Citanest Plain Dental Injection and HistaFlex

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using prilocaine together with acetaminophen may increase the risk of methemoglobinemia, a condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have anemia, diseases of the heart or lungs, blood circulation disorders, shock, sepsis, and certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M. Close medical supervision is necessary when medications that can cause methemoglobinemia are used together. Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment with prilocaine. Patients (or their caregivers) should seek immediate medical attention if they develop a gray discoloration of the skin, mouth, or nail bed; nausea; headache; dizziness; lightheadedness; fatigue; shortness of breath; rapid or shallow breathing; a rapid heartbeat; anxiety; and confusion. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR CLOSELY: Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other agents that are also associated with methemoglobinemia including other local anesthetics (e.g., benzocaine, lidocaine), antimalarials (e.g., chloroquine, primaquine, quinine, tafenoquine), nitrates and nitrites, sulfonamides, acetaminophen, aminosalicylic acid, dapsone, dimethyl sulfoxide, flutamide, metoclopramide (primarily in infants), nitrofurantoin (primarily in infants), phenazopyridine, phenobarbital, phenytoin, and rasburicase may increase the risk. Additional risk factors include very young age, anemia, cardiac/pulmonary disease, peripheral vascular disease, shock, sepsis, acidosis, and genetic predisposition (e.g., NADH cytochrome-b5 reductase deficiency; glucose-6-phosphate dehydrogenase deficiency; hemoglobin M). The development of methemoglobinemia due to prilocaine is usually dose-related and asymptomatic in normal patients receiving recommended doses, but symptoms may occur at any dose in susceptible individuals. Neonates and infants are particularly susceptible due to a lower activity of the enzyme that reduces methemoglobin to hemoglobin. Neonatal methemoglobinemia has been reported after paracervical or pudendal block in the obstetric patient. The repeated administration of prilocaine, even in relatively small doses, can lead to clinically overt methemoglobinemia (cyanosis). Prilocaine is therefore not recommended for continuous techniques of regional anesthesia.

MANAGEMENT: Prilocaine should be used with caution in the presence of other methemoglobin-inducing drugs. Patients should be closely monitored to ensure adequate perfusion and oxygenation during treatment with prilocaine. Methemoglobin levels should be monitored and oxygen administered whenever possible. Signs and symptoms of methemoglobinemia may be delayed some hours after drug exposure. Patients or their caregivers should be advised to seek medical attention if they notice signs and symptoms of methemoglobinemia such as slate-grey cyanosis in buccal mucous membranes, lips, and nail beds; nausea; headache; dizziness; lightheadedness; lethargy; fatigue; dyspnea; tachypnea; tachycardia; anxiety; and confusion. In severe cases, patients may progress to central nervous system depression, stupor, seizures, acidosis, cardiac arrhythmias, syncope, and shock. Methemoglobinemia should be considered if central cyanosis is unresponsive to oxygen. Calculated oxygen saturation and pulse oximetry are generally not accurate in the setting of methemoglobinemia. The diagnosis can be confirmed by an elevated methemoglobin level of at least 10%. If patient does not respond to administration of oxygen, clinically significant methemoglobinemia should be treated with methylene blue 1 to 2 mg/kg by slow intravenous injection over 5 minutes.

Citanest Plain Dental Injection

Generic Name: prilocaine

Brand name: Citanest Plain Dental

Synonyms: n.a.

What is Citanest Plain Dental Injection?

