Procaine trade name. Novocain (solution for injection and infusion): instructions for use. Indications for the use of Novocaine

Procaine INN (solution for injection, ointment for external use)

International name: Procaine

Dosage form: ointment for external use, solution for injection,

Chemical Name:

2-(diethylamino)ethyl-4-aminobenzoate (as hydrochloride)

Pharmachologic effect:

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of other modalities. With absorption and direct vascular injection into the bloodstream, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. When administered intravenously, it has an analgesic, anti-shock, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automatism and conductivity), in large doses it can disrupt neuromuscular conduction. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 h). When administered intramuscularly, it is effective in elderly patients in the early stages of diseases associated with functional disorders of the central nervous system (arterial hypertension, spasms of the coronary vessels and cerebral vessels, etc.).

Pharmacokinetics:

undergo complete systemic absorption. The degree of absorption depends on the site and route of administration (especially on vascularization and blood flow velocity in the injection site) and the final dose (amount and concentration). It is rapidly hydrolyzed by plasma and liver esterases to form 2 main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and PABA (it is a competitive antagonist of sulfanilamide chemotherapeutic drugs and can weaken their antimicrobial effect). T1 / 2 - 30-50 s, in the neonatal period - 54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications:

Infiltration (including intraosseous), conduction, epidural, spinal anesthesia; terminal (surface) anesthesia (in otorhinolaryngology); vagosympathetic cervical and perirenal blockade, retrobulbar (regional) anesthesia. Rectally: hemorrhoids, anal fissures. It was previously prescribed for such indications as peptic ulcer of the stomach and duodenum, nausea, ulcerative colitis, itching of the skin (atopic dermatitis, eczema), keratitis, iridocyclitis, glaucoma.

Contraindications:

Hypersensitivity (including to PABA and other local anesthetic esters). For anesthesia by the creeping infiltrate method: pronounced fibrotic changes in the tissues; for subarachnoid anesthesia - AV blockade, bleeding, arterial hypotension, shock, infection of the lumbar puncture site, septicemia. With caution. Emergency surgery with acute blood loss, conditions with decreased hepatic blood flow (eg, CHF, liver disease), progression of cardiovascular failure (usually due to heart block and shock), inflammatory disease or injection site infection, pseudocholinesterase deficiency, renal failure, children's age (up to 18 years), in elderly patients (over 65 years), seriously ill, debilitated patients, pregnancy, childbirth. For subarachnoid anesthesia: back pain, brain infections, benign and malignant neoplasms of the brain, coagulopathy, migraine, subarachnoid hemorrhage, arterial hypotension, skin paresthesia, psychosis, hysteria, non-contact patients, impossibility of puncture due to spinal deformity.

Dosing regimen:

For infiltration anesthesia 350-600 mg 0.25-0.5% solutions; for anesthesia according to the Vishnevsky method (tight creeping infiltration) - 0.125-0.25% solutions; for conduction anesthesia - 1-2% solutions (up to 25 ml); for epidural - 2% solution (20-25 ml); for spinal - 5% solution (2-3 ml); for terminal anesthesia (in otorhinolaryngology) - 10-20% solution. To reduce absorption and prolong the action during local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is administered - 1 drop per 2-5-10 ml of procaine solution. With pararenal blockade (according to A.V. Vishnevsky), 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution are injected into the perirenal tissue, and with vagosympathetic blockade - 30-100 ml of a 0.25% solution. A 10% solution is also used for electrophoretic administration. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation is not higher than 1 g of a 0.25% solution (500 ml) and 0.75 g of a 0.5% solution (150 ml). The maximum dose for use in children is up to 15 mg / kg.

