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Lidocaine and prilocaine (Gingival)

Generic name: lidocaine/prilocaine (LYE-doe-kane, PRIL-oh-kane)
Drug class: Topical anesthetics

Medically reviewed by Drugs.com. Last updated on Nov 10, 2020.

Commonly used brand name(s)

In the U.S.

  • Oraqix

Available Dosage Forms:

  • Gel/Jelly

Therapeutic Class: Anesthetic, Amino Amide Combination

Chemical Class: Amino Amide

Uses for lidocaine and prilocaine

Lidocaine and prilocaine periodontal (gingival) gel is used on the gums to cause numbness or loss of feeling during dental procedures. Lidocaine and prilocaine contains a mixture of two topical local anesthetics (numbing medicines). It deadens the nerve endings in the gum.

Lidocaine and prilocaine is to be given only by or under the direct supervision of your dentist.

Before using lidocaine and prilocaine

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 lidocaine and prilocaine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to lidocaine and prilocaine 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 lidocaine and prilocaine periodontal gel in the pediatric population. 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 lidocaine and prilocaine periodontal gel in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving lidocaine and prilocaine periodontal gel.

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 lidocaine and prilocaine, 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 lidocaine and prilocaine 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
  • Dronedarone
  • Saquinavir
  • Vernakalant

Using lidocaine and prilocaine 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.

  • Acecainide
  • Amifampridine
  • Amiodarone
  • Amprenavir
  • Arbutamine
  • Atazanavir
  • Bretylium
  • Bupivacaine Liposome
  • Bupropion
  • Cobicistat
  • Dasabuvir
  • Delavirdine
  • Disopyramide
  • Dofetilide
  • Donepezil
  • Dronedarone
  • Encainide
  • Etravirine
  • Flecainide
  • Fosamprenavir
  • Fosphenytoin
  • Hyaluronidase
  • Ibutilide
  • Lopinavir
  • Metoprolol
  • Mexiletine
  • Moricizine
  • Nadolol
  • Phenytoin
  • Procainamide
  • Propafenone
  • Quinidine
  • Sotalol
  • Succinylcholine
  • Telaprevir
  • Tocainide

Using lidocaine and prilocaine 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.

  • Cimetidine

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 lidocaine and prilocaine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency, or
  • Heart problems or
  • Lung or breathing problems or
  • Methemoglobinemia (blood disorder), hereditary or idiopathic (unknown cause)—Use with caution. May increase risk of having methemoglobinemia.
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of lidocaine and prilocaine

A dentist or other trained health professional will give you lidocaine and prilocaine in an office or clinic setting. The medicine is applied to the gums using an applicator and a special dispenser.

Precautions while using lidocaine and prilocaine

It is very important that your dentist check your progress closely for any problems or unwanted effects that may be caused by lidocaine and prilocaine.

Lidocaine and prilocaine may cause serious types of allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your dentist right away if you have a rash, itching, hoarseness, trouble with breathing or swallowing, or any swelling of your hands, face, or mouth after you receive the medicine.

Lidocaine and prilocaine may cause a rare, but serious blood problem called methemoglobinemia. Call your dentist right away if you develop a blue or bluish purple color on the lips, fingernails, or skin, or have headaches, dizziness, fainting, sleepiness, or trouble with breathing after you receive lidocaine and prilocaine.

During the time that the gum feels numb, serious injury can occur. Be especially careful to avoid injury until the numbness wears off and you have normal feeling in the area. Avoid foods or liquids that are very hot or very cold. Do not chew gum or food while your mouth feels numb. You may accidentally bite your tongue or the inside of your cheeks.

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.

Lidocaine and prilocaine 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:

More common

  • Gum numbness that continues
  • gum swelling or irritation
  • nausea

Rare

  • Hoarseness
  • rash
  • swelling of the eyelids, face, lips, or tongue
  • tightness in the chest
  • trouble with breathing
  • trouble with swallowing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Blue or blue-purple color of the lips, fingernails, mouth, or skin
  • blurred or double vision
  • dark urine
  • dizziness or drowsiness
  • fainting
  • feeling hot, cold, or numb
  • headache
  • irregular or fast heartbeat
  • muscle twitching or trembling
  • ringing or buzzing in the ears
  • seizures
  • unusual excitement, nervousness, or restlessness
  • unusual tiredness or weakness
  • 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:

More common

  • Bad or bitter taste
  • mouth pain or soreness
  • mouth ulcers

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.