Usual Adult Dose for Anesthesia

Below are the recommended volumes and concentrations of articaine-epinephrine for various types of anesthetic procedures. The dosages suggested below are for normal healthy adults, administered by submucosal infiltration and/or nerve block.

Infiltration: 0.5 mL to 2.5 mL or 20 mg to 100 mg of articaine
Nerve block: 0.5 mL to 3.4 mL or 20 mg to 136 mg of articaine
Oral surgery: 1.0 mL to 5.1 mL or 40 mg to 204 mg of articaine

For most routine dental procedures articaine-epinephrine 1:200,000 is preferred. However, when more pronounced hemostasis is required, articaine-epinephrine 1:100,000 may be used.

The above suggested volumes serve only as a guide. Other volumes may be used provided the total maximum recommended dose is not exceeded. The recommended doses above also serve only as a guide to the amount of anesthetic required for most routine procedures. The actual volumes to be used depend on a number of factors such as type and extent of surgical procedure, depth of anesthesia, degree of muscular relaxation, and condition of the patient. In all cases, the smallest dose that will produce the desired result should be given.

For normal healthy adults, the maximum dose of articaine administered by submucosal infiltration and/or nerve block should not exceed 7 mg/kg (0.175 mL/kg) or 3.2 mg/lb (0.0795 mL/lb) of body weight, e.g. 7 cartridges (11.9 mL) for a 150 lb. patient.

Usual Geriatric Dose for Anesthesia

In clinical trials, 54 patients between the ages of 65 and 75 years, and 11 patients 75 years and over received articaine-epinephrine 1:100,000. Among all patients between 65 and 75 years, doses from 0.43 mg/kg to 4.76 mg/kg (0.9 to 11.9 mL) were administered safely to 35 patients for simple procedures and doses from 1.05 mg/kg to 4.27 mg/kg (1.3 to 6.8 mL) were administered safely to 19 patients for complex procedures. Among the 11 patients 75 years and over, doses from 0.78 mg/kg to 4.76 mg/kg (1.3 to 11.9 mL) were administered safely to 7 patients for simple procedures and doses of 1.12 mg/kg to 2.17 mg/kg (1.3 to 5.1 mL) were safely administered to 4 patients for complex procedures.

No overall differences in safety or effectiveness were observed between elderly subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Approximately 6% of patients between the ages of 65 and 75 years and none of the 11 patients 75 years of age or older required additional injections of anesthetic for complete anesthesia compared with 11% of patients between 17 and 65 years old who required additional injections.

Usual Pediatric Dose for Anesthesia

4 to 10 years of age:
The quantity to be injected should be determined by the age and weight of the child and the magnitude of the operation.

For children of less than 10 years who have a normal lean body mass and normal body development, the maximum dose may be determined by the application of one of the standard pediatric drug formulas. In any case, the maximum dose of 4% articaine should not exceed the equivalent of 7 mg/kg (0.175 mL/kg) or 3.2 mg/lb (0.0795 mL/lb) of body weight.

4 to 16 years of age:
In clinical trials, 61 pediatric patients between the ages of 4 and 16 years received articaine-epinephrine 1:100,000. Among these pediatric patients, doses from 0.76 mg/kg to 5.65 mg/kg (0.9 to 5.1 mL) were administered safely to 51 patients for simple procedures and doses between 0.37 mg/kg and 7.48 mg/kg (0.7 to 3.9 mL) were administered safely to 10 patients for complex procedures. However, there was insufficient exposure to articaine-epinephrine 1:100,000 at doses greater than 7 mg/kg in order to assess its safety in pediatric patients. No unusual adverse events were noted in these patients.

Approximately 13% of these pediatric patients required additional injections of anesthetic for complete anesthesia. Safety and effectiveness in pediatric patients below the age of 4 years have not been established.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Dosages should be reduced for patients with liver disease.

Dose Adjustments

Dosages should be reduced for patients with cardiac disease.

Dosages in pediatric patients should be reduced, commensurate with age, body weight, and physical condition.

Precautions

The onset of anesthesia, and the duration of anesthesia are proportional to the volume and concentration (i.e., total dose) of local anesthetic used. Caution is recommended when employing large volumes since the incidence of side effects may be dose-related.

Dialysis

Data not available