Side effects:

From the side of the central and peripheral nervous system: headache, dizziness, drowsiness, weakness, restlessness, loss of consciousness, convulsions, trismus, tremor, visual and auditory disturbances, nystagmus, cauda equina syndrome (leg paralysis, paresthesia), respiratory muscle paralysis, motor and sensory block, respiratory paralysis often develops with subarachnoid anesthesia. From the CCC: increase or decrease in blood pressure, peripheral vasodilation, collapse, bradycardia, arrhythmias, chest pain. From the urinary system: involuntary urination. From the digestive system: nausea, vomiting, involuntary defecation. On the part of the blood: methemoglobinemia. Allergic reactions: skin itching, skin rash, other anaphylactic reactions (including anaphylactic shock), urticaria (on the skin and mucous membranes). Other: return of pain, persistent anesthesia, hypothermia, impotence; with anesthesia in dentistry: insensitivity and paresthesia of the lips and tongue, lengthening of anesthesia. Overdose. Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, "cold" sweat, increased respiration, tachycardia, decreased blood pressure, up to collapse, apnea, methemoglobinemia. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation. Treatment: maintaining adequate pulmonary ventilation with oxygen inhalation, intravenous administration of short-acting drugs for general anesthesia, in severe cases, detoxification and symptomatic therapy.

Special instructions:

Patients require control of the functions of the cardiovascular system, the respiratory system and the central nervous system. It is necessary to cancel MAO inhibitors 10 days before the introduction of a local anesthetic. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Interaction:

Local anesthetics increase the inhibitory effect on the central nervous system of other drugs. Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) increase the risk of bleeding. When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases. When using local anesthetic drugs for spinal and epidural anesthesia with guanadrel, guanethidine, mecamylamine, trimethaphan, the risk of developing a sharp decrease in blood pressure and bradycardia increases. Use with MAO inhibitors (furazolidone, procarbazine, selegiline) increases the risk of hypotension. Strengthen and lengthen the action of muscle relaxant drugs. When prescribing procaine together with narcotic analgesics, an additive effect is noted, which is used during spinal and epidural anesthesia, while respiratory depression increases. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect. Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis. Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarin, ecothiophate, thiotepa) reduce the metabolism of local anesthetic drugs. Procaine metabolite (PABA) is a sulfonamide drug antagonist.

The drug Novocain in the form of a solution is used for various types of anesthesia, has a wide range of effects.

Novocaine solution is available in the following types:

for injection in ampoules with an active substance concentration of 0.25% and 0.5%;
in polymer containers - bufuses, 5%, 5 ml each;
in vials for infusions of 0.25% and 0.5% of 100, 200, 400 and 500 ml.

The active substance is procaine hydrochloride. The liquid is clear, colorless.

Manufacturers are different.

Properties

The local anesthetic Novocain is characterized by moderate activity and a large therapeutic effect. Procaine helps to reduce the sensitivity of nerve endings as a result of direct contact with the membranes of nerve cells, inhibits the conduction of excitation along sensitive nerve fibers, eliminates spasm of smooth muscles, reduces the excitability of the heart muscle of the myocardium and motor areas of the cerebral cortex.

With intramuscular and intravenous administration of Novocain, the rate of absorption depends on the dosage of the drug, the site of the manipulation and the type of parenteral administration. The drug is instantly hydrolyzed with the formation of two main and active metabolic products in living cells: diethylaminoethanol and para-aminobenzoic acid.

The duration of excretion is from 30 seconds to one minute, in the neonatal period about two minutes. It is excreted with the active participation of the kidneys in the form of substances formed in the cells during metabolism. Absorption from the mucous membranes is very slow and poor.

Indications

Novocaine in solution for injection is most often used in the following situations:

blockade of the cervical sympathetic trunk and the vagus nerve at the same time;
the introduction of an anesthetic into the perirenal space;
reversible blockade of the transmission of a nerve impulse along a large nerve trunk by the introduction of a local anesthetic solution into the paraneural space;
infiltration anesthesia;
local anesthesia, in which the anesthetic is injected into the subarachnoid space during the lumbar puncture, and the blocking of the impulse transmission occurs at the level of the roots of the spinal nerves;
epidural anesthesia;
to dilute penicillin and lengthen its shelf life.

Contraindications

Only procaine intolerance.

Dosing

Doses are determined by the doctor individually for each patient.

Intramuscularly, 5-10 ml of a 1-2% solution 3 times a week for a month with a ten-day break.

