Storage conditions for novocaine. Novocain: instructions for use

Novocaine

International nonproprietary name

Dosage form

Solution for injection 5 mg/ml

Compound

1 ml of the drug contains

active substance- procaine hydrochloride (novocaine) 5.0 mg Excipients: 0.1 M hydrochloric acid, water for injection.

Description

Clear, colorless or slightly yellowish solution.

Pharmacotherapeutic group

Drugs for the treatment of diseases of the nervous system. Anesthetics. Local anesthetics. Aminobenzoic acid esters. Procaine.

ATX code N 01BA 02

Pharmacological properties

Pharmacokinetics

Subject to complete systemic absorption. The extent of absorption depends on the site and route of administration (especially vascularity and blood flow velocity in the area of ​​administration) and the final dose (amount and concentration). It is quickly hydrolyzed by plasma and liver esterases to form 2 main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilator effect) and para-aminobenzoic acid (is a competitive antagonist of sulfonamide chemotherapeutic drugs and can weaken their antimicrobial effect). The half-life is 30-50 seconds, in the neonatal period - 54-114 s. It is excreted primarily by the kidneys in the form of metabolites; no more than 2% is excreted unchanged.

Pharmacodynamics

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks N a+ channels, preventing the generation of impulses in 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 direct intravascular administration, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (has some ganglion-blocking effect), eliminates spasm of smooth muscles, reduces the excitability of the myocardium and motor areas of the cerebral cortex. It has an analgesic, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automaticity and conductivity); in large doses it can disrupt neuromuscular conduction. Eliminates descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In large doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour).

Indications for use

Infiltration (including intraosseous) anesthesia

For blockades (vagosympathetic cervical, paranephric, circular and paravertebral)

Directions for use and doses

For local anesthesia, the dose of the drug depends on the concentration, the nature of the surgical intervention, the method of administration, the condition and age of the patient. For perinephric blockade, adults are injected with 50-70 ml of 0.5% (5 mg/ml) novocaine solution into the perinephric tissue. For infiltration anesthesia, the following highest doses are established (for adults): the first single dose at the beginning of the operation is 0.75 g (150 ml of 0.5% novocaine solution). Then, during each hour of surgery - no more than 2 g (400 ml of 0.5% novocaine solution).

Side effects

Novocaine is usually well tolerated, but sometimes the following adverse reactions are possible:

Headache, dizziness, drowsiness, weakness, motor restlessness, loss of consciousness, convulsions, trismus, tremor, visual and auditory disturbances, nystagmus, cauda equina syndrome (leg paralysis, paresthesia), paralysis of the respiratory muscles, motor and sensory block, return of pain, persistent anesthesia

Increased or decreased blood pressure, peripheral vasodilation, collapse, bradycardia, arrhythmias, chest pain

Involuntary urination

Nausea, vomiting, involuntary bowel movements

Methemoglobinemia

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

Hypothermia

Contraindications

Increased individual sensitivity 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 using the creeping infiltrate method)

Children's age up to 12 years

Carefully

Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, with CHF, liver diseases); progression of cardiovascular failure (usually due to the development of heart block and shock); inflammatory diseases or infection of the injection site; pseudocholinesterase deficiency; renal failure; children from 12 to 18 years old and elderly patients (over 65 years old); weakened patients; pregnancy and childbirth

Drug interactions

Strengthens the inhibitory effect on the central nervous system of general anesthesia, sleeping pills and sedatives, narcotic analgesics and tranquilizers.

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.

Use with MAO inhibitors (furazolidone, procarbazine, selegiline) increases the risk of developing hypotension.

Strengthen and lengthen the effect of muscle relaxants.

When procaine is prescribed 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 of the treatment of myasthenia gravis.

Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarine, ecothiophate, thiotepa) reduce the metabolism of procaine.

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

special instructions

Administer with caution to patients with heart blockades, cardiac arrhythmias (especially bradycardia), patients with a history of allergies, 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. It is of little use for superficial anesthesia due to its weak ability to penetrate intact mucous membranes. To reduce the systemic effect, 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 25 ml of solution).

