Prilocaine + Felypressin


Concise Prescribing Info
Indications/Uses
Dental infiltration or dental nerve block.
Dosage/Direction for Use
Adult : Inj As soln containing prilocaine HCI 3% and felypressin 0.03 IU/mL: Usual: 1-5 mL. Max: 10 mL.
Dosage Details
Injection
Dental infiltration and dental nerve block
Adult: As combination containing prilocaine hydrochloride 30 mg and felypressin 0.03 IU/ml: Usual dose: 1-5 ml, adjust according to response. Max: 10 ml.
Child: As combination containing prilocaine hydrochloride 30 mg and felypressin 0.03 IU/ml: <10 yr: 1-2 ml; 10-18 yr: 1-5 ml, max 10ml. Adjust dose according to response.
Elderly: Dose adjustments may be needed.
Contraindications
Hypersensitivity to local anaesthetics of amide type. Anaemia, congenital or acquired methaemoglobinaemia. Infants.
Special Precautions
Elderly, debilitated patients, liver or kidney impairment, epilepsy, severe or uncontrolled hypertension, impaired cardiac conduction or respiratory function, severe heart disease. Pregnancy and lactation. Avoid IV inj.
Adverse Reactions
Rarely, nervousness, dizziness, blurred vision, tremors, drowsiness, convulsions, unconsciousness, hypotension, myocardial depression, bradycardia. Dose related methaemoglobinaemia.
Potentially Fatal: Rarely, respiratory or cardiac arrest.
Overdosage
Symptoms: Methaemoglobinaemia, convulsions, respiratory and cardiac arrest. Management: Treatment is symptomatic and supportive. Convulsions may be treated by IV inj of thiopentone 100-200 mg or diazepam 5-10 mg. Methaemoglobinaemia may be treated by IV inj of 1% solution of methylene blue over a 5 minute period, at a dose of 1 mg/kg.
Drug Interactions
Increased risk of methaemoglobinaemia with sulfonamides. Additive toxic effects with other local anaesthetics, anti-arrhythmics or drugs structurally related to amide type anaesthetics.
Action
Description: Prilocaine, an amide-type local anaesthetic, acts by preventing impulse transmission along nerve fibres and nerve endings. Compared to lidocaine, it is less toxic with a slower onset of action and slightly longer duration of action. Felypressin, a synthetic analogue of vasopressin, is sometimes used in combination with prilocaine as a vasoconstrictor to reduce absorption and localise the effect of prilocaine.
Onset: 2-3 minutes (infiltration block)
Duration: 45 minutes (infiltration block), ≥2 hr (regional block e.g. mandibular block)
Pharmacokinetics:
Distribution: Prilocaine: Protein binding 55%, crosses placenta and distributes into breast milk.
Metabolism: Prilocaine: Rapidly metabolised in liver and kidneys by amidases. Elimination half life: 1.5 hr (after IV inj).
Excretion: Prilocaine: Excreted in urine mainly as metabolites e.g. o-toluidine.
Storage
Store below 25°C.
Disclaimer: This information is independently developed by MIMS based on Prilocaine + Felypressin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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