Prilocaine

Prilocaine (/ˈpraɪləˌkeɪn/[1]) 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 topical 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).

Prilocaine

Clinical data
AHFS/Drugs.com	Monograph
MedlinePlus	a603026
License data	EU EMA: by INN
Pregnancy category	B (U.S.)
ATC code	N01BB04 (WHO)
Pharmacokinetic data
Protein binding	55%
Metabolism	Hepatic and renal
Elimination half-life	10-150 minutes, longer with impaired hepatic or renal function
Identifiers
IUPAC name (RS)-N-(2-methylphenyl)-N^2-propylalaninamide
CAS Number	721-50-6^Y
PubChem CID	4906
IUPHAR/BPS	7276
DrugBank	DB00750^Y
ChemSpider	4737^Y
UNII	046O35D44R
KEGG	D00553^Y
ChEBI	CHEBI:8404^Y
ChEMBL	ChEMBL1194^Y
CompTox Dashboard (EPA)	DTXSID7031955
ECHA InfoCard	100.010.871
Chemical and physical data
Formula	C13H20N2O
Molar mass	220.316 g·mol^−1
3D model (JSmol)	Interactive image
Chirality	Racemic mixture
Melting point	37 to 38 °C (99 to 100 °F)
SMILES O=C(Nc1ccccc1C)C(NCCC)C
InChI InChI=1S/C13H20N2O/c1-4-9-14-11(3)13(16)15-12-8-6-5-7-10(12)2/h5-8,11,14H,4,9H2,1-3H3,(H,15,16)^Y Key:MVFGUOIZUNYYSO-UHFFFAOYSA-N^Y
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Contraindications

In some patients, ortho-toluidine, a metabolite of prilocaine, may cause methemoglobinemia, which may be treated with methylene blue. Prilocaine may also be contraindicated in people with sickle cell anemia, anemia, or symptomatic hypoxia.[2]

Combinations

It is given as a combination with the vasoconstrictor epinephrine under the trade name Citanest Forte. It is used as an eutectic mixture with lidocaine, 50% w/w, as lidocaine/prilocaine. The mixture is an oil with a melting point of 18 °C (64 °F). A 5% emulsion preparation, containing 2.5% each of lidocaine/prilocaine, is marketed by APP Pharmaceuticals under the trade name EMLA (an abbreviation for eutectic mixture of local anesthetics).[3]

Compendial status

• United States Pharmacopeia 31 [4]

Notes

1. "Prilocaine". Merriam-Webster Dictionary. Retrieved 2016-01-21.
2. Patel, Vinod; Morrissey, John (2011-09-15). Practical and Professional Clinical Skills. Oxford University Press. p. 267. ISBN 9780199585618.
3. "Topical Anesthesia Use in Children: Eutectic Mixture of Local Anesthetics". Medscape.com. Retrieved 2014-01-07.
4. The United States Pharmacopeial Convention, Revision Bulletin: Lidocaine and Prilocaine Cream–Revision to Related Compounds Test, archived from the original on 5 July 2010, retrieved 10 July 2009

See also

• Lidocaine/prilocaine