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5. How to store Citanest

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date, which is stated on the container after
EXP. The expiry date refers to the last day of that month.
Store below 25°C.
Your doctor or the hospital will normally store Citanest and they are responsible
for the quality of the product when it has been opened if it is not used immediately.
They are also responsible for disposing of any unused Citanest correctly.

Package leaflet: Information for the user

Citanest 1% solution for injection
prilocaine hydrochloride

6. Contents of the pack and other information
What Citanest contains
The active substance is prilocaine hydrochloride. Each millilitre (ml) of solution
contains 10 mg of prilocaine hydrochloride (500 mg per 50 ml vial).
The other ingredients are sodium chloride, hydrochloric acid and/or sodium hydroxide,
methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216) and water
for injections.
What Citanest looks like and contents of the pack
Citanest is a solution for injection. It comes in glass multi-dose vials of 20 ml or 50 ml.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder: Aspen Pharma Trading Limited, 3016 Lake Drive,
Citywest Business Campus, Dublin 24, Ireland
Tel: +44 (0)1 748 828 391
Manufacturer: AstraZeneca UK Ltd, Silk Road Business Park, Macclesfield, Cheshire,
SK10 2NA, UK.

To listen to or request a copy of this leaflet in Braille,
large print or audio please call, free of charge:
0800 198 5000 (UK only)
Please be ready to give the following information:
Product name
Reference number
Citanest 1%
This is a service provided by the Royal National Institute
of Blind People.
This leaflet was last revised in November 2016.
© AstraZeneca 2014.
Citanest® is a trade mark of the AstraZeneca group of companies.

Read all of this leaflet carefully before you start using this medicine because it
contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or nurse.
• This medicine has been prescribed for you only. Do not pass it on to others. It may
harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or nurse. This includes any possible
side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Citanest is and what it is used for
2. What you need to know before you use Citanest
3. How to use Citanest
4. Possible side effects
5. How to store Citanest
6. Contents of the pack and other information
1. What Citanest is and what it is used for
Citanest contains a medicine called prilocaine hydrochloride. This belongs to a group
of medicines called local anaesthetics.
Citanest is used in adults and children above 6 months in age to numb (anaesthetise)
parts of the body. It stops pain happening during medical procedures and surgery
2. What you need to know before you use Citanest
Do not use Citanest:
• if you are allergic to prilocaine hydrochloride or any of the other ingredients of this
medicine (listed in section 6).
• if you are allergic to any other local anaesthetics of the same class (such as
lidocaine or bupivacaine).
• if you are anaemic (a blood problem which means you have too few red blood cells).
• if you have a problem with blood pigment levels called ‘methaemoglobinaemia’.
You must not be given Citanest if any of the above apply to you. If you are not sure,
talk to your doctor before you are given Citanest.
Warnings and precautions
Talk to your doctor or nurse before using Citanest if:
• you have high blood pressure or heart problems.
• you have liver or kidney problems.
• you have difficulty breathing.
• you have epilepsy.
• you have an infection or inflammation at the site where the injection is to be given.
• you have ever been told that you have a rare disease of the blood pigment called
‘porphyria’ or anyone in your family has it.
If you are not sure if any of the above apply to you, talk to your doctor before having



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Other medicines and Citanest
Tell your doctor or nurse if you are taking, have recently taken or might take any other
medicines. This includes medicines that you buy without a prescription and herbal
medicines. This is because Citanest can affect the way some medicines work and
some medicines can have an effect on Citanest.

More serious side effects from being given too much Citanest include problems
with your speech, twitching of your muscles, tremors, trembling, fits (seizures), and
loss of consciousness, low blood pressure, erratic heart beat, slowing or stopping of
your heart.

In particular, tell your doctor if you are taking any of the following medicines:
• Other local anaesthetics.
• Medicines called sulphonamides, such as co-trimoxazole (used to treat infections
caused by bacteria).
• Anti-malarial medicines (used to prevent or treat malaria).
• Nitrate medicines (used to treat heart problems).
• Medicines to treat an uneven heart beat (arrhythmia), such as amiodarone.

