Equis ISSN 2398-2977

Prilocaine

Contributor(s): Adam Auckburally, Joanne Michou

Introduction

Name

  • Prilocaine hydrochloride.

Class of drug

  • Amino amide local anesthetic.

Description

Chemical name

  • (RS)-N-(2-methylphenyl)-N2-propylalaninamide.

Molecular formula

  • C13H20N2O.

Molecular weight

  • 220.311 g.

Physical properties

  • Injection - sterile, clear aqueous solution; contains methyl/propyl paraben preservatives.
  • EMLA cream - 2.5% prilocaine with 2.5% lidocaine   Lidocaine  ; white soft cream; contains polyoxyethylene hydrogenated castor oil.
  • A eutectic mixture is a mixture of components where the melting point is less than that of the individual components, allowing it to form a solid.

Storage requirements

  • Do not store >25°C.

Uses

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Indications

  • Infiltration anesthesia.
  • Nerve block.
  • Intra-articular block.
  • Topical anesthesia (EMLA) - minor dermatological procedures, eg needle insertion, jugular cannulation; genitalia anesthesia for episioplasty.
  • Listed within the Substances Essential for the Treatment of Equidae (Commission Regulation 1950/2006) and therefore can be administered to horses intended for human consumption within the EU (as EMLA cream).

Administration

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Pharmocokinetics

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Precautions

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Interactions

with other drugs

  • Drugs which predispose to the development of methemoglobinemia.
  • Toxic effects of local anesthetic drugs are additive, therefore caution should be exercised if administering more than one type.
  • Caution is advised if class III anti-arrhythmics are used concurrently (amiodarone).

with diagnostic tests

  • Methemoglobinemia interferes with pulse oximetry and falsely drives SpO2 towards 85%.

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references fromPubMed.
  • Erkert R S, MacAllister C G, Campbell Get al(2005)Comparison of topical lidocaine/prilocaine anesthetic cream and local infiltration of 2% lidocaine for episioplasty in mares.J Vet Pharmacol Therap28, 299-304PubMed.

Other sources of information

  • Heavner J E (1996)Local Anaesthetics.In:Lumb and Jones Veterinary Anaesthesia. 3rd edn. Eds: Thurnon J C, Tranquilli W J & Benson J G. Lippincott Williams & Wilkins, Baltimore. pp 30-36.
  • Schmitz D G (2004)Toxicologic Problems.In:Equine Internal Medicine. 2nd edn. Eds: Reed S M, Bayly W M & Sellon D C. Saunders Elsevier, Missouri, USA. pp 1441-1512.
  • Citanest®summary of product characteristics (SPC) - Website:www.medicines.org.uk/emc/medicine/163/SPC.
  • EMLA®summary of product characteristics (SPC) - Website:www.medicines.org.uk/EMC/medicine/171/SPC/EMLA+Cream+5.

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