For infiltration anesthesia, 0.25–0.5% solutions are used. For conduction and epidural - 2% solution.

Compress

At home, the drug Novocain is used for cooking. One of the most common prescriptions for pain relief is a mixture of dimexide (30 ml) with novocaine (2% solution of 50 ml).

The procedure for the procedure is as follows:

soak a gauze bandage with a solution;
apply to the site of pain;
to improve efficiency, cover the compress with cellophane on top;
keep the pad on for 30 to 60 minutes.

The duration of the procedure can be increased depending on the severity of pain.

Side effects

lowering blood pressure;
collapse;
sensation of objects spinning;
weakness;
allergic manifestations on the skin;
anaphylactic shock.

special instructions

The toxic effect on the patient's body increases depending on the concentration of the solution used.

Drug Interactions

with the combined use of Novocain with antagonists of sulfanilamide drugs, a decrease and weakening of the antimicrobial effect occurs;
when administered intravenously, procaine enhances the inhibitory effect on the central nervous system of general anesthesia, hypnotics, sedatives, narcotic analgesics and tranquilizers.

Novocaine is a local anesthetic agent with a wide spectrum of therapeutic action with moderate anesthetic activity.

Release form and composition

Dosage forms of Novocain:

Solution for injection 0.5%: colorless, clear liquid (2, 5 or 10 ml per ampoule; in a carton box 10 ampoules complete with a scarifier or ampoule knife);
Solution for injection 2%: colorless, transparent or slightly colored liquid (2 or 5 ml per ampoule, in a carton box 10 ampoules complete with a scarifier or ampoule knife; 5 ampoules in a blister pack, in a carton box 2 packs complete with scarifier or ampoule knife.In packs with ampoules with a ring or a break point, do not put a scarifier or ampoule knife);
Solution for injection 0.25% (1, 2, 5 or 10 ml per ampoule, 10 ampoules in a carton box);
Solution for injection 1% (1, 2 or 5 ml per ampoule, 10 ampoules in a carton box);
Rectal suppositories (5 pcs. in a contour pack, 2 packs in a carton box; 5 pcs. in a contour pack, 2 packs in a carton box).

Active ingredient: procaine hydrochloride (in 1 ml of solution - 2.5; 5; 10 or 20 mg; in 1 suppository - 100 mg).

Additional components:

Solution for injection: water for injection, hydrochloric acid;
Rectal suppositories: solid fat.

Indications for use

Injection

Infiltration, epidural and conduction anesthesia;
Vagosympathetic cervical, circular, pararenal and paravertebral blockades.

Suppositories rectal

Contraindications

Injection

Absolute

With epidural anesthesia: a pronounced decrease in blood pressure, atrioventricular blockade, shock, septicemia, infection of the lumbar puncture site;
During anesthesia by the method of creeping infiltrate: pronounced fibrous changes in the tissues;
Age up to 12 years;
Hypersensitivity to the components of the drug (including para-aminobenzoic acid and other local anesthetic esters).

Relative (should be used with extreme caution, as there is a risk of complications):

Emergency operations occurring with acute blood loss;
Conditions accompanied by a decrease in hepatic blood flow (liver damage, chronic heart failure);
Progression of cardiovascular insufficiency (usually due to shock and the development of blockades);
Inflammatory diseases or infection of the injection site;
kidney failure;
Pseudocholinesterase deficiency;
Age from 12 to 18 years;
Old age (over 65 years).

With extreme caution, the drug should be used in seriously ill and / or debilitated patients, as well as during childbirth.

During pregnancy, the use of Novocain is possible only after a careful balance of the possible benefits of taking the drug and the risk of side effects. When prescribing the drug during lactation, it is required to stop breastfeeding.

Suppositories rectal

Hypersensitivity to the components of the drug (including para-aminobenzoic acid and other local anesthetic esters);
Age up to 18 years.

Method of application and dosage

Injection

For infiltration anesthesia, 0.25-0.5% solutions of the drug are prescribed, when anesthesia is carried out by the creeping infiltrate method (according to the Vishnevsky method) - 0.125-0.25% solutions. To prolong the action of the drug and reduce absorption during local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is additionally used, administering 1 drop per 2-5-10 ml of procaine solution.