To prevent adverse reactions, a tolerance test is first performed. Intolerance is indicated by swelling and redness of the injection site. If the reaction is positive, do not use procaine. When using the drug, monitoring of the function of the cardiovascular, respiratory and central nervous systems is required. Prescribe with caution in severe diseases of the heart, liver and kidneys. When performing local anesthesia when using the same total dose, the toxicity of procaine is higher, the more concentrated the solution used. 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 to a lower concentration (with a sterile isotonic sodium chloride solution). The drug should be used with caution in conditions accompanied by decreased hepatic blood flow, progression of cardiovascular failure (usually due to the development of heart block and shock), inflammatory diseases, pseudocholinesterase deficiency, renal failure, in elderly patients (over 65 years old), seriously ill, debilitated patients , during pregnancy and lactation, childbirth.

Use during pregnancy and lactation

Use during pregnancy is possible provided it is well tolerated.

During breastfeeding, the use of the drug is possible after a preliminary careful assessment of the expected benefits of therapy for the mother and the potential risk for the baby.

When used during childbirth, bradycardia, apnea, and convulsions may develop in the newborn.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms.

During the treatment period, it is necessary to exercise caution when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

In cases of overdose, administration of the drug should be stopped immediately. When performing local anesthesia, the injection site can be injected with adrenaline. When administered intravenously, take measures to establish forced diuresis. Therapy is symptomatic.

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, increased nervous excitability, “cold” sweat, tachycardia, decreased blood pressure almost to the point of collapse, tremor, convulsions, apnea, methemoglobinemia, respiratory depression, sudden cardiovascular collapse. The effect on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, and motor agitation.

Treatment: general resuscitation measures, including oxygen inhalation, and, if necessary, artificial ventilation of the lungs. If convulsions last more than 15-20 seconds, they should be stopped by intravenous administration of thiopental (100-150 mg) or diazepam (5-20 mg). In case of arterial hypotension and/or myocardial depression, administer ephedrine (15-30 mg) intravenously; in severe cases, detoxification and symptomatic therapy.

Novocaine is an injection solution that is used as a local anesthetic. The product can be used in dentistry, surgery and dermatology. The drug can be used externally as a compress. The medication has a number of contraindications that must be identified in the patient in advance to avoid the development of side effects.

The medication has several forms of release: suppositories and Novocaine solution. The liquid form and suppositories contain one active ingredient - procaine. Additional components (solid fat, distilled water, aqueous hydrogen chloride solution) may vary depending on the manufacturer.

Solution (0.25%, 0.5%, 2%) is a colorless (less often yellowish) transparent liquid, poured into glass ampoules of 10 ml, 5 ml or 2 ml. There is a scarifier in the cardboard box. Torpedo-shaped suppositories are sold in plastic pallets of 10 pcs. in everyone.

Pharmacological properties

Novocaine intravenously as an anesthetic agent has moderate activity. The drug relieves pain attacks and impulses of various modalities. When released into the blood, the main component reduces the rate of release and production of choline derivatives. As absorption progresses, the degree of excitability of cholinergic neurons decreases.

The drug can smooth out muscles and reduce the level of excitability of the motor areas of the brain and myocardium. Polysynaptic reflexes are inhibited, and any inhibitory descending influences are eliminated. Novocaine, used in large doses, can provoke seizures.

Duration of action - no more than 60 minutes. The anesthetic activity is short-term. The main component is completely absorbed. The level of absorption depends on the place of administration (intramuscular, into a vein or via a dropper) and the dose of the drug. Hydrolysis is rapid; para-aminobenzoic acid and diethylaminoethanol are formed in the process. The latter has a slight vasodilator effect.

Indications and contraindications

The use of injections with Novocaine is possible with the following types of anesthesia:

• spinal;
• conductive;
• epidural;
• intraosseous;
• infiltration.

A 0.5 percent solution is used in otolaryngology for anesthesia of the mucous membranes of the nose and oral cavity. With its help they carry out a blockade:

• circular;
• paravertebral;
• vagosympathetic cervical;
• perinephric.

