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articaine

N01BB08

Forms & Strengths

Injectable solution: 4% articaine hydrochloride with epinephrine 1:100,000 (1.8 mL cartridge)
Injectable solution: 4% articaine hydrochloride with epinephrine 1:200,000 (1.8 mL cartridge)

Adult Dosing

Infiltration: 0.5 to 3.4 mL (20 to 136 mg)
Nerve block: 0.5 to 3.4 mL (20 to 136 mg)
Max recommended dose: 7 mg/kg (3.2 mg/lb), not to exceed 500 mg (12.5 mL of 4% solution)

Pediatric Dosing

Pediatric patients 4 to 16 years: Infiltration and nerve block
Max recommended dose for children >4 years: 7 mg/kg (3.2 mg/lb)

Indications

Local, infiltrative, or conductive anesthesia for dental procedures

Mechanism of Action

Amide local anesthetic; blocks sodium ion channels in neuronal membranes, preventing the generation and conduction of nerve impulses

Contraindications

Known hypersensitivity to local anesthetics of the amide type
Patients with severe hepatic dysfunction
Concomitant use with monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants due to severe hypertension risk

Adverse Reactions

Central nervous system: Nervousness, dizziness, blurred vision, tremors, convulsions, drowsiness
Cardiovascular: Hypotension, myocardial depression, bradycardia, cardiac arrest
Local: Injection site pain, edema, prolonged anesthesia, paresthesia

Drug Interactions

MAOIs and tricyclic antidepressants: Potentiate pressor effects of epinephrine, risking severe hypertension
Phenothiazines and butyrophenones: May reduce or reverse the pressor effect of epinephrine
Class III antiarrhythmic drugs (e.g., amiodarone): Cardiac effects may be additive

Curated Content: Needs Vetting Before Put to Clinical Use