Prilocaine

Prilocaine is an active ingredient used in anesthesia for local anesthesia. It belongs to the group of local anesthetics of the amide type. Prilocaine is a white crystalline powder and is only slightly soluble in water. It is available as a cream, plaster and solution for injection. In solution it is available as prilocaine hydrochloride. It has a similar effect to lidocaine and is very popular in dentistry. It acts very quickly and the effect lasts between 3 and 6 hours.

Prilocaine works by binding to the intracellular sodium channels. There it blocks the sodium influx into the cell by changing the permeability of the cell membrane and subsequently the action potential and thus the transmission of stimuli. Due to the lack of action potential and the lack of stimulus transmission, there is no pain sensation in the affected area. The effect is reversible and is terminated as soon as the concentration of the active substance is too low to block the receptor. Prilocaine is broken down both in the liver and in the kidneys. It is excreted via the kidneys.

Always take Prilocaine exactly as described in the package leaflet or as advised by your doctor.

The usual recommended dose is 40-60 mg. These are only injected into the spinal canal by a healthcare professional.

The maximum dose is 80 mg .

When used as a patch, Prilocaine is applied to the desired area.

When used as a cream, Prilocaine is applied to the desired area. Prilocaine cream or plaster should not be applied to the following skin areas:

• Cuts
• skin abrasions or wounds (excluding leg ulcers)
• on areas with rashes or eczema
• on or near the eyes
• in the mouth
• in the anal region - only with Prilocaine creams
• on the genitals of children - only with Prilocaine creams
• on the ear or in the nose - only with Prilocaine creams

The cream and the plaster are also only used by healthcare professionals.

The following side effects may occur:

Very common:

• Low blood pressure
• Nausea

Frequent:

• Paresthesia (symptoms of paralysis)
• Dizziness
• vomiting

Occasional:

• Seizures
• Circumoral paresthesia
• Loss of consciousness
• tremor
• Numbness of the tongue
• speech disorders
• hearing disorders
• tinnitus
• Visual disturbances
• back pain
• temporary muscle weakness
• slowed heartbeat
• Increased blood pressure

Rarely:

• methemoglobinemia
• cyanosis
• anaphylactic shock
• allergic reactions
• itching
• arachnoiditis
• neuropathy
• peripheral nerve lesions
• diplopia
• cardiac arrest
• irregular heartbeat
• respiratory depression
• high or total spinal block with impairment of the cardiovascular and respiratory systems

Interactions may occur if the following medicines are taken at the same time:

• Medication for the treatment of cardiac arrhythmia
• Medication for pain relief

Prilocaine must NOT be taken in the following cases:

• in case of allergy to prilocaine
• in case of severe conduction disorders of the heart
• anemia
• in decompensated heart failure (severe heart failure)
• in cardiogenic or hypovolemic shock
• in congenital or acquired methemoglobinemia

Prilocaine solution for injection must NOT be used in children under 6 months of age.

Prilocaine solution for injection is NOT recommended for children under 18 years of age.

Prilocaine as a cream or patch is approved for all ages.

Prilocaine can be used during pregnancy with the approval of your doctor . However, there are no systematic studies on prilocaine in pregnancy. There is no evidence of an increased risk of malformation.

Prilocaine should NOT be usedduring childbirth as there are several case reports of methemoglobinemia in newborns where Prilocaine was used during delivery.

Better alternatives are: Bupivacaine, ropivacaine, lidocaine or articaine.

Prilocaine should NOT be used during breastfeeding due to a lack of clinical reports. However, if it has been used, breastfeeding can be continued after a 24-hour break.