Prilocaine is a local anesthetic of the amino amide type, first prepared by Claes Tegner and Nils Löfgren. In its injectable form (trade name Citanest), it is often used in dentistry. It is also often combined with lidocaine as a topical preparation for dermal anesthesia (lidocaine/prilocaine or EMLA), for treatment of conditions like paresthesia. As it has low cardiac toxicity, it is commonly used for intravenous regional anaesthesia.
Prilocaine Hydrochloride (Prilocaine HCL) Injection, USP, 4% contains prilocaine HCl, which is chemically designated as propanamide, N-(2-methyl-phenyl) -2- (propylamino)-, monohydrochloride, is a sterile, non pyrogenic isotonic solution that contains a local anesthetic agent and is administered parenterally by injection.
Prilocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action.
Maxillary infiltration: initially 1–2mL; max recommended dose within a 2-hour period: <70kg: 8mg/kg; ≥70kg: 600mg. Elderly, debilitated, acutely ill: reduce dose.
<10yrs: use Clarks rule to calculate dose.
When used for infiltration injection in dental patients, the time of onset of anesthesia averages less than 2 minutes with an average duration of soft tissue anesthesia of approximately 2 hours.
In some patients, ortho-toluidine, a metabolite of prilocaine, may cause methemoglobinemia, which may be treated with methylene blue. Prilocaine may also be contraindicated in people with sickle cell anemia, anemia, or symptomatic hypoxia. People with pseudocholinesterase deficiency may have difficulty metabolizing this anesthetic.
Information derived from diverse formulations, concentrations and usages reveals that prilocaine is completely absorbed following parenteral administration, its rate of absorption depending, for example, upon such factors as the site of administration and the presence or absence of a vasoconstrictor agent. Prilocaine is metabolized in both the liver and the kidney and excreted via the kidney. It is not metabolized by plasma esterases. Hydrolysis of prilocaine by amidases yields ortho-toluidine and N-proylalanine. Both of these compounds may undergo ring hydroxylation.
Swelling and persistent paresthesia of lips, oral tissue; CNS effects (eg, excitation, depression, restlessness, anxiety, dizziness, tremors), cardiovascular effects (eg, bradycardia, hypotension, cardiovascular collapse), allergic-type reactions, neurologic effects, increased creatinine phosphokinase.
To minimize the likelihood of intravascular injection, aspiration should be performed before the local anesthetic solution is injected. If blood is aspirated, the needle must be repositioned until no return of blood can be elicited by aspiration. Note, however, that the absence of blood in the syringe does not assure that intravascular injection will be avoided.
Lidocaine and prilocaine topical cream is used on the skin or in the genital area to cause numbness or loss of feeling before certain medical procedures. It is used to prevent pain caused by an injection, the drawing of blood from a vein, or minor surgeries such as removing warts. This medicine contains a mixture of two topical local anesthetics (numbing medicines). It deadens the nerve endings in the skin.
Use this medication only on normal skin and the genital area. Do not apply to broken/irritated skin or open wounds unless directed by your doctor. Wash your hands before using this product.
To apply, squeeze out the prescribed amount of cream directly onto the skin. You can also squeeze it onto a measuring guide to make sure you get the right dose and then apply it to the area.
Dosage and length of application time are based on your age and medical condition and the procedure you are having. In children, dosage may also be based on weight. Do not use larger amounts than prescribed. Do not use on large areas of skin, apply heat, or leave it in place longer than directed or serious side effects may occur.
Do not take lidocaine and prilocaine cream by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
If you get this medicine in any of these areas, rinse well with water.
Clean affected part before use. Make sure to dry well.
Use a rubber glove to put on.
Put a thick layer on the area to be treated. Do not rub in.
Tell all of your health care providers that you take lidocaine and prilocaine cream. This includes your doctors, nurses, pharmacists, and dentists.
This medicine may cause harm if swallowed. If this medicine is swallowed, call a doctor or poison control center right away.
Do not put on open wounds, cuts, or irritated skin.
Use care when putting on a large part of the skin or where there are open wounds. Talk with the doctor.
Do not use lidocaine and prilocaine cream for longer than you were told by your doctor.
Do not scratch or rub the skin while it is numb. Do not let it get very hot or very cold.
If you are 65 or older, use this medicine with care. You could have more side effects.
Use with care in children. Talk with the doctor.
Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using lidocaine and prilocaine cream while you are pregnant.
Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
Lidocaine-Prilocaine topical cream storage
Store at room temperature. Do not freeze.
Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
Check with your pharmacist about how to throw out unused drugs.
This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information aboutprilocaine . It does not include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine.
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