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articaine, combinations

N01BB58

Forms & Strengths

Injectable solution: articaine HCl 4% with epinephrine 1:100,000 (1.7 mL or 1.8 mL cartridges)
Injectable solution: articaine HCl 4% with epinephrine 1:200,000 (1.7 mL or 1.8 mL cartridges)

Adult Dosing

Infiltration: 0.5 - 2.5 mL (20 - 100 mg)
Nerve block: 1.0 - 3.4 mL (40 - 136 mg)
Max recommended dose: 7 mg/kg (3.2 mg/lb); absolute max 500 mg

Pediatric Dosing

Children aged 4 to 16 years: Infiltration and/or nerve block
Max dose calculation: 7 mg/kg (3.2 mg/lb)
Safety and efficacy not established in children under 4 years of age

Indications

Local, infiltrative, and conductive anesthesia in routine dental procedures

Mechanism of Action

Amide-type local anesthetic containing a thiophene ring
Reversibly blocks sodium channels in nerve fibers, inhibiting propagation of nerve impulses

Contraindications

Hypersensitivity to amide-type local anesthetics
Patients with severe hepatic dysfunction (for amide metabolism)
Concomitant use of certain monoamine oxidase (MAO) inhibitors or tricyclic antidepressants due to epinephrine component
Patients with sulfite sensitivity (if preservative-containing formulations are used)

Adverse Reactions

Central nervous system effects (dizziness, nervousness, apprehension, euphoria, drowsiness, convulsions)
Cardiovascular effects (myocardial depression, hypotension, bradycardia, cardiac arrest)
Allergic reactions (urticaria, angioedema, bronchospasm, anaphylaxis)
Prolonged anesthesia or paresthesia of the tongue and lip

Drug Interactions

Vasopressors (epinephrine component may cause severe hypertension or cardiac arrhythmias when combined with MAOIs or tricyclic antidepressants)
Class I antiarrhythmic drugs (additive cardiodepressant effects)
Other local anesthetics (additive systemic toxicity)

Curated Content: Needs Vetting Before Put to Clinical Use