Benzocaina 15% — 15.00%, Lidocaina HCl 4% — 4.00%, Polietilenglicol 1500 30% — 30.00%, Polietilenglicol 4000 20% — 20.00%, Hidroxipropilceluloza HPC 15% — 15.00%, Carboximetilceluloza 10% — 10.00%, Glicerina 10% — 10.00%, Aqua purificata 11% (patch 1 cm x 2 cm = 0.1 g) — q.s.