prilocaine (Rx)

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Brand and Other Names:Citanest

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution (cartridge for dental use)

  • 4%
  • 4% with epinephrine 1:200,000
more...

Local Anesthesia

Dental infiltration: 40-80 mg (1-2 mL) of 4% solution prilocaine or prilocaine with epinephrine

Not to exceed 600 mg (8 mg/kg) within 2 hr 

Dosage Forms & Strengths

injectable solution (cartridge for dental use)

  • 4%
  • 4% with epinephrine 1:200,000
more...

Local Anesthesia

< 10 years

  • Dental infiltration: 40 mg of (1 mL) 4% solution; not to exceed 8 mg/kg within 2 hr 

> 10 years

  • Dental infiltration: 40-80 mg (1-2 mL) of 4% solution prilocaine or prilocaine with epinephrine; not to exceed 600 mg (8 mg/kg) within 2 hr
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Interactions

Interaction Checker

and prilocaine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            CNS depression manifested by drowsiness, unconsciousness, respiratory arrest, nausea, vomiting, chills, miosis, tinnitus; myocardial depression, bradycardia, cardiac arrhythmias, hypotension, cardiovascular collapse, cardiac arrest; palpitation, headache, tremors, tachycardia, anginal pain, hypertension (epinephrine-containing solutions)

            Anxiety

            Apprehension

            Restlessness

            Nervousness

            Disorientation

            Confusion

            Dizziness

            Blurred vision

            Tremors

            Twitching

            Shivering

            Seizures

            Edema

            Status asthmaticus

            Anaphylactoid reactions (sometimes fatal)

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            Warnings

            Contraindications

            Hypersensitivity to prilocaine, amide-type local anesthetics, sulfites, parabens

            Idiopathic or congenital methemoglobinemia

            Cautions

            Administration of >600 mg to adults causes non-acute 15% methemoglobinemia via formation of o-toluidine metabolite

            Use preservative-free preparations for spinal or epidural anesthesia

            DO NOT use solutions with epinephrine in distal areas of body (e.g. digit, nose, ear, etc)

            History of malignant hyperthermia

            Respiratory arrest reported with local anesthetics

            Seizures reported with systemic toxicity

            Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold

            Absorption

            Duration: the greater the degree of vasodilation produced by the local anesthetic, the faster the rate of absorption & shorter the duration of action (bupivacaine has a long duration of action)

            Distribution

            Protein bound: 55%

            Vd: 0.6-4.4 L/kg

            Onset: 2 min (infiltration); 3 min (inferior alveolar nerve block)

            Metabolism

            Metabolism: Liver and kidney

            Metabolites: Ester- & amide-type local anesthetics

            Elimination

            Excretion: Urine (principally)

            Half-life: 10-150 min

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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