Adult Dosing
Anesthesia in simple and complex dental procedures
Infiltration
- 20-100 mg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: 1 hr
Nerve block
- 20-136 mg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: 2 hr
Oral surgery
- 40-204 mg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: Not defined
Notes:- Dosing is based on articaine component and varies based on age, weight, and procedure type
- For most routine dental procedures, product containing epinephrine 1:200000 is preferred
Pediatric Dosing
Anesthesia in simple and complex dental procedures
Infiltration
- Children >4 yrs: 0.37-7 mg/kg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: 1 hr
Nerve block
- Children >4 yrs: 0.37-7 mg/kg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: 2 hr
Oral surgery
- Children >4 yrs: 0.37-7 mg/kg submucosal inj x1
- Max: 7 mg/kg/dose
- Onset of anesthesia: 1-9 min; duration: Not defined
Notes:- Safety and effectiveness in pediatric patients <4 years of age have not been established
- Dosages in pediatric patients should be reduced depending on age, body weight, and physical condition
- For most routine dental procedures, product containing epinephrine 1:200000 is preferred
See Supplemental Patient Information
- Resuscitative equipment, oxygen, and other resuscitative drugs should be available for immediate use because accidental intravascular injection may be associated with convulsions followed by CNS or cardiorespiratory depression and coma, progressing to respiratory arrest
- Aspiration should be performed before administering articaine/epinephrine to avoid intravascular injection
- Small doses of local anesthetics injected in dental blocks may produce adverse reactions similar to systemic toxicity observed with unintentional intravascular injections of larger doses; patients receiving these blocks should be monitored constantly
- Therapy may cause systemic toxicity including effects on the central nervous and cardiovascular systems. Use reduced doses in debilitated, elderly, acutely ill, and pediatric patients
- Therapy may be associated with vasoconstrictor toxicity. Local anesthetic solutions that contain a vasoconstrictor should be used cautiously, especially in patients with impaired cardiovascular function or peripheral vascular disease. The minimum possible amount of vasoconstrictor should be used
- Therapy when used in conjunction with methemoglobin-inducing agents, may cause methemoglobinemia
- Therapy may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible individuals
Cautions: Use cautiously in
- Severe hepatic impairment
- Impaired cardiac function
- Heart block
- Sulfite-sensitive asthma
- Hypertensive vascular disease
- Potent general anesthetic use
Supplemental Patient Information
- Inform patients in advance of the possibility of temporary loss of sensation and muscle function following infiltration and nerve block injections
- Advise patients not to drink or eat until normal sensation returns
Pregnancy Category:C
Breastfeeding: No data available regarding the use of articaine during breastfeeding. A single dose of articaine injected during breastfeeding is unlikely to adversely affect the breastfed infant. However, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. No data available regarding the use of epinephrine during breastfeeding. It is unlikely to affect the nursing infant owing to its poor oral bioavailability and short half-life; however, high IV doses may reduce milk production or milk letdown. This information is based on LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5 July 2011). Manufacturer advises caution.
US Trade Name(s)
US Availability
articaine/epinephrine (generic)
Orabloc (articaine/epinephrine)
- INJ: 4%/1:100000
- INJ: 4%/1:200000
Septocaine (articaine/epinephrine)
- INJ: 4%/1:100000
- INJ: 4%/1:200000
Canadian Trade Name(s)
- Astracaine Dental with Epinephrine
- Astracaine Dental with Epinephrine Forte
- Karticaine
- Karticaine Forte
- Septanest N
- Septanest SP
- Ultracaine D-S
- Ultracaine D-S Forte
- Zorcaine
Canadian Availability
Astracaine Dental with Epinephrine (articaine/epinephrine)
Astracaine Dental with Epinephrine Forte (articaine/epinephrine)
Karticaine (articaine/epinephrine)
Karticaine Forte (articaine/epinephrine)
Septanest N, Ultracaine D-S (articaine/epinephrine)
Septanest SP, Ultracaine D-S Forte, Zorcaine (articaine/epinephrine)
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
- Bucanest
- Deltazine
- Septanest
Australian Availability
Bucanest, Deltazine, Septanest (articaine/epinephrine)