Aftamed vs Oral Aid Gel: Key Differences
Aftamed (benzydamine) oral gel is an anti-inflammatory agent that reduces inflammation and provides analgesia through multiple mechanisms beyond simple numbing, while Oral Aid (lidocaine) gel is a local anesthetic that works solely by blocking nerve conduction to provide temporary pain relief.
Active Ingredient and Mechanism of Action
Aftamed (Benzydamine)
- Contains benzydamine hydrochloride, a topical nonsteroidal anti-inflammatory drug (NSAID) with unique properties 1
- Works through multiple mechanisms: inhibits pro-inflammatory cytokine production (particularly TNF-alpha at EC50 of 25 micromol/L), stabilizes cell membranes, and provides local anesthetic effects through interaction with cationic channels 1, 2
- Unlike traditional NSAIDs, benzydamine is a weak inhibitor of cyclooxygenase and does not primarily work through prostaglandin inhibition 1, 2
- Possesses antimicrobial properties against both gram-positive and gram-negative bacteria, plus antifungal activity against Candida species 1
Oral Aid (Lidocaine)
- Contains lidocaine, an amide local anesthetic 3
- Blocks sodium ion channels required for neuronal impulse initiation and conduction, resulting in local anesthesia 3
- Creates temporary numbness with minimal systemic absorption when applied topically 3
Clinical Applications
Benzydamine (Aftamed)
- Recommended by NCCN guidelines for prevention and treatment of mucositis in cancer patients 4
- Recommended by ESMO guidelines for preventing oral mucositis in head and neck cancer patients receiving moderate-dose radiation therapy (up to 50 Gy) without concomitant chemotherapy 4
- Recommended by UK guidelines as an anti-inflammatory oral rinse for Stevens-Johnson syndrome/toxic epidermal necrolysis, used every 3 hours particularly before eating 4
- Effective for sore throat, oral inflammation, dental plaque, tonsillitis, and chemo/radiotherapy-induced mucositis 1
Lidocaine (Oral Aid)
- Used for topical anesthesia of oral and genital ulcers 3
- Effective for pain management in mucositis, pharyngitis, and esophagitis 4, 3
- Provides temporary symptomatic relief only, without addressing underlying inflammation 3
Duration of Effect
- Benzydamine: Provides sustained anti-inflammatory effects through multiple mechanisms, addressing both pain and underlying pathology 1, 2
- Lidocaine: Provides temporary anesthetic effect lasting approximately 30 minutes to 2 hours; patients should avoid eating or drinking for at least 30 minutes after application 3
Safety Considerations
Benzydamine
- Generally well-tolerated with local application 4, 1
- Can be used multiple times daily (typically every 3 hours) 4
Lidocaine
- Contraindicated in patients with known hypersensitivity to amide anesthetics 3
- Should not be applied to broken or inflamed skin 3
- Requires caution in patients with severe liver disease due to reduced drug metabolism 3
Clinical Decision-Making
Choose Aftamed (benzydamine) when:
- Treating inflammatory conditions like mucositis, particularly in cancer patients 4
- Prevention of oral mucositis is needed in radiation therapy patients 4
- Both anti-inflammatory and analgesic effects are desired 1
- Antimicrobial properties would be beneficial 1
Choose Oral Aid (lidocaine) when:
- Rapid, temporary pain relief is the primary goal 3
- Simple topical anesthesia is needed for procedures or acute painful ulcers 3
- Patient cannot tolerate NSAIDs or anti-inflammatory agents 3
Important Clinical Pearls
- Benzydamine has tissue concentrations around 100 micromol/L in oral tissues after local application, sufficient for its anti-inflammatory effects 2
- Lidocaine gel is particularly practical when used as patches on feet or hands, delivering medication gradually over hours 4
- For comprehensive oral care in mucositis, benzydamine should be part of a protocol including good oral hygiene 4, 3
- The choice between these agents fundamentally depends on whether you need to treat inflammation (benzydamine) or simply provide temporary anesthesia (lidocaine) 4, 3, 1