Lidocaine for Premature Ejaculation: What Is Actually Licensed

One lidocaine-containing topical treatment is licensed in the UK for premature ejaculation: a lidocaine and prilocaine cutaneous spray. It is a prescription-only medicine.

The important distinction is between a product that contains lidocaine and one that has actually been assessed and licensed for this use. Lidocaine creams and gels may be licensed for other medical purposes, but that does not make them treatments for premature ejaculation.

This page covers what the licensed product information says about how the spray works, how quickly, what the trials found, transfer to a partner, side effects and the barrier-material warning. It does not give application instructions for unlicensed creams or gels.

Key things to know

• A lidocaine and prilocaine cutaneous spray is licensed in the UK for primary premature ejaculation in adult men
• Lidocaine creams and gels may be licensed for other uses, but not for premature ejaculation
• The product information describes a rapid onset, with effect within five minutes of application
• In the trials, mean measured time rose from 0.58 minutes to 3.17 minutes, against 0.56 to 0.94 minutes on placebo
• It is contraindicated where either the patient or their partner has the relevant hypersensitivity
• Polyurethane barrier products should not be used with it. Latex rubber, polyisoprene, nitrile and silicone are recorded as compatible
• Reduced sensation is a recorded effect, and erectile difficulty was reported by 4.4% of patients in the trials

What Holds a UK Licence, and What Does Not

A medicine's licence relates to the uses described in its product information. A product can contain the same active ingredient as a licensed treatment and still be licensed for a completely different purpose.

The Licensed Product

The lidocaine and prilocaine cutaneous spray is indicated for primary premature ejaculation in adult men.

Two things in that sentence do work. It is a spray applied to the skin, not a cream. And its licensed indication covers the primary, or lifelong, form.

It is prescription-only, so a prescriber assesses whether it is appropriate before it is supplied.

Creams and Gels

Lidocaine-containing creams and gels are available for other medical uses, but the product information reviewed for this page does not identify premature ejaculation as an indication for any of them.

Lidocaine and prilocaine 5% cream, for example, is licensed for numbing the skin before needle insertion and minor surgical procedures, for the genital mucosa before procedures, and for leg ulcers. Premature ejaculation appears nowhere in that list.

Other lidocaine sprays are licensed for different medical uses too. Containing lidocaine does not make them interchangeable with the spray licensed for this condition.

Why No Application Instructions Appear Here

The appropriate amount, the application site, the exposure and the transfer to a partner all depend on the individual product and its licensed use. Applying instructions from one product to another could give a false impression of safety or effectiveness.

The safer approach is to follow the product information for the medicine you have actually been prescribed.

How the Licensed Spray Performs

Lidocaine and prilocaine are both amide-type local anaesthetics applied to the skin, reducing sensation at the site. Amide-type is a chemical family, and it matters for a reason covered below.

Onset

The product information describes a rapid onset, effective within five minutes of application. It also directs that after five minutes any excess is wiped off before use, which limits how much is available to transfer, so that step is not optional.

That short application window is one of the practical differences between the spray and the oral treatment, which works on a different timescale.

What the Trials Found

The evidence comes from two randomised controlled trials with 539 patients between them.

Across three months, the active spray took mean measured time from a baseline of 0.58 minutes up to 3.17 minutes. The placebo group rose from 0.56 to 0.94 minutes.

That is a rise of roughly two and a half minutes on treatment, against about twenty seconds on placebo. A clear gap, and worth stating plainly rather than dressing up.

There is no head-to-head trial establishing whether the spray is better or worse than the licensed oral treatment, so the evidence does not support ranking one above the other.

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Transfer to a Partner

Because this is a topical treatment, transfer to a partner is part of its safety information.

What Is Recorded

Effects experienced by partners appear in the product information with frequencies. A burning sensation was reported by 3.9% of partners, and reduced sensation by 1.0%. Discomfort led to discontinuation in 0.3%.

These are not speculative. They were collected during the trials, which is why they can be quoted with figures rather than described vaguely.

A Contraindication Covering Two People

The product is contraindicated where either the patient or their partner is hypersensitive to the active substances or any other ingredient, or has a known history of sensitivity to amide-type local anaesthetics.

That makes your partner's allergy history relevant before treatment is used. If either of you has previously reacted to a local anaesthetic, discuss it with the prescriber rather than assuming every past reaction carries the same significance.

Why Unlicensed Creams Make This Worse

Everything above comes from an assessed product, with recorded frequencies and a stated contraindication.

An unlicensed cream used this way raises the same transfer question with none of the answers. No frequencies were collected. No contraindication covering a second person was written, because nobody assessed the second person. The risk does not disappear when the documentation does.

Barrier Product Compatibility

The product information records a material incompatibility, and it is safety-relevant rather than a footnote.

The spray must not be used with polyurethane barrier products. Latex rubber, polyisoprene, nitrile and silicone are recorded as compatible.

That matters because the warning concerns the performance of the barrier product as well as the medicine. If you have been prescribed the spray and use a barrier product, check its material rather than assuming every type is compatible.

Your Own Sensation

Reduced sensation is a recorded effect, listed among the common ones. It does not necessarily mean the product has been used incorrectly, since reducing sensation is part of how a topical local anaesthetic works.

Erectile difficulty was reported by 4.4% of patients in the trials, and a burning sensation at the application site is also recorded.

Using more than the recommended amount is not a way to guarantee better control. It increases exposure and the likelihood of unwanted effects, which is why the prescribed product should be used according to its product information.

If You Have Already Used an Unlicensed Cream

Tell the prescriber at your assessment.

Using a product outside its licensed indication does not tell you whether it is safe or effective for that use. The formulation, concentration, application site and potential transfer to a partner all matter, and it is particularly important to mention any reaction you or your partner had.

Do not keep increasing the amount because the first attempt did not produce the result you wanted. Discuss the options with a prescriber who can assess which product is appropriate.

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Spray or Cream: The Wrong Comparison

The important difference is not whether a product contains lidocaine. It is whether that formulation has been assessed for premature ejaculation.

The licensed spray has product-specific evidence, instructions, contraindications and safety information for this use. None of that transfers automatically to a cream or gel with a different formulation.

So the comparison is less about which is stronger, and more about what is actually known about each for this particular use.

Getting Assessed

The spray is prescription-only, so an assessment comes before supply.

It establishes whether the presentation is the primary form the licence covers, whether erectile function has changed, what else you take, and whether either you or your partner has any history of reaction to a local anaesthetic.

An online consultation with UK registered prescribers works through all of it before any supply. Where treatment is not suitable, the decision comes back plainly with its reason.

EveryDayMeds holds GPhC registration number 9012878, checkable on the regulator's register. Every order leaves in plain unbranded packaging.

Medical Disclaimer

This page provides general information about lidocaine-containing treatments for premature ejaculation. It does not provide application instructions, and it is not a diagnosis. Treatment suitability depends on an individual clinical assessment, and results vary between individuals.

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