prilocaine hydrochloride at a glance
Medicine class
Amide-type local anaesthetic
Licensed role
Spinal anaesthesia for short surgical procedures in adults
Administration
Given by a specialist into the fluid around the spinal nerves in hospital
Important risk
Rarely, methaemoglobinaemia can reduce the blood's ability to carry oxygen
What is prilocaine hydrochloride used for?
The selected UK product has one licensed use:
Spinal anaesthesia in adults undergoing short surgical procedures.
How does prilocaine hydrochloride work?
Prilocaine reversibly reduces sodium movement through nerve-cell membranes. This stops pain and other sensory signals travelling along spinal nerves; movement and autonomic functions may also be temporarily affected.
prilocaine hydrochloride preparations and strengths
Injection
Route: Parenteral
Strengths: 20 mg/mL, 1%
How to take prilocaine hydrochloride
This is not self-administered. A trained anaesthetist gives the clear, glucose-containing solution into the fluid around the spinal nerves while monitoring circulation, breathing and the developing nerve block.
It is restricted to hospital use.
It is for intrathecal spinal injection, not epidural or intravenous injection.
Move carefully until sensation and strength have fully returned, following the clinical team's discharge instructions.
prilocaine hydrochloride side effects
Common or expected effects
- Low blood pressure, sometimes causing faintness or nausea
- Nausea or vomiting
- Dizziness
- Temporary tingling or altered sensation
Get urgent medical advice
- Severe allergic reaction, including swelling, marked blood-pressure reduction or collapse
- Blue or grey skin, breathlessness or confusion suggesting methaemoglobinaemia
- Seizures, loss of consciousness or breathing difficulty from systemic toxicity
- Very slow or abnormal heartbeat, cardiac arrest or severe respiratory depression
- High or total spinal block causing profound circulatory or breathing problems
- Persistent neurological symptoms, including weakness, loss of sensation or paralysis
prilocaine hydrochloride in pregnancy
Prilocaine crosses the placenta, and adequate pregnancy data are unavailable. The selected product should be used during pregnancy only when there is a compelling clinical indication; late pregnancy also increases susceptibility to a high spinal block. Prilocaine should be avoided for paracervical or pudendal anaesthesia because neonatal methaemoglobinaemia has been reported in obstetric use.
prilocaine hydrochloride while breastfeeding
General NHS information considers local anaesthetics compatible with breastfeeding. However, the selected product's SmPC advises that breastfeeding can resume approximately 24 hours after treatment. Follow the product-specific plan from the anaesthetist or maternity team.
prilocaine hydrochloride interactions
The anaesthetic team should review all medicines because some combinations increase toxicity or affect whether spinal anaesthesia is suitable.
Methaemoglobin-forming medicines, including sulfonamides, antimalarials, sodium nitroprusside and nitrates
They may add to prilocaine's risk of methaemoglobinaemia.
Other local anaesthetics
Central nervous system and cardiovascular adverse effects may be additive.
Structurally related antiarrhythmics, including lidocaine, mexiletine and tocainide
Similar pharmacological effects may increase toxicity.
Common questions about prilocaine hydrochloride
Answers are fully visible for fast scanning and source review.
Is prilocaine hydrochloride a local anaesthetic?
Yes. It is an amide-type local anaesthetic that temporarily interrupts nerve signalling.
How is it given for spinal anaesthesia?
A specialist injects it into the fluid around the spinal nerves in the lower back while monitoring the patient.
Can it be given as an epidural?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.