Dibucaine is a local anesthetic that belongs to the family of amino amides. It works by blocking the transmission of nerve impulses and thus numbing the area where it is applied. Dibucaine is commonly used topically to relieve pain, itching, or discomfort caused by various conditions such as minor burns, insect bites, hemorrhoids, and minor skin irritations. It is often found in over-the-counter products like creams, ointments, or sprays designed for external use.

A local anesthetic called dibucaine (Faktu) is used to treat mild itchiness, burning, or stinging that is brought on by cuts, scrapes, skin irritation, or anorectal discomfort and itching in hemorrhoid patients.

Dibucaine Uses:

• Dermal pain/itching:
  • It is prescribed for the short-term alleviation of pain and itching brought on by small skin irritation, minor cuts, minor scrapes, and minor burns (including sunburns).
• Hemorrhoids and anorectal disorders, rectal pain, and itching:
  • It is utilized to provide individuals with hemorrhoids and other anorectal problems with short-term relief from their discomfort and irritation.

Dibucaine (Faktu) Dose in Adults:

Dibucaine (Faktu) Dose in the treatment of Dermal pain and itching:

• Put dibucaine on the area of your skin that's bothering you.
• You can apply it up to 3 or 4 times a day.
• But make sure you don't use more than 30 grams of dibucaine in a day.

Just follow these instructions, and it should help relieve your skin discomfort.

Dibucaine (Faktu) Dose in the treatment of Hemorrhoids and anorectal disorders, rectal pain, and itching:

• Apply dibucaine to the affected external anal area.
• You can do this up to 3 or 4 times a day.

By following these instructions, you can help alleviate the pain and itching associated with hemorrhoids or rectal discomfort.

Dibucaine (Faktu) Dose in Children:

Dibucaine (Faktu) Dose in the treatment of Dermal pain and itching:

If your child is at least 2 years old and weighs at least 16 kilograms, you can use dibucaine to help with their skin pain or itching.

• Apply dibucaine to the affected area of their skin.
• You can do this up to 3 or 4 times a day.
• But make sure your child doesn't use more than 7.5 grams of dibucaine in a day.

Just follow these instructions, and it should help relieve your child's skin discomfort.

Dibucaine (Faktu) Dose in the treatment of Hemorrhoids, anorectal disorders, and rectal pain or itching:

For children aged 12 years and older, as well as adolescents, you can use dibucaine to alleviate hemorrhoids, anorectal disorders, rectal pain, or itching. Here's how to use it:

• Apply dibucaine to the affected external anal area.
• You can do this up to 3 or 4 times a day.

Following these instructions can help ease the discomfort associated with hemorrhoids or rectal pain/itching in older children and adolescents.

Pregnancy Risk Category: C

• Its use in pregnancy is not well-documented. 
• It has not yet been tested in pregnancy studies with humans or animals.
• It should not be used by pregnant or lactating mothers without caution.   

Dose in Kidney Disease:

• According to the manufacturer's labeling, there are no specific dosage adjustments recommended for dibucaine in individuals with renal impairment.
• This suggests that the usual dosage guidelines for dibucaine apply regardless of renal function.

Dose in Liver disease:

• According to the manufacturer's labeling, there are no specific dosage adjustments recommended for dibucaine in individuals with hepatic impairment.
• This suggests that the usual dosage guidelines for dibucaine apply regardless of hepatic function.

Side Effects of Dibucaine (Faktu):

• Central nervous system:
  • Localized burning
• Dermatologic:
  • Contact dermatitis
• Hypersensitivity:
  • Angioedema

Contraindications to Dibucaine (Faktu):

In over-the-counter (OTC) labeling, it's important to note the following precautions:

• Do not use dibucaine in or near the eyes.
• Avoid using dibucaine in children younger than 2 years old or weighing less than 16 kilograms.

Additionally, regarding allergenic cross-reactivity for amide local anesthetics like dibucaine, documentation is limited. However, due to similarities in chemical structure and/or pharmacologic actions among these substances, there's a possibility of cross-sensitivity. While it's not certain, it's important to be aware of this potential risk, especially if you have a known allergy to other local anesthetics.

Dibucaine: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Moitoring Parameters:

None mentioned.   

How to administer Dibucaine (Faktu)?

Topical Use:

• External Use Only: Only use dibucaine on the outside of your body. Do not apply it in or around your eyes.
• Before Rectal Use: If you're using dibucaine around the rectal area, first clean the affected area with mild soap and warm water. Rinse it well, then gently pat or blot it dry with toilet tissue or a soft cloth.
• Rectal Application: Do not insert dibucaine into the rectum using your fingers, any tools, or applicators.

Mechanism of action of Dibucaine (Faktu):

• Dibucaine works by stopping nerve signals in your body.
• It does this by making it harder for sodium ions to move through nerve cell membranes, which prevents the nerves from sending signals.
• This stops the process called depolarization, which is needed for nerve signals to travel.
• As a result, dibucaine blocks both the start and the movement of nerve signals, effectively reducing pain and other sensations.

Onset of Action:

• Dibucaine starts working within about 15 minutes after application.

Duration:

• Its effects typically last between 2 to 4 hours.

Absorption:

• Dibucaine is not absorbed well through unbroken skin, but it is absorbed effectively through mucous membranes (like those in the mouth or rectum) and through skin that is damaged or broken.

International Brand Names of Dibucaine:

• Nupercainal
• Faktu
• H-Formula

Dibucaine Brand Names in Pakistan: