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tetracaine + lidocaine (Pliaglis / TetraPeel / Pliaglis)

✓ Approved

Sun Pharmaceutical Industries Ltd. · SCN9A · Small Molecule

What is tetracaine + lidocaine?

tetracaine + lidocaine is a small molecule developed by Sun Pharmaceutical Industries Ltd.. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesPliaglis, TetraPeel, Pliaglis
CompanySun Pharmaceutical Industries Ltd.
Drug ClassSmall Molecule
Molecular TargetSCN9A
RouteTopical
StatusApproved
Sources: ClinicalTrials.gov, Sun Pharmaceutical Industries Ltd.

Mechanism of Action

Molecular Targets

tetracaine + lidocaine acts on 1 molecular target:

SCN9Asodium voltage-gated channel alpha subunit 9 (SFNP, GEFSP7)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

tetracaine + lidocaine is developed for 2 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersAnaesthesia✓ Approved
Nervous system disordersSensory loss✓ Approved

Related Research Articles

PubMedFrontiers in allergy2026-09-19

Severe anaphylactic shock suspectedly induced by injection of recombinant humanized type III collagen lyophilized fiber for facial skin improvement: a case report.

Liu Junjie J, Yan Wenjing W, Liu Jing J, Yang Bowen B et al.

Recombinant humanized type III collagen is widely used in facial rejuvenation due to its excellent biocompatibility and overall favorable safety profile; however, severe systemic hypersensitivity reactions are exceedingly rare. We report a case of a 47-year-old woman with no prior history of allergy who received topical lidocaine to the face, followed by injection of recombinant humanized type III collagen lyophilized fibers for skin texture improvement. Immediately after the injection, she developed suspectedly severe anaphylactic shock temporally associated with the recombinant collagen injectionpresenting with confusion, respiratory distress, followed by marked bradycardia (33 beats/min), and loss of palpable arterial pulse. Emergency protocols were activated immediately, including cardiopulmonary resuscitation, intravenous adrenaline, corticosteroids, and fluid resuscitation. The patient's vital signs gradually recovered, and she was discharged after complete recovery two days later after complete recovery. This case suggests that recombinant humanized collagen, as a macromolecular protein, inherently carries the risk of triggering immediate-type anaphylactic shock despite its favorable safety profile. Clinicians should perform rigorous preoperative assessment, adhere to standardized procedures, and be proficient in the emergency management of anaphylactic shock to minimize the risk of severe adverse reactions and ensure medical safety.

PMID 42760965
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PubMedVeterinary research communications2026-09-19

Macroscopic and ultrasonographic anatomy of the brachial plexus in the American kestrel (Falco sparverius).

Morel Ana Paula AP, Rösler Maria Lúcia ML, de Souza Ana Júlia Fazenda AJF, da Silva Luana Célia Stunitz LCS et al.

The American kestrel (Falco sparverius) is a small raptor frequently admitted to wildlife rehabilitation centers, often due to traumatic injuries requiring surgical intervention. Regional anesthesia techniques, particularly brachial plexus blocks, may improve perioperative management; however, species-specific anatomical and ultrasonographic data remain limited. This study aimed to characterize the macroscopic and ultrasonographic anatomy of the brachial plexus in F. sparverius and to assess the distribution of injectate following ultrasound-guided administration. Nineteen kestrels were allocated into three groups: anatomical dissection (n = 6), ultrasonographic evaluation (n = 8), and cadaveric ultrasound-guided dye injection 0.5 mL kg⁻¹ of a lidocaine-methylene blue solution resulted in consistent dye distribution within the plexus location (n = 5). The brachial plexus was formed by the ventral rami of spinal nerves C13-T2, organized into dorsal and ventral fascicles. Ultrasonographically, the brachial plexus appeared as small hypoechoic structures beneath the superficial and deep pectoral muscles using a ventral approach. These findings demonstrate that the brachial plexus of F. sparverius follows a typical avian pattern with species-specific variations and that the ventral ultrasonographic approach allows reliable visualization and accurate injectate delivery. This study provides anatomical and imaging data to support the development of regional anesthesia techniques in small raptors.