HistaFlex

Generic Name: acetaminophen / pyrilamine

Brand name: Berocca, Primaplex, Becomject-100, MVI-12, NephPlex RX, Nephrocaps, B-Ject 100, Therobec, B-Plex, Formula B, Vitaplex, Tri-Vi-Sol, Vi-Daylin ADC, Nephro-Vite Rx, Lipogen, Lipotriad, Lipoflavonoid, Cholinoid, Liponol, Bee-Comp with C, Cholidase, Cota-B-Plex, 1000 BC, Neurodep, Neuroforte-Six, MVI. Pediatric, B-Plex Plus, Nephrolan Rx, Zymacap, Vi-Daylin, Poly-Vi-Sol, Dayalets, Sigtab, Therems, StressTabs, Allbee-C 800, Cefol, Cod Liver Oil, Daily Multiple Vitamins, Daily Vite, Protegra, Sesame St. Vitamins with Extra C, Surbex-T, Theragran, Superplex-T, Vi-Stress, Cod Liver Oil Mint, Animal Shape Vitamins, B-50 Complex, B-Complex 50, Vitamin B Complex 100, Balanced B-100, B-Stress, B-Scorbic, Bee with C, Children's Chewable Multivitamins, Balanced B-50, Balanced B-150, Unicap Capsule, Unicap Jr, Unicap, Optilets-500, Super Plenamins, Vitamins for Hair, Tab-A-Vite, One-A-Day Essentials, Essential Balance, Vi-Daylin Chewable, Sunkist Child Chewable with C, Sunkist Child Chewable, Poly-Vi-Sol Chewable, Fruity Chew, Poly-Vit Chew, Chewable-Vite, Flintstones Multivitamins, Bugs Bunny with Extra C, Flintstones with C Multivitamins, Bounty Bear Vitamins, Garfield Vitamins, Vi-Daylin Drops, Poly-Vi-Sol Drops, Baby Vitamin Drop, Vita Drop, Poly Vit Drops, MVC. SDV, Glutofac, Allbee-C, Nephro-Vite, Vitabee with C, Stress B with C, High Potency B+C, Farbee with C, Surbex with C, Super B Complex, Surbex, Vitamin B-50, Vitamin B-100, Vitamin B-100 T/R, Hexavitamin, Kenwood Therapeutic, Thera, Theravite, Thera-Plus, Oncovite, Beminal-500, High Potency B Complex with B12 and C, Super B-50, Super B-100 TD, Tri-Vit Drops, Stress Formula, One Tab Daily, Vitamin C, E, and Rose Hips, Scotts Emulsion, Stress Formula 600, Tri-Vit, B Complex 50, Mega B, Folgard, Apatate, T-Vites, High B Complex, Theragenerix, Cernevit, Cardiotek, Beminal, Beminal with C Fortis, Bugs Bunny Multiple Vitamins, Fletanol, Male Formula, Allbee with C, Prevital, Surbex Filmtab, T-BMP, Tender Age Vitamin ADC, Watkins Harvest, Foltx, Folgard Rx 22, Cernevit-12, Infuvite, Infuvite Pediatric, Diatx, Vitamin A, D, One-A-Day 50+, Thex Forte, Protegra Cardio, Vitamin Daily Liquid, Rena-Vite Rx, Renal Caps, Icar C, Renaphro, Cerefolin, Dialyvite Rx, Dialyvite 800, Vesselvite, Folbee Plus, Folbee, Folcaps, Combgen, Abidec, Unichem Multivitamin, Topfit Vitamin B Complex, Topfit Vitamin B Complex Forte, Vitamin B Compound Strong, Health Aid Multivitamin, Vitamins, Daflon, Essentiale, Jetepar, Neurobion, Vitamin A and D Concentrate, Centrum 8400, MVI. Adult, Nephronex, Animi-3, Foltrate, Cardiotek Rx, Folbic, Metanx, D-400 international units, Folbalin Plus, Folbalin, Multi Vits with Beta Carotene, Foltabs 800, Folgard Rx, B-Complex with B-12, FaBB, CerefolinNAC, Folamin, DexFol, One-A-Day Men's Health Formula, Rena-Vite, Equaline One Daily Essential, Daily-Vite Men's Formula, Folplex, Folmor, Zycose, Biotin Forte, Vigomar Forte, Vimar, Multi-Delyn, Foleve Plus, Folnate, Folnate Plus, Foleve, B 100 Complex, Renatabs, AllanTex, Cardiotek-Rx, NuFol, Folplex 22, Reno Caps, Ivites Rx, TL Gard, Vita-Respa, Folast, Triphrocaps, Enfolast-N, Enfolast, Neurpath-B, Triveen-CF, Rovin-CF, Vol-Care Rx, Nephrocaps QT, B-Complex SR, Apetigen, L-methylfolate Ca, Me-Cbl NAC, P-5-P, Me-Cbl, MTX Support, Menopause Relief with Lifenol, Vitacirc-B, Alz-Nac, Tri-Vita Drops, Poly-Vita Drops, Prostate 24, Apetex, Folastin, Folbee AR, Metafolbic, Metafolbic Plus, Foltanx, Virt-Vite Forte, Virt-Vite, Foltanx RF, Folbic RF, One Daily Multi-Essential, Flintstones Toddler, Full Spectrum B with C, Metafolbic Plus RF, PoDiaPN, Super Theravite-M, Nature's Bounty Hair Skin & Nails, Total B with C, Hair, Skin, & Nails Gummies, Concentrated Whole Food Multivitamin, Niva-Fol, Glycogenics, SeroSyn, Virt-Vite Plus, Rheumate, Folinic-Plus, Allbee Plus, Av-VITE FB Forte, Celebrate B-12, Virt-Gard, Mebolic, DEKAs Essential, Multi Vitamin+, Xyzbac, Nufola, Folika-T, Hylavite, K2 Plus D3, Dosoquin, VP-Vite Rx, Genicin Vita-S, Genicin Vita-Q, Zyvit, Folika-V, Tobakient, Renal Vitamin, Folic-K, HistaFlex

Synonyms: n.a.

What is HistaFlex?