4. Possible side effects

Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to
have a baby, ask your doctor or nurse for advice before taking this medicine.
Driving and using machines
Citanest may make you feel sleepy and affect the speed of your reactions. After you
have been given Citanest, you should not drive or use tools or machines until the
next day.
Citanest contains sodium
• Citanest contains 2.36 mg of sodium per millilitre (ml), equivalent to 118 mg per
50 ml ampoule. Your doctor will take this into account if you are on a sodium
controlled diet.
Citanest contains methyl parahydroxybenzoate (E218) and propyl
parahydroxybenzoate (E216)
Citanest contains methyl parahydroxybenzoate (E218) and propyl
parahydroxybenzoate (E216). These may cause allergic reactions (possibly delayed)
such as a skin rash, and exceptionally bronchospasm (breathlessness). This may
happen a while after you have been given the medicine.
3. How to use Citanest
Always use this medicine exactly as your doctor or nurse has told you. Check with
your doctor or nurse if you are not sure. Citanest will be given to you by a doctor. It will
be given to you as an injection. The dose that your doctor gives you will depend on
the type of pain relief that you need. It will also depend on your body size, age, and
physical condition and the part of your body that the medicine is being injected into.
You will be given the smallest dose possible to produce the required effect.
Citanest will usually be given near the part of the body to be operated on. It stops the
nerves from being able to pass pain messages to the brain. It will stop you feeling pain.
It will start to work a few minutes after being injected and will slowly wear off when the
medical procedure is over.
Use in children and adolescents
Citanest is not recommended for use in children under 6 months old.
If you use more Citanest than you should
Serious side effects from getting too much Citanest need special treatment and the
doctor treating you is trained to deal with these situations. The first signs of being given
too much Citanest are usually as follows:
• Feeling dizzy or light-headed.
• Numbness of the lips and around the mouth.
• Numbness of the tongue.
• Hearing problems.
• Problems with your sight (vision).
To reduce the risk of serious side effects, your doctor will stop giving you Citanest as
soon as these signs appear. This means that if any of these happen to you, or you
think you have received too much Citanest, tell your doctor immediately.

Like all medicines, this medicine can cause side effects, although not everybody
gets them.
If you have any of these side effects, stop taking the medicine and/or seek urgent
medical advice immediately:
• Swelling of your face, lips, tongue or throat. This may make it difficult to swallow.
• Severe or sudden swelling of your hands, feet and ankles.
• Difficulty breathing.
• Severe itching of the skin (with raised lumps).
Other possible side effects:
Very common: may affect more than 1 in 10 people
• Low blood pressure. This might make you feel dizzy or light-headed.
• Feeling sick (nausea).
Common: may affect up to 1 in 10 people
• Being sick (vomiting).
• Feeling dizzy.
• Pins and needles.
• Slow heart beat.
• High blood pressure.
Uncommon: may affect up to 1 in 100 people
• Blurred vision.
• Ringing in the ears (tinnitus) or being sensitive to sound.
• Numbness of the lips and around the mouth.
• Numbness of the tongue.
• Difficulty in speaking.
• Loss of consciousness.
• Shakiness.
• Fits (convulsions).
Rare: may affect up to 1 in 1,000 people
• Uneven heart beat (arrhythmias).
• Heart attack.
• Nerve damage that may cause changes in sensation or muscle weakness
(neuropathy). This may include peripheral nerve damage.
• Methaemoglobinaemia (a problem with blood pigment levels). If this happens, the
skin becomes bluish-grey due to a lack of oxygen (this is more likely in infants).
Not known: frequency cannot be estimated from the available data
• Double vision.
• Shallow breathing.
Do not be concerned by this list of possible side effects. You may not get any of them.
If any of the side effects get serious, or if you notice any side effects not listed in this
leaflet, please tell your doctor or nurse.
Reporting of side effects
If you get any side effects, talk to your doctor or nurse. This includes any possible side
effects not listed in this leaflet. You can also report side effects directly via the Yellow
Card Scheme at:
By reporting side effects you can help provide more information on the safety of this

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