PMID 42760395
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PubMedInternational journal of clinical pediatric dentistry2026-09-18

Comparative Evaluation of the Effectiveness of Intrapulpal Crushed Ice and Intrapulpal Local Anesthesia during Pulpectomy in Primary Molars.

Jagtap Snehal D SD, Ninawe Nupur N, Kalaskar Ritesh R RR, Sharma Nidhi N et al.

This study aimed to evaluate the effectiveness of intrapulpal crushed ice compared to intrapulpal lidocaine as a supplementary anesthetic during pulpectomy in primary second molars of children aged 5-10 years. The goal was to assess whether crushed ice could serve as a less painful, effective alternative to intrapulpal local anesthesia when the inferior alveolar nerve block (IANB) alone is insufficient in cases of symptomatic irreversible pulpitis. A randomized controlled clinical trial was conducted among 52 children fulfilling the inclusion criteria: Frankl Behavior Rating of 3 or 4, vital pulp with bleeding on exposure, and requiring supplementary anesthesia following IANB. Participants were randomly assigned using concealed envelopes to group I (intrapulpal lidocaine, 0.2-0.5 mL under pressure) or group II (intrapulpal crushed ice, placed in the pulp chamber for 3-5 minutes at -4 to 0°C). Pain perception was assessed at access opening and during biomechanical preparation using a visual analog scale (VAS) by the child and a sound, eye, motor (SEM) score by a blinded dentist. Procedure duration was recorded, and cases requiring additional anesthesia were noted. The correlation between VAS and SEM scores was not uniform across groups and assessment stages. A statistically significant positive correlation was observed during access opening in Group II and during biomechanical preparation in Group I, whereas the correlations at the other assessment stages were not statistically significant. Intrapulpal cryotherapy using crushed ice may be a safe, child-friendly, and effective alternative to intrapulpal lidocaine, providing acceptable pain control with improved behavioral outcomes and clinical efficiency. This alternative technique helps avoid the pain of intrapulpal anesthesia while providing effective pain control with a positive impact on the child's experience, making it a more child-friendly option. Jagtap SD, Ninawe N, Kalaskar RR, et al. Comparative Evaluation of the Effectiveness of Intrapulpal Crushed Ice and Intrapulpal Local Anesthesia during Pulpectomy in Primary Molars. Int J Clin Pediatr Dent 2026;19(8):1017-1022.

PMID 42756939
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PubMedBrain research2026-09-17

Lidocaine suppresses glioma growth through DPP9-mediated ferroptosis.

Wang Feng F, Peng Yuan Y, Liu Maoqiao M, Lei Ganni G et al.

Glioma is one of the most aggressive malignant tumors of the central nervous system, with limited benefit from current therapeutic strategies. Identifying novel, safe, and effective therapeutic agents remains an urgent unmet need. Lidocaine, a widely used clinical local anaesthetic, has recently attracted attention for its potential anti-tumor effects. This study aimed to evaluate the inhibitory effects of lidocaine on glioma, identify potential molecular targets, and explore whether its anti-tumor activity is mediated through ferroptosis. Human glioma cell lines U251 and LN229 were used to assess the effects of lidocaine on cell proliferation, migration, and invasion. Antitumor efficacy in vivo was evaluated using subcutaneous and orthotopic xenograft models in nude mice, combined with PET/CT and bioluminescence imaging. Network pharmacology integrated with glioma transcriptomic datasets was applied to screen potential targets. SMR analysis based on human serum and brain tissue datasets identified DPP9 as a glioma-associated risk gene. Single-cell RNA sequencing was used to characterise DPP9 expression, and DPP9 knockout models were established to investigate its role in ferroptosis. Intracellular ROS, MDA levels, and ferroptosis-related gene expression were subsequently analysed. Lidocaine significantly inhibited glioma cell proliferation, migration, and invasion in vitro, and markedly reduced tumor growth in vivo. Integrated analyses identified DPP9 as a high-risk gene promoting glioma progression, predominantly expressed in malignant astrocytes. Both lidocaine treatment and DPP9 interference increased ROS and MDA levels, downregulated GPX4 and SLC7A11, and upregulated ACSL4. Lidocaine suppresses glioma growth by targeting DPP9 and inducing ferroptosis, providing a mechanistic basis for its potential repurposing as an adjunctive therapeutic strategy for glioma.

