Prilocaine

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Prilocaine /ˈpraɪl[invalid input: ‘ɵ’]keɪn/ is a local anesthetic of the amino amide type first prepared by Claes Tegner and Nils Löfgren. In its injectable form (trade name Citanest), it is often used in dentistry. It is also often combined with lidocaine as a preparation for dermal anesthesia (lidocaine/prilocaine or EMLA), for treatment of conditions like paresthesia. As it has low cardiac toxicity, it is commonly used for intravenous regional anaesthesia (IVRA).

In some patients, ortho-toluidine, a metabolite of prilocaine may cause methemoglobinemia, which may be treated with methylene blue.

Maximum dosage for dental use: 8.0 mg/kg (2.7 mg/lb), with a maximum dose of 500 mg.

It is given as a combination with the vasoconstrictor epinephrine under the trade name Citanest Forte.

Prilocaine can be synthesized from o-toluidine, 2-bromopropionyl bromide, and n-butylamine.^[1]

• United States Pharmacopeia 31 ^[2]

• Lidocaine/prilocaine