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Amide LA + vasopressin analogue

Prilocaine with felypressin

Brand names: Citanest with Octapressin

Adult dose

Dose: Max 8 mg/kg prilocaine; total max 400mg
Route: Infiltration
Frequency: single

Clinical pearls

  • Dental anaesthesia where adrenaline contraindicated
  • Felypressin = synthetic vasopressin (Octapressin)

Contraindications

  • Hypersensitivity
  • Methaemoglobinaemia
  • Severe heart block
  • Pregnancy (vasopressin caution)

Side effects

  • Methaemoglobinaemia
  • Vasoconstrictor effects (less than adrenaline)
  • CNS toxicity

Interactions

  • Sympathomimetics

Reference: BNF; https://bnf.nice.org.uk/drugs/prilocaine-with-felypressin/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.