PMID 42753884
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PubMedInternational medical case reports journal2026-09-17

Awake Fiberoptic Intubation for Segmental Mandibulectomy in a Patient with Follicular Ameloblastoma of the Anterior Mandible: A Case Report.

Kambuaya Noy Norman NN, Fuadi Iwan I

Awake tracheal intubation (ATI) is recommended for patients with predicted difficult airways. This approach preserves spontaneous ventilation until the airway is secured. In this case, a 52-year-old male (ASA II) with a large anterior mandibular tumor underwent segmental mandibulectomy. Awake fiberoptic intubation (AFOI) was performed nasally via a flexible bronchoscope in a semi-sitting, face-to-face position. Topical anesthesia was achieved by combining nebulized 2% lidocaine (4 mL, 80 mg) with the spray-as-you-go technique (2-4 mL of 2% lidocaine). The total dose used was approximately 120-160 mg, or 1.8-2.5 mg/kg for a 65-kg patient. Sedation was achieved with dexmedetomidine (loading dose 1 µg/kg over 10 minutes, then maintenance at 0.4 µg/kg/hour). As HFNO was unavailable due to limited equipment availability, oxygenation was maintained using a low-flow nasal cannula at 3 L/min. Tracheal tube placement was confirmed by direct visualization and capnography. No episodes of desaturation occurred. This report highlights the practical adaptability of the DAS sTOP framework for AFOI when HFNO availability is limited, demonstrating that low-flow nasal oxygen combined with dual-method topicalization and a single sedative agent may serve as a feasible alternative.

PMID 42751328
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PubMedPain2026-09-17

Pharmacological modulation of peripheral nerve excitability-a novel way to investigate sodium channel subtypes in humans.

Andresen Trine T, Tigerholm Jenny J, Røikjer Johan J, Mørch Carsten Dahl CD

Despite considerable progress in pain management, recommended systemic pharmacotherapy often comes with a high risk of serious side effects adversely affecting quality of life. Hence, topical routes of drug administration are currently gaining popularity in painful conditions such as diabetic peripheral neuropathy. Voltage-gated sodium channels (Nav) are expressed in peripheral nerves and are crucial for development and maintenance of neuropathic pain. Subtypes Nav1.7, 1.8, and 1.9 are highly expressed in nociceptors and are therefore interesting targets for topical pharmacotherapeutics. The aim of this study was to assess pharmacologically modulated excitability of peripheral sensory nerves using the human experimental perception threshold tracking technique, an indirect method for measuring the excitability of peripheral nerves. This randomized, placebo-controlled, and double-blinded study included 20 healthy participants. A novel electrical stimulation protocol-the Sodium channel Excitability Nociceptor Testing protocol-was used to identify alterations in Nav1.7, 1.8, and 1.9 after applying 3 (5% lidocaine, 10% phenytoin, and 2% mepyramine) topical pharmacological drugs. There was a significant difference in the relative increase in the perception threshold after drug application between drugs (P < 0.01) and between drugs and placebo (P < 0.01), except for phenytoin (P = 0.22). The computational model suggests that lidocaine and mepyramine caused different alterations of the Nav1.7, 1.8, and 1.9 currents. The Sodium channel Excitability Nociceptor Testing protocol can be used to investigate differential pharmacological alterations of specific Nav subtypes. This may lead to better insight of neurophysiological mechanisms of sensory afferents, forming the basis for targeted drug development, leading the way to stratified treatment regimens of peripheral pain.

PMID 42751727
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