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Articaine and epinephrine (Injection)

Generic Name: articaine/epinephrine (Articaine Hydrochloride, ep-i-NEF-rin)

Medically reviewed by Drugs.com. Last updated on May 5, 2020.

Commonly used brand name(s)

In the U.S.

  • Articadent Dental with Ephinephrine
  • Ultacan
  • Ultacan Forte

Available Dosage Forms:

  • Solution

Therapeutic Class: Anesthetic, Amino Amide Combination

Pharmacologic Class: Sympathomimetic

Chemical Class: Articaine

Uses for articaine and epinephrine

Articaine and epinephrine combination injection is used to numb the mouth before a dental procedure.

Articaine and epinephrine is to be given by or under the direct supervision of your dentist.

Before using articaine and epinephrine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For articaine and epinephrine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to articaine and epinephrine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of articaine and epinephrine combination injection in children younger than 4 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of articaine and epinephrine combination injection in the elderly. However, elderly patients are more sensitive to the effects of articaine and epinephrine than younger adults.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving articaine and epinephrine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using articaine and epinephrine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Dihydroergotamine
  • Isocarboxazid
  • Linezolid
  • Phenelzine
  • Tranylcypromine

Using articaine and epinephrine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Benperidol
  • Bromperidol
  • Bucindolol
  • Bupivacaine
  • Carteolol
  • Carvedilol
  • Clomipramine
  • Desipramine
  • Dibenzepin
  • Digoxin
  • Dilevalol
  • Dixyrazine
  • Doxepin
  • Droperidol
  • Entacapone
  • Ergonovine
  • Fexofenadine
  • Fluphenazine
  • Furazolidone
  • Haloperidol
  • Halothane
  • Imipramine
  • Iobenguane I 123
  • Iproniazid
  • Levalbuterol
  • Levobunolol
  • Lofepramine
  • Loxapine
  • Melitracen
  • Melperone
  • Methdilazine
  • Methotrimeprazine
  • Methylene Blue
  • Methylergonovine
  • Metipranolol
  • Metopimazine
  • Nadolol
  • Nialamide
  • Nortriptyline
  • Opicapone
  • Opipramol
  • Oxprenolol
  • Penbutolol
  • Perazine
  • Periciazine
  • Perphenazine
  • Pindolol
  • Pipamperone
  • Pipotiazine
  • Practolol
  • Procarbazine
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propiomazine
  • Propranolol
  • Protriptyline
  • Rasagiline
  • Selegiline
  • Sotalol
  • Terfenadine
  • Tertatolol
  • Thiethylperazine
  • Thioproperazine
  • Thioridazine
  • Tianeptine
  • Timolol
  • Trifluoperazine
  • Triflupromazine
  • Trimipramine

Using articaine and epinephrine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Labetalol

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of articaine and epinephrine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or
  • Blood vessel disease or
  • Heart disease or
  • Heart rhythm problems (eg, heart block)—Use with caution. May increase risk for more side effects.
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
  • Heart problems or
  • Lung or breathing problems—Use with caution. May increase risk of having methemoglobinemia.
  • Kidney disease or
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Methemoglobinemia (blood disorder), hereditary or idiopathic (unknown cause) or
  • Sulfite allergy—Should not be used in patients with these conditions.

Proper use of articaine and epinephrine

Your dentist or other trained health professional will give you articaine and epinephrine in a medical facility. It is given through a needle placed into your gum, usually near the underside of your tongue. Before you receive the injection, a numbing gel may be rubbed onto the gum to make the injection more comfortable.

Articaine and epinephrine should cause numbness only to the area where it is injected. You may experience temporary loss of sensation or movement in the injected area. This type of numbing procedure is called local anesthesia. It is not meant to cause you to fall asleep or become unconscious.

Your mouth may be numb for several hours. To avoid injury after dental work, do not eat or drink until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking the treated area.

Precautions while using articaine and epinephrine

It is very important that your dentist check your or your child's progress closely while receiving articaine and epinephrine to see if it is working properly. Blood tests may be needed to check for any unwanted effects.

Articaine and epinephrine may increase your risk of having serious heart and blood vessel problems such as a heart attack, heart rhythm changes, or low blood pressure. Check with your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, pounding, slow heartbeat, troubled breathing, or unusual tiredness or weakness.

Tell your dentist right away if you have the following symptoms with articaine and epinephrine: anxiety, blurred vision, depression, drowsiness, lightheadedness, nausea or vomiting, numbness and tingling of the mouth or lips, restlessness, ringing in the ears, speech problems, or tremors.

Articaine and epinephrine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving articaine and epinephrine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Articaine and epinephrine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat after receiving articaine and epinephrine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Articaine and epinephrine side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

  • Bleeding, redness, or swelling of the gums
  • chills
  • cough
  • fast, irregular, pounding, or racing heartbeat or pulse
  • fever
  • hoarseness
  • lower back or side pain
  • mouth ulcers
  • painful or difficult urination
  • swelling of the face
  • swelling or irritation of the mouth

Rare

  • Blurred vision
  • body aches or pain
  • bruising
  • congestion
  • coughing up blood
  • difficulty in breathing or swallowing
  • difficulty opening the mouth
  • dizziness
  • dryness or soreness of the throat
  • earache
  • facial paralysis
  • fainting
  • headache, severe and throbbing
  • increase in bone pain
  • increased menstrual flow or vaginal bleeding
  • increased sensitivity to pain or touch
  • large, flat, blue or purplish patches in the skin
  • lockjaw
  • muscle spasm, especially of the neck and back
  • nervousness
  • nosebleeds
  • paralysis
  • pounding in the ears
  • prolonged bleeding from cuts
  • red or black, tarry stools
  • red or dark brown urine
  • redness or swelling in the ear
  • runny or stuffy nose
  • slow or fast heartbeat
  • swelling of the tongue
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • tingling in the hands and feet
  • trouble in swallowing
  • voice changes

Incidence not known

  • Bigger, dilated, or enlarged pupils (black part of the eye)
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings of the mouth
  • chest pain or discomfort
  • double vision
  • drooping upper eyelids
  • increased sensitivity of the eyes to light
  • nausea
  • pain in the shoulders, arms, jaw, or neck
  • seeing double
  • vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • Sleepiness

Rare

  • Belching
  • change in taste
  • bad unusual or unpleasant (after) taste
  • difficulty in moving
  • dry mouth
  • heartburn
  • increased salivation
  • indigestion
  • itching skin
  • joint pain or swelling
  • lack or loss of strength
  • muscle pain or stiffness
  • nervousness
  • pain or burning at the injection site
  • runny nose
  • sleepiness or unusual drowsiness
  • sneezing
  • stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.