Chemical Properties
White Solid
Uses
Prilocaine is a local anesthetic of the amino amide type. Prilocaine is often used in dentistry. Prilocaine is also often combined with lidocaine as a preparation for dermal anesthesia (lidocaine/pril
ocaine or EMLA), for treatment of conditions like paresthesia.
Definition
ChEBI: The monohydrochloride salt of prilocaine.
Brand name
Citanest (AstraZeneca).
Biological Functions
Prilocaine hydrochloride (Citanest) is an amide
anesthetic whose onset of action is slightly longer than
that of lidocaine; its duration of action is comparable.
Prilocaine is 40% less toxic acutely than lidocaine, making
it especially suitable for regional anesthetic techniques.
It is metabolized by the liver to orthotoluidine,
which when it accumulates, can cause conversion of hemoglobin
(HB+++ to methemoglobin (HB+++. Oxygen
transport is impaired in the presence of methemoglobinemia.
Treatment involves the use of reducing agents,
such as methylene blue, given intravenously, to reconvert
methemoglobin to hemoglobin.
Side effects
Common adverse reactions include bradycardia, hypotension, urticaria, edema, anaphylactoid reactions, lightheadedness, nervousness, euphoria, confusion, dizziness, drowsiness, tinnitus. The safety and effectiveness of prilocaine depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies.
