Prilocaine

Indications
 Injection
Dental infiltration and dental nerve block
Adult: 40-80 mg (1-2 ml) as a 4% solution without felypressin or 30-150 mg (1-5 ml) as a 3% solution with felypressin 0.03 IU/ml. Max: 400 mg if used alone and 300 mg if used with felypressin.
Child: <10 yr: 40 mg (1 ml) as a 4% soln without felypressin or 30-60 mg (1-2 ml) as a 3% soln with felypressin 0.03 units/ml.
Topical/Cutaneous
Local anaesthesia
Adult: Eutectic mixture of prilocaine base 2.5% and lignocaine base 2.5% applied as a cream under occlusive dressing (except for removal of genital warts).

Special Populations: Reduction in dosage may be necessary for elderly or debilitated patients, esp those with compromised CV and/or hepatic function.
Contraindications
 Hypersensitivity, hypovolaemia, complete heart block, congenital or idiopathic methemoglobinaemia, paracervical block in obstetrics, porphyria, pregnancy, anaemia and hypoxia.
Warnings / Precautions
 Lactation. Rate of Inj shoud not be too rapid. Avoid inadvertent intravascular injection. Avoid prolonged use. Elderly; child; debilitated; epilepsy; impaired resp function or cardiac conduction; shock; hepatic impairment; epidural or spinal block should not be employed to patients with cerebrospinal diseases; cardiogenic or hypovolemic shock; altered coagulation status, pyogenic infection of the skin at or near the Inj site. Do not inject into or apply to inflamed or infected tissues or damaged skin or mucosa. Do not instill into the middle ear.
Adverse Reactions
 Methemoglobinaemia; cyanosis; restlessness; excitement; nervousness; paraesthesias; dizziness; tinnitus; blurred vision; nausea; vomiting; muscle twitching; tremors; convulsions; hypotension; bradycardia; arrhythmias; cardiac arrest.
Drug Interactions
 Sulfonamides, antimalarials, certain nitric compounds may potentiate methemoglobinemia. Additive toxic effects with agents structurally related to local anaesthetics. Increased risk of myocardial depression when used with antiarrhythmics.
See Below for More prilocaine Drug Interactions
Mechanism of Actions
 Prilocaine is a local anaesthetic of the amide group. It has similar anesth potency to lignocaine but it has slower onset of action, less vasodilator activity and a slightly longer duration of action; it is also less toxic.
Onset: Dental anaesthesia: 2 min. Inferior alveolar nerve block: 3 min.
Duration: Dental anaesthesia: 10-15 min (pulp analgesia); 1-2 hr (soft tissue anaesthesia). Inferior alveolar nerve block: 2.5 hr (soft tissue anaesthesia).
ATC Classification
 N01BB04 - prilocaine ; Belongs to the class of amides. Used as local anesthetics.
Available As
  • Prilocaine 2.5%
  • Prilocaine 2.5% w/w
  • Prilocaine 25 mg

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