FDA Issues Warnings for Some OTC Topical Pain Relievers

by Staff Writer
April 12, 2024 at 11:16 AM UTC

The FDA has issued consumer warnings regarding certain over-the-counter topical pain relievers.

Clinical relevance: The FDA has issued consumer warnings regarding certain over-the-counter topical pain relievers.

  • These warnings pertain to 19 pain relievers marketed by six companies, containing ingredients like lidocaine at levels higher than allowed by law.
  • High lidocaine levels could lead to serious health risks such as irregular heartbeat, seizures, and breathing difficulties.
  • Consumers are advised not to use OTC pain relief products with more than 4% lidocaine, apply them heavily over large areas of skin, or wrap treated skin with plastic wrap.

The U.S. Food and Drug Administration (FDA)  has fired off a warning to consumers about a handful of over-the-counter topical pain relievers. Regulators also issued a warning to each of the six companies that market the 19 pain relievers.

Consumers take these analgesics ahead of, or as a treatment for, some cosmetic procedures, such as microdermabrasion, laser hair removal, tattooing, and piercing.

What’s Wrong With Them?

According to the FDA, some of these pain relievers have ingredients – such as lidocaine – at much higher levels than the laws allow for OTC topical pain relievers. And that’s because topicals with these lidocaine levels, “could lead to increased absorption of the drug product through the skin, it may lead to serious injuries such as irregular heartbeat, seizures, and breathing difficulties.”

Worse still, these topicals can interact badly with other medications or even dietary supplements.

“These products pose unacceptable risks to consumers and should not be on the market,” said Jill Furman,  director of the Office of Compliance in the FDA’s Center for Drug Evaluation and Research, said in a press release. “We are committed to using all available tools to stop the sale of these illegal high-risk products.”

Part of a Larger Trend

Despite earlier FDA warnings about similar products – dating back to 2009 – regulators are still coming across these products online and in retail outlets. In fact, the FDA has insisted that it doesn’t have any evidence that back up the safety of these topicals.

The agency also warned consumers that when someone applies lidocaine over a large patch of skin, and leave it, it can lead to a serious injury.

The FDA advised consumers to:

  • not use OTC pain relief products with more than 4% lidocaine on their skin.
  • not apply OTC pain relief products heavily over large areas of skin or to irritated or broken skin.
  • not wrap skin treated with OTC pain relief products with plastic wrap or other dressings. Wrapping or covering treated skin with any type of material can increase the chance of serious side effects.

FDA IDs the Players

Finally, the FDA revealed that the companies that received the warning letters were: 

Specifically, the agency told the companies they had to respond within 15 days. None of the companies have responded publicly.

Additionally, the FDA’s already put some of these companies on import alert.

Further Reading

What’s Next After 50 Years of Psychiatric Drug Development

Research Suggests CBD Pain Relief is a Myth

Stimulant Use for Analgesia: A Case Series

Academic Highlights

Difficult to Treat Depression: Focus on Approach, Algorithms, and Access

The Southwest Forum on Difficult to Treat Depression brought together 11 experts to discuss aspects of managing difficult-to-treat depression. This article presents highlights from the forum, covering such topics as barriers to equitable care, evidence-based algorithms, novel tre...

Jordan F. Karp and others

Case Report

Panic Attacks in the Presentation of COVID-19

This case describes panic attacks that occurred repeatedly as part of the constellation of presenting symptomatology during 2 separate COVID-19 infections.

Tej Joshi and others