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Prilocaine/epinephrine (By injection)

Epinephrine Bitartrate (ep-i-NEF-rin bye-TAR-trate), Prilocaine Hydrochloride (PRIL-oh-kane hye-droe-KLOR-ide)

Numbs your mouth before a dental procedure.

Brand Name(s):

Citanest Forte Dental

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. You should not receive it if you had an allergic reaction to prilocaine or similar medicines.

How to Use This Medicine:


  • Your dentist or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into the head and neck area or injected directly into your gums.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Some medicines can affect how prilocaine/epinephrine works. Tell your dentist if you are using any of the following:
    • Acetaminophen, chloroquine, metoclopramide, primaquine, quinine, sulfasalazine
    • Blood pressure medicine
    • Cancer medicine (including cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase)
    • Ergot medicine
    • Medicine to treat an infection (including dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamide)
    • Medicine to treat depression
    • Medicine to treat seizures (including phenobarbital, phenytoin, sodium valproate)
    • Nitrate or nitrite medicine (including nitric oxide, nitroglycerin, nitroprusside, nitrous oxide)
    • Phenothiazine medicine (including chlorpromazine, perphenazine, prochlorperazine, promethazine, thioridazine)

Warnings While Using This Medicine:

  • Tell your dentist if you are pregnant or breastfeeding, or if you have liver disease, kidney disease, asthma, heart disease, heart block, blood vessel disease, high blood pressure, lung or breathing problems, a blood disorder, or G6PD deficiency. Tell your dentist if you have a sulfite allergy.
  • This medicine may cause methemoglobinemia (blood disorder).
  • Your mouth may be numb for several hours. To avoid injury after dental work, do not chew solid foods until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking the treated area.
  • You may also experience temporary loss of sensation and movement where the medicine was injected.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Dizziness, lightheadedness, fainting
  • Fast, slow, or uneven heartbeat, trouble breathing
  • Pale, gray, or blue lips, nails, or skin, dark urine, headache, unusual tiredness or weakness
  • Seizures or tremors
  • Shaking, chills, unexplained sweating
  • Tired feeling, confusion, restlessness, nervousness

If you notice these less serious side effects, talk with your doctor:

  • Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 5/1/2020

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