This information is intended for use by health professionals
CALGEL TEETHING GEL
CALGEL TEETHING GEL contains:
Lidocaine Hydrochloride 0.33% w/w
Cetylpyridinium Chloride 0.10% w/w
Excipients: sorbitol solution (E420), xylitol (E967), ethanol 96% and glycerol.
For the full list of excipients, see section 6.1.
For relief of pain and discomfort associated with teething in children from 5 months of age, where non-pharmacological treatments have failed to provide sufficient relief.
It also has mild antiseptic properties.
CALGEL TEETHING GEL is suitable for babies from the age of 5 months.
Apply a pea-sized amount (0.2 grams) of CALGEL TEETHING GEL with a clean finger to the affected area of gum.
The dose may be repeated if necessary after 3 hours, up to a maximum of 6 doses in 24 hours.
Treatment should be stopped once symptoms have resolved.
Not to be used for more than 7 days.
Parents or carers should seek medical attention if the child's condition deteriorates during treatment.
In case of vomiting, spitting or accidental ingestion, the dose should not be repeated immediately. The dose may be repeated if necessary after 3 hours.
Hypersensitivity to lidocaine hydrochloride and/or cetylpyridinium chloride or to any of the excipients listed in section 6.1.
Do not use more than one product containing lidocaine at the same time.
The recommended dose should not be exceeded. Keep out of the sight and reach of children.
Patients with rare hereditary problems of fructose intolerance should not use this medicine.
No drug interactions with CALGEL TEETHING GEL are known.
Drug interactions between intravenously administered lidocaine and oral procainamide, oral phenytoin alone or in combination with phenobarbital, primidone or carbamazepine, oral propanolol and non-potassium sparing diuretics including bumetanide, furosemide and thiazide have been reported. These drug effects are unlikely to be relevant to the use of CALGEL TEETHING GEL.
The medicinal product is indicated for use in toddlers and infants, therefore use during pregnancy and lactation is not applicable.
Calgel Teething Gel has no influence on the ability to drive and use machines.
When used according to instructions side effects would not be expected. However, isolated cases of hypersensitivity to lidocaine hydrochloride have been reported in adults and in a child over 12 years following local injection. Hypersensitivity presented in these cases as localised oedema with slight difficulty in breathing or as generalised rash.
Chamomile, a minor ingredient in the herbal flavouring agent, has been documented as causing allergic reactions. Hypersensitivity to chamomile normally manifests as breathing difficulties in atopic individuals. Anaphylactic reactions have been reported in individuals drinking herbal tea infusions containing chamomile (herbal tea asthma). Sensitised individuals may demonstrate positive skin reactions to preparations containing chamomile.
In the event of any unwanted side effects, use should be discontinued and a doctor consulted.
Adverse drug reactions (ADRs) identified during post-marketing experience with Cetylpyridinium/Lidocaine are included in Table 1. The frequencies are provided according to the following convention:
Very common ≥1/10
Common ≥1/100 and < 1/10
Uncommon ≥1/1,000 and <1/100
Rare ≥1/10,000, and <1/1,000
Very rare <1/10,000
Not known (cannot be estimated from the available data)
Table 1: Adverse Drug Reactions Identified During Post-Marketing Experience with Cetylpyridinium/Lidocaine Frequency Category Estimated from Clinical Trials or Epidemiology Studies
Adverse Event Preferred Term
Immune System Disorders
Hypersensitivity (including Dermatitis)
General Disorders and Administration Site Conditions
Application site reactions (including Erythema)
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Ingestion of cetylpyridinium in large doses may cause gastric upset and central nervous system depression. Concentrations where overdose symptoms were observed were 70 times higher than the concentrations of cetylpyridinium chloride found in this product.
Systemic toxic effects with local anaesthetics (all forms of administration) may include central nervous system and cardiac effects.
No symptoms of overdosage have been identified from the analysis of post-marketing data for this product.
Pharmacotherapeutic group: Anaesthetics, local (Amides) Lidocaine combinations
ATC code: N01 BB52
Established local anaesthetic (lidocaine) for topical application.
No additional information.
Sorbitol solution (70%) (E420)
Hydroxyethyl cellulose 5000
Macrogolglycerol hydroxystearate (Cremophor RH 40) (castor oil polyoxyl hydrogenated)
Macrogol lauryl ether 9
Pharmaceutical liquid flavour, (containing chamomile)
Citric acid monohydrate
Sodium citrate dihydrate
3 years (unopened)
Do not store above 25°C.
10 g collapsible, internally lacquered, aluminium tube, the nozzle of which possesses a membrane.
No special requirements for disposal
McNeil Products Limited
10 August 2018