Articaine

SEPTOCAINE

What it isPeripheral sodium-channel blocker with amide and ester features; dental anesthesia.

Why this oneRapid onset and good bone penetration make it a dental workhorse, and plasma esterases clear it quickly.

What limits itParesthesia after mandibular block is reported more often with articaine than with lidocaine.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Local/regional anesthesia for dental procedures (infiltration or nerve block)	adults	Infiltration 0.5-2.5 mL (20-100 mg); nerve block 0.5-3.4 mL (20-136 mg); oral surgery 1-5.1 mL (40-204 mg)	lowest effective dose	7 mg/kg (0.175 mL/kg)
Local/regional dental anesthesia	peds 4-16 y	per procedure	lowest effective dose	7 mg/kg (0.175 mL/kg)

Renal Undefined

Hepatic Undefined

Maximum 7 mg/kg articaine HCl (healthy adults and children 4-16 y).

Intraoral submucosal infiltration or nerve block only.
Aspirate before injecting to avoid intravascular injection; reposition needle until no blood returns.
Use the lowest dose that produces the desired effect.
1:200,000 epinephrine preferred for routine procedures; 1:100,000 when more hemostasis/visualization is needed.

Accidental intravascular injection — convulsions, coma, respiratory arrest
Systemic toxicity affecting CNS and cardiovascular systems
Vasoconstrictor toxicity — caution in impaired cardiovascular function or vascular disease
Methemoglobinemia

Pregnancy Pregnancy Category C; no adequate studies; use only if benefit justifies risk (animal fetal death/skeletal variations).

Lactation Exercise caution when administering to a nursing woman.

NO BOXED WARNINGS

Principal riskParaesthesia after mandibular block is reported more with articaine than with lidocaine

Direct muscarinic antagonism0 / 4