Prilocaine (Injection)

Prilocaine (Injection) is used to make the mouth numb before a dental procedure.

This medicine must be given by or under the direct supervision of your dentist.

It is very important for your doctor to monitor your or your child's progress closely while using this medicine to ensure it is effective. Blood tests may be necessary to check for any side effects.

This medicine may cause a rare but serious blood issue called methemoglobinemia. The risk may be higher in children younger than 6 months, elderly patients, or patients with certain genetic conditions. It is more likely to happen if too much of the medicine is given, but it can also occur with small amounts. Contact your doctor immediately if you or your child experiences any of the following symptoms after receiving this medicine: pale, gray, or blue skin, lips, or nails; confusion; headache; lightheadedness; fast heartbeat; or unusual tiredness or weakness.

Inform your doctor or nurse right away if you have any of the following symptoms while using this medicine: anxiety; blurred vision; depression; drowsiness; lightheadedness; nausea or vomiting; numbness and tingling in the mouth or lips; restlessness; ringing in the ears; speech difficulties; or tremors.

This medicine can cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical help. Call your doctor right away if you experience a rash, itching, hoarseness, difficulty breathing, trouble swallowing, or swelling of your hands, face, mouth, or throat after using this medicine.

This medicine may also raise your risk of serious heart and blood vessel issues such as a heart attack, changes in heart rhythm, or low blood pressure. Contact your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, pounding heartbeat, difficulty breathing, or unusual tiredness or weakness.

Before undergoing any medical tests, inform the doctor in charge that you are using this medicine. The results of some tests may be influenced by this medicine.

Do not take any other medicines unless you have discussed them with your doctor. This includes prescription, over-the-counter (OTC) medicines, and herbal or vitamin supplements.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, inform your health care professional about any other types of allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Due to this medicine's toxicity, it should be used very carefully in children. Recommended doses should not be exceeded, and the patient should be closely monitored during treatment.

Geriatric

There is no information available on how age affects the use of prilocaine injection in older patients. However, because of this medicine's toxicity, it should be used with caution. Recommended doses should not be exceeded, and the patient should be closely monitored during treatment.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication while breastfeeding. Weigh the potential benefits against the potential risks before taking this medication during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. In these situations, your doctor may want to adjust the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Bupivacaine
• Bupivacaine Liposome
• Disopyramide
• Encainide
• Flecainide
• Hyaluronidase
• Mexiletine
• Moricizine
• Procainamide
• Propafenone
• Propranolol
• Quinidine
• St John's Wort
• Tocainide

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Nitric Oxide

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at or around the time of eating food or certain types of food, as interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to tell your doctor if you have any other medical issues, especially:

• Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
• Heart problems or
• Lung or breathing problems—Use with caution. May increase the risk of methemoglobinemia.

• Kidney disease or
• Severe liver disease—Use with caution. The effects may be stronger because the medicine is removed from the body more slowly.

• Hereditary or idiopathic (unknown cause) methemoglobinemia (blood disorder)—Should not be used in patients with this condition.

Along with its necessary effects, this medicine may cause some unwanted effects. Not everyone will experience these side effects, but if they do happen, they may require medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

Incidence not known

• Blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles," or tingling feelings in the lips or mouth
• chest pain or discomfort
• cold, clammy, pale skin
• confusion
• continuing ringing or buzzing or other unexplained noise in the ears
• cough
• difficulty swallowing
• discouragement
• dizziness, faintness, or lightheadedness when standing up quickly from lying down or sitting
• drowsiness
• excitement
• false or unusual sense of well-being
• fast or irregular heartbeat
• feeling sad or empty
• general feeling of illness
• hearing loss
• hives, itching, skin rash
• irritability
• lack of appetite
• loss of consciousness
• loss of interest or pleasure
• nausea
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• restlessness
• seizures
• severe headache
• shivering
• slow heart rate
• slowing of labor
• stiff neck or back
• sweating
• tightness in the chest
• trouble concentrating
• trouble sleeping
• unusual tiredness or weakness
• vomiting
• weakness of the muscles in your face

Some side effects may occur that usually do not require medical attention. These side effects may go away as your body adjusts to the medicine. Your health care professional may also have ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects persist or are bothersome, or if you have any questions about them:

Incidence not known

• Feeling of heat
• numbness

Other side effects not listed may also happen in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Citanest Plain Dental

Available Dosage Forms:

• Solution

Therapeutic Class: Anesthetic, Local

Chemical Class: Amino Amide

Your dentist or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into the head and neck area or injected directly into your gums.

This medicine should cause numbness only to the area where it is injected. You may experience temporary loss of sensation or movement in the injected area. This type of numbing procedure is called local anesthesia. It is not meant to cause you to fall asleep or become unconscious.

Your mouth may be numb for several hours. To avoid injury after dental work, do not chew solid foods until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking the treated area.