For adults, when performing infiltration anesthesia at the beginning of the operation, the first single dose should not exceed 150 ml for a 0.5% solution or 500 ml for a 0.25% solution. During the operation, during each hour it is recommended to inject no more than 400 ml for a 0.5% solution and 1000 ml for a 0.25% solution.

In children over 12 years of age, the maximum single dose is 15 mg / kg.

For conduction anesthesia, 1-2% solutions are used (not higher than 25 ml), for epidural - 2% solution (20-25 ml). During the pararenal blockade (according to A.V. Vishnevsky), a 0.5% solution at a dose of 50-80 ml or a 0.25% solution at a dose of 100-150 ml is injected into the perirenal tissue. With vagosympathetic blockade, the recommended dose of a 0.25% solution is 30-100 ml. For paravertebral or circular blockade, injections of 0.25-0.5% solution are carried out intradermally.

Suppositories rectal

The drug is injected deep into the anus, 1 suppository 1-2 times a day after a bowel movement or cleansing enema. As a local anesthetic, it is recommended to use no more than 5 days. If pain persists after the course of treatment, you should contact your doctor.

Side effects

Cardiovascular system: chest pain, arrhythmias, bradycardia, collapse, peripheral vasodilation, decrease or increase in blood pressure;
Nervous system: trismus, weakness, drowsiness, dizziness, headache, convulsions, cauda equina syndrome;
Urinary system: involuntary urination;
Organs of hematopoiesis: methemoglobinemia;
Digestive system: vomiting, nausea, involuntary defecation;
Allergic reactions: skin rash, skin itching, urticaria (on mucous membranes and skin), anaphylactic reactions (including anaphylactic shock);
Others: hypothermia, persistent anesthesia, return of pain; with anesthesia in dentistry - lengthening of anesthesia, paresthesia and numbness of the lips and tongue;
Local reactions: a feeling of discomfort and the urge to defecate (observed in the first days of the use of suppositories and pass on their own, without requiring discontinuation of therapy); rarely - itching and hyperemia in the anus (when used in high doses).

Symptoms of an overdose of Novocain are: vomiting, nausea, dizziness, pallor of the mucous membranes and skin, increased respiration, "cold" sweat, lowering blood pressure (up to collapse), tachycardia, methemoglobinemia, apnea, fear, hallucinations, motor agitation, convulsions . In this condition, measures are taken to maintain adequate ventilation of the lungs, detoxification and symptomatic therapy is carried out.

special instructions

Before using the drug, it is mandatory to conduct tests for individual sensitivity to its components.

In the case of therapy with monoamine oxidase inhibitors, the use of the latter must be canceled 10 days before the use of a local anesthetic.

It should be borne in mind that with the introduction of the same total dose of the drug, the toxicity of procaine is directly proportional to the concentration of the solution used.

During the introduction of the drug, it is required to monitor the activity of the central nervous, respiratory and cardiovascular systems.

When applied on the skin, Novocaine does not provide surface anesthesia.

drug interaction

It should be borne in mind that when combined with Novocaine:

Warfarin, sodium heparin, sodium enoxaparin, sodium danaparoid, sodium dalteparin, sodium ardeparin (anticoagulants) - increase the risk of bleeding;
Trimethaphan, mecamylamine, guanethidine, guanadrel - increase the risk of a sharp decrease in blood pressure and bradycardia;
Disinfectant solutions containing heavy metals (when treating the injection site) - increase the risk of swelling and pain at the injection site;
Selegiline, procarbazine, furazolidone (monoamine oxidase inhibitors) - exacerbate the threat of severe hypotension;
Phenylephrine, methoxamine, epinephrine (vasoconstrictors) - prolong the local anesthetic effect;
Narcotic analgesics - lead to an additive effect, which is used in epidural and spinal anesthesia (in this case, there is an increase in respiratory depression);
Ecothiopata iodide, demecarium bromide, thiotepa, cyclophosphamide, antimyasthenic drugs (cholinesterase inhibitors) - reduce the rate of drug metabolism.

