemoglobinemia precipitated by benzocaine used during intubation.
Proceedings (Baylor University. Medical Center) 2014 Apr;27;133-5 2014 Apr
Methemoglobinemia with the use of benzocaine spray for awake fiberoptic intubation.
Middle East journal of anaesthesiology 2013 Oct;22;337-40 2013 Oct
Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures.
Local and regional anesthesia 2011;4;25-8 2011
A rare side effect of transesophageal echocardiography: methemoglobinemia from topical benzocaine anesthesia.
European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 2008 Mar;9;289-90 2008 Mar
Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report.
Journal of medical case reports 2008 Jan 23;2;16 2008 Jan 23
Intraoperative detection of methemoglobinemia in a patient given benzocaine spray to relieve discomfort from a nasogastric tube: a case report.
AANA journal 2008 Apr;76;99-102 2008 Apr
Topical benzocaine-induced methemoglobinemia in the pediatric population.
Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 2008;22;335-9; quiz 340-1 2008
Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors.
Archives of internal medicine 2007 Oct 08;167;1977-82 2007 Oct 08
Methemoglobinemia and benzocaine.
Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 2007;30;342-5; quiz 346-7 2007
Methemoglobinemia-induced cardio-respiratory failure secondary to topical anesthesia.
American journal of therapeutics 2006;13;545-9 2006
Benzocaine-induced methemoglobinemia.
Anesthesia progress 2005;52;136-9 2005
Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals.
Medicine 2004 Sep;83;265-273 2004 Sep
Reported adverse event cases of methemoglobinemia associated with benzocaine products.
Archives of internal medicine 2004 Jun 14;164;1192-6 2004 Jun 14
Critical rebound methemoglobinemia after methylene blue treatment: case report.
Pharmacotherapy 2004 Apr;24;538-40 2004 Apr
Benzocaine induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
Ochsner journal 2003;5;34-5 2003
Benzocaine-induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
Texas Heart Institute journal 2003;30;308-10 2003
Severe methemoglobinemia after transesophageal echocardiography.
American journal of therapeutics 2003;10;225-7 2003
Severe methemoglobinemia on reexposure to benzocaine.
Journal of clinical anesthesia 2001 Mar;13;128-30 2001 Mar
Severe methemoglobinemia from topical anesthetic spray: case report, discussion and qualitative systematic review.
CJEM 2001 Jan;3;51-6 2001 Jan
Unexpected cyanosis in the surgical patient.
Surgical endoscopy 2000 Jun;14;595 2000 Jun
Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature.
The Annals of pharmacotherapy 1994 May;28;643-9 1994 May
Benzocaine-adultered street cocaine in association with methemoglobinemia.
Clinical chemistry 1992 Apr;38;596-7 1992 Apr

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