What Is Prilocaine Hydrochloride and How Does It Work?
Prilocaine hydrochloride is an amino amide anesthetic similar to, and often combined with,Lidocaine. The drug stabilizes the neuronal membrane by preferentially binding to sodium channels, thereby preventing sodium from entering the cell. Without the influx of sodium ions. the initiation and conduction of signals is blocked.1 Prilocaine hydrochloride can be given by injection for use as a local anesthetic in dentistry, either through infiltration techniques (that is, delivered directly into the area of terminal nerve endings) or by nerve block. Prilocaine hydrochloride can also be applied topically as a local anesthetic to deaden nerve endings in the skin, possible in preparation for surgery or other procedures in the area.
Injection: Prilocaine hydrochloride can be given via injection parenterally for use as a local anesthetic during dental surgery. The drug can be delivered through infiltration techniques (for minor surgeries) or by nerve block (for major surgeries and pain management).2
Topical: Prilocaine hydrochloride is often given alongside Lidocaine in a cream or film form to deaden the skin for minor procedures such as blood draws or wart removal.3
Side Effects and Drug Interactions
Side effects in patients taking prilocaine hydrochloride depend on delivery type. In the case of injections, common side effects include4:
Numbness or tingling of the face or mouth
Pain or irritation at the injection site
Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience anxiety, difficulty breathing, dizziness or drowsiness, nausea or vomiting, seizures, skin hives or itching, palpitations, tremors, or swelling of the face or mouth should contact their physician right away.
Patients who are allergic to prilocaine hydrochloride should not take this drug. Patients taking blood thinners, monoamine oxidase inhibitors (MAOIs), blood pressure medications, medicines that improve muscle strength or tone (such as for myasthenia gravis), or mecamylamine should inform their physician before starting this medication. Patients who have or who have had blood clotting problems, heart or blood vessel disease, or other local anesthetics should also inform their physician before taking this drug. This drug may not be indicated for pregnant or breastfeeding patients.
In the case of topical delivery, common side effects include5:
Mild burning, swelling, itching, or rash at application site
White or red skin at application site
Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience a severe allergic reaction (hives, difficulty breathing, swelling of the face, lips, tongue, or throat) should call for emergency help right away. Patients who experience severe burning or stinging at application site, swelling, sudden dizziness or drowsiness, bruising, or warming should inform their physician immediately.
Patients who are allergic to prilocaine hydrochloride or lidocaine should not take this drug. This drug should be used with caution in patients receiving Class I antiarrhythmic drugs since the toxic effects are additive and/or synergistic, and in patients receiving drugs that cause the formation of methemoglobin.6
Latest News and Research
Prilocaine hydrochloride is currently being investigated for use in a variety of other conditions. For example, there is a need for spinal anesthesia for ambulatory surgery. One particular study evaluated the use of hyperbaric Prilocaine Hydrochloride in cases where lidocaine was not a good fit. The results showed that Prilocaine Hydrochloride is a good fit as an anesthetic in perianal outpatient surgery.7
The topical use of a prilocaine/lidocaine cream has also shown to be effective as a treatment for premature ejaculation.8 The drug combination showed good response in terms of ejaculatory control, sexual satisfaction and distress, with little or no evidence of systemic side effects or desensitization of the genitalia in subjects and their partners.