The effect of Novocain on concomitantly taken substances / drugs:

Muscle relaxant drugs - prolongs and enhances their action;
Medicines for general anesthesia, sedatives, hypnotics, tranquilizers - exacerbates the depressing effect on the central nervous system;
Antimyasthenic drugs - reduces their effectiveness (requires correction of myasthenia therapy);
Sulfonamides - weakens the antibacterial effect, since the procaine metabolite (para-aminobenzoic acid) belongs to sulfonamide antagonists.

Terms and conditions of storage

Store in a place protected from light, out of the reach of children: solution for injection - at a temperature not exceeding 25 ° C; rectal suppositories - not higher than 20 ° C.

The shelf life of the solution is 3 years, suppositories - 2 years.

Compound

Active substance: novocaine (procaine)

100 ml of solution contains novocaine (procaine hydrochloride) 0.25 g or 0.5 g

Excipients: dilute hydrochloric acid solution, water for injection.

Dosage form

Injection.

Pharmacological group

Preparations for local anesthesia. ATX code N01B A02.

Indications

Local and infiltration anesthesia. Therapeutic blockade.

Contraindications

Hypersensitivity to the drug. Myasthenia gravis, arterial hypotension, purulent process at the injection site, urgent surgical interventions accompanied by acute blood loss, pronounced fibrous changes in tissues (for anesthesia by the creeping infiltrate method).

Dosage and administration

With local anesthesia, the dose of the drug depends on the concentration, the nature of the surgical intervention, the route of administration, the condition and age of the patient. With pararenal blockade, adults should inject 50-70 ml of 0.5% or 100-150 ml of 0.25% novocaine solution. For infiltration anesthesia, the following higher doses (for adults) are established: the first single dose at the beginning of the operation is not more than 1.25 g of a 0.25% solution (i.e. 500 ml) and 0.75 g of a 0.5% solution (t .e. 150 ml). In the future, during each hour of the operation - no more than 2.5 g of a 0.25% solution (i.e. 1000 ml) and 2 g of a 0.5% solution (i.e. 400 ml).

Adverse reactions

As a rule, novocaine is well tolerated, but some patients experience increased sensitivity to the drug (dizziness, general weakness, lowering blood pressure, collapse, shock).

From the side of the central and peripheral nervous systems: headache, drowsiness, restlessness, loss of consciousness, convulsions, trismus, tremor, visual and auditory disturbances, nystagmus, cauda equina syndrome (leg paralysis, paresthesia), respiratory muscle paralysis, motor and sensory block , return of pain, persistent anesthesia.

From the cardiovascular system: increased blood pressure, peripheral vasodilation, bradycardia, arrhythmia, chest pain.

From the urinary system: involuntary urination.

From the digestive tract: nausea, vomiting, involuntary defecation.

On the part of the blood: methemoglobinemia.

Allergic reactions: skin itching, peeling, rash, dermatitis, other anaphylactic reactions (including angioedema, anaphylactic shock), urticaria (on the skin and mucous membranes).

Others: hypothermia.

Overdose

In cases of overdose, the administration of the drug should be stopped immediately. During local anesthesia, the injection site can be punctured with adrenaline. With intravenous administration, take measures to establish forced diuresis. SPECIAL.

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, increased nervous excitability, "cold" sweat, tachycardia, lowering blood pressure almost to collapse, tremor, convulsions, apnea, methemoglobinemia, respiratory depression, sudden cardiovascular collapse. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation. In cases of overdose, the administration of the drug should be stopped immediately.

Treatment: general resuscitation measures, including oxygen inhalation, if necessary, artificial lung ventilation. If convulsions continue for more than 15-20 seconds, they should be stopped with the introduction of thiopental (100-150 mg) or diazepam (5-20 mg). In case of arterial hypotension and / or myocardial depression, intravenously administer ephedrine (15-30 mg), in severe cases, detoxification and symptomatic therapy. In case of intoxication after injections of novocaine into the muscles of the leg or arm, an urgent application of a tourniquet is recommended to reduce the further flow of the drug into the general circulation.

