articaine/epinephrine (Rx)

Brand and Other Names:Septocaine, Zorcaine with Epinephrine, more...Orabloc
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

articaine/epinephrine

injectable solution

  • 4% (40mg/mL)/1:100,000 (0.01mg/mL)
  • 4% (40 mg/mL)/1:200,000 (0.005mg/mL)
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Local, Infiltrative, or Conductive Anesthesia in Dental Procedures

Infiltration: 0.5-2.5 mL injection of 4% solution; 20-100 mg total dose

Nerve block: 0.5-3.4 mL injection of 4% solution; 20-136 mg total dose

Oral surgery: 1-5.1 mL injection of 4% solution; 40-204 mg total dose

Not to exceed 7 mg/kg (0.175 mL/kg) 

Dosage Forms & Strengths

articaine/epinephrine

injectable solution

  • 4%(40mg/mL)/1:100,000(0.01mg/mL)
  • 4%(40 mg/mL)/1:200,000(0.005mg/mL)
more...

Local, Infiltrative, or Conductive Anesthesia in Dental Procedures

<4 years: Safey and efficacy not established

4-16 years: Use lower end of dose range; 0.76-5.65 mg/kg used safely in simple procedures; 0.37-7.48 mg/kg used safely in complex procedures

Not to exceed 7 mg/kg (0.175 mL/kg) 

Storage

Storage: room temperature, protect from light, do not freeze

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Interactions

Interaction Checker

and articaine/epinephrine

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Facial edema

            Headache

            Pain

            Paresthesia

            Sleepiness

            Gingivitis

            Nausea

            Vomiting

            Infection

            Frequency Not Defined

            Systemic absorption of significant concentrations of local anesthetic can produce myocardial depression, cardiac conduction changes, CNS excitation, convulsions, and cardiorespiratory arrest, facial paralysis, hemorrhage, hyperesthesia, methemoglobinemia

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            Warnings

            Contraindications

            Hyperensitivity to amide-type local anesthetics, sulfites

            Cautions

            Vasoconstrictor epinephrine, will promote local hemostasis, decrease systemic absorption, increase duration of action

            Local anesthetics may produce cardiovascular effects when absorbed

            Risk of methemoglobinemia and sudden respiratory arrest

            CNS toxicity may occur; monitor state of consciousness, drowsiness, restlessness, anxiety, tinnitus, tremors, blurred vision following local injections of the anesthetic

            Avoid IV use

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            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

            Pharmacokinetics

            Half-Life: 44 min

            Peak Plasma Time: 25-48 min

            Protein Bound: 60-80%

            Metabolism: primarily through plasma carboxyesterase to inactive articainic acid

            Excretion: urine (2% unchanged)

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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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