Indications
Articaine Hydrochloride is a local anaesthetic used mainly in dentistry. It is usually combined with a small amount of Epinephrine (adrenaline) in dental cartridges. It numbs the teeth, gums and surrounding tissues for procedures such as fillings, root canal treatment, tooth extraction, scaling and minor oral surgery.
How It Works
Articaine blocks sodium channels in nerve fibres, which stops pain signals from travelling along the nerves to the brain. The area becomes numb within a few minutes. Epinephrine narrows the small blood vessels at the injection site, which keeps the anaesthetic in place longer, deepens the numbness and reduces bleeding. Articaine spreads well through bone, which helps it work in the jaw.
Dosage and Administration
It is given only by a dentist or doctor as an injection into the gum or near a nerve in the mouth. The amount depends on the procedure, the area to be numbed and the patient’s weight and health, and stays within maximum safe limits. Numbness usually lasts 1 to 3 hours for soft tissues. Do not eat, chew or drink hot drinks until feeling returns, to avoid biting or burning the lips, cheek or tongue. It is not recommended in children under 4 years.
Interactions
Tell your dentist about all medicines you take. The Epinephrine content can interact with non-selective beta blockers such as Propranolol (risk of high blood pressure), tricyclic antidepressants such as Amitriptyline, MAO inhibitors, some anaesthetic gases, and Digoxin. Other local anaesthetics add to its effects. Blood thinners increase the risk of bleeding or bruising at the injection site.
Contraindications
- Allergy to Articaine or other amide local anaesthetics, or to sulphites (preservative for Epinephrine).
- Severe heart rhythm or conduction problems without a pacemaker.
- Uncontrolled high blood pressure, recent heart attack, unstable angina or uncontrolled overactive thyroid (for products with Epinephrine).
- Injection into an inflamed or infected area.
- Children under 4 years.
Side Effects
Common effects include pain or swelling at the injection site, headache, tingling or prolonged numbness, and a fast heartbeat or anxiety from the Epinephrine. Rarely, numbness or altered sensation of the lip or tongue may last for weeks or longer (nerve injury), and allergic reactions can occur.
Get urgent medical help if you notice dizziness or fainting, ringing in the ears, metallic taste, blurred vision, twitching or seizures, chest pain, a very fast or irregular heartbeat, difficulty breathing, or swelling of the face or throat, or if numbness has not worn off after a day.
Pregnancy and Lactation
Dental treatment with local anaesthetic can be carried out in pregnancy when needed, ideally in the middle trimester; tell your dentist you are pregnant. Only small amounts pass into breast milk; mothers are usually advised to discard milk for a few hours after a large dose, or follow the dentist’s advice.
Precautions and Warnings
Tell your dentist about heart disease, high blood pressure, diabetes, epilepsy, liver or kidney disease, asthma, allergies, bleeding disorders or methaemoglobinaemia. The dentist will draw back on the syringe to avoid injecting into a blood vessel. Do not drive until you feel fully normal if you feel unwell after treatment.
Overdose
Too much or an injection into a blood vessel can cause restlessness, numb tongue, dizziness, tremor, seizures, slow or irregular heartbeat, low blood pressure and breathing problems. The dental team will stop the injection and give emergency treatment.
Therapeutic Class
Local anaesthetic (amide type), usually combined with a vasoconstrictor.
Storage
Clinic medicine: store as directed on the pack, usually below 25°C, protected from light; do not freeze. Do not use if the solution is cloudy or discoloured. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.