Use during pregnancy or lactation.

Use during pregnancy is possible subject to good tolerance. During lactation, the use of the drug is possible after a preliminary thorough assessment of the expected benefit of therapy for the mother and the potential risk to the infant. When used during childbirth, the development of bradycardia, apnea, and trial in a newborn is possible.

Children should not use the drug.

Application features

Administer with caution to patients with heart blockade, cardiac arrhythmias (especially bradycardia), patients with a burdened allergic history, as well as during breastfeeding. To identify adverse reactions, first prescribe novocaine in small doses or conduct a sensitivity test. To reduce and eliminate adverse reactions, use antihistamines and corticosteroids. For surface anesthesia, it is of little use due to its poor ability to penetrate through intact mucous membranes. To reduce systemic action, toxicity and prolong the effect of local anesthesia, procaine is used in combination with vasoconstrictors (0.1% solution of epinephrine hydrochloride at the rate of 1 drop per 2-5 ml of solution).

To prevent adverse reactions, a tolerance test should first be carried out. Intolerance is evidenced by swelling and redness of the injection site. If positive, do not use procaine. When using the drug, control of the function of the cardiovascular, respiratory and central nervous systems is required. Use with caution in severe diseases of the heart, liver and kidneys. When conducting local anesthesia with the same total dose, the toxicity of procaine is the higher, the more concentrated the solution used is. In this regard, with an increase in the concentration of the solution, it is recommended to reduce the total dose or dilute the drug solution at a lower concentration (sterile saline sodium chloride solution). The drug should be used with caution in conditions accompanied by a decrease in hepatic blood flow, progression of cardiovascular insufficiency (usually due to the development of heart blocks and shock), inflammatory diseases, pseudocholinesterase deficiency, renal failure, in elderly patients (65 years of age), seriously ill, debilitated patients , during pregnancy and lactation, childbirth.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms.

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Interaction with other drugs and other types of interactions.

The drug reduces the effect of anticholinesterase drugs on neuromuscular transmission. The introduction of novocaine potentiates the action of drugs used for anesthesia. To reduce the absorption and prolong the action of novocaine in local anesthesia, combine the introduction of novocaine with the introduction of 0.1% adrenaline hydrochloride at the rate of 1 drop per 2-5-10 ml of novocaine. Novocaine reduces the effectiveness of sulfa drugs. The use simultaneously with MAO inhibitors increases the risk of arterial hypotension. The toxicity of procaine is increased by anticholinesterase drugs (they inhibit its hydrolysis). Cross-sensitization is possible. When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases. Potentiates the action of direct anticoagulants.

Treatment: maintaining adequate pulmonary ventilation, detoxification and symptomatic therapy.

drug interaction

Enhances the inhibitory effect on the central nervous system of drugs for general anesthesia, hypnotics, sedatives, narcotic analgesics and tranquilizers.

Anticoagulants (sodium ardeparin, sodium dalteparin, sodium danaparoid, sodium heparin, warfarin) increase the risk of bleeding. When treating the injection site with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.

Use with monoamine oxidase inhibitors (, procarbazine, selegiline) increases the risk of developing a pronounced decrease in blood pressure. Enhances and prolongs the action of muscle relaxant drugs. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.

Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.

Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarium bromide, ecothiopa iodide, thiotepa) reduce the metabolism of local anesthetic drugs.

The metabolite of procaine (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions

Patients require monitoring of the functions of the cardiovascular system, the respiratory system and the central nervous system.

It is necessary to cancel monoamine oxidase inhibitors 10 days before the introduction of a local anesthetic.

It should be borne in mind that when performing local anesthesia using the same total dose, the toxicity of procaine is the higher, the more concentrated the solution is used.

Influence on the ability to drive vehicles and mechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Pregnancy and lactation

If it is necessary to prescribe the drug during pregnancy, the expected benefit to the mother and the potential risk to the fetus should be compared. With caution during childbirth.