The drug for anesthesia is combined with the main anesthetic drugs. When administered intramuscularly, the drug accelerates the dissolution process of penicillin. Novocaine is used for the following pathologies:

• rheumatic and infectious diseases of the joints;
• high blood pressure (hypertension);
• vascular spasms;
• endarteritis;
• atherosclerosis.

The medicine is effective for toothache. You can use the solution for compresses for skin diseases. Suppositories help with anal fissures and hemorrhoids.

The drug has a number of absolute and relative contraindications for use. The absolute ones include:

• individual intolerance to procaine;
• childhood;
• renal failure;
• inflammatory pathologies;
• pseudocholinesterase deficiency;
• progressive cardiovascular failure;
• slow blood flow in the liver;
• emergency operations accompanied by blood loss.

Relative contraindications include pregnancy, a tendency to allergic reactions and old age.

Instructions for use of Novocaine in ampoules

The drug should be used only according to the instructions. Before administering the medication, the doctor should ask the patient in detail about possible contraindications. The treatment regimen, course and dosage are selected individually; the patient’s age must be taken into account.

How to breed?

There is no need to dilute the pure solution with anything. If necessary, antibiotics are diluted with Novocaine.

Directions for use and doses

For children over 12 years of age, the maximum daily dose is 5 mg/kg body weight. To lengthen the effect and reduce the rate of absorption of Novocaine during anesthesia, epinephrine hydrochloride 0.1% (one drop per 5-10 ml). For paravertebral and circular blockade, the solution is administered intradermally (5-10 ml). With vagosympathetic blockade, the rate is increased 3-4 times (not more than 40 ml at a time).

Perinephric blockade involves the introduction of a solution into the perinephric area (no more than 80 ml at a time). For infiltration anesthesia, Novocaine 0.5% is used, the maximum dose is 600 ml. Before surgery, adult patients are administered 150 ml of solution. During the operation (every hour), another 400 ml is infused through a dropper.

Side effects and overdose

The risk of side effects increases if the individually selected treatment regimen is not followed. They arise from:

1. Cardiovascular system: aching chest pain, collapse, arrhythmia, peripheral vasodilation, bradycardia, blood pressure surges.
2. Hematopoietic systems: methemoglobinemia.
3. Central nervous system: weakness, drowsiness, dizziness, prolonged headaches.

Most often, patients complain of the appearance of characteristic allergy symptoms, which include hives, itching, and skin rashes. In rare cases, anaphylactic shock is possible. Side effects are reversible and disappear on their own after stopping treatment.

Symptoms of overdose appear when the daily norm is exceeded multiple times. Main features:

• motor excitement;
• auditory and visual hallucinations;
• feelings of fear and anxiety;
• apnea;
• a sharp decrease in blood pressure;
• breathing problems (even attacks of suffocation);
• tachycardia;
• increased sweating (“cold” sweat);
• uncontrollable vomiting;
• dizziness (up to fainting);
• attacks of nausea;
• pale skin.

Gastric lavage will not help in this case. Symptomatic treatment is required: the patient must be immediately taken to the nearest medical facility, where doctors are able to maintain pulmonary ventilation and, if necessary, prescribe detoxification therapy.

special instructions

It is not recommended to instill the solution into the eyes without consulting your doctor. If the patient has been prescribed electrophoresis for osteochondrosis, then the procedure is carried out only after the diagnosis has been clarified and under the supervision of a specialist. During the treatment period, it is recommended to stop driving a car and other vehicles: the drug can reduce concentration. Procaine does not penetrate well through intact mucous membranes, so it is not used for superficial anesthesia.

Monoamine oxidase inhibitors should be discontinued 2 weeks before starting treatment. Systematic use of novocaine requires regular monitoring of the functions of the respiratory and nervous systems, heart and blood vessels. Before administering the solution to the patient, it is necessary to conduct an individual sensitivity test. The drug is incompatible with alcohol. 7 days before the start of treatment, the patient must completely stop drinking alcohol (including low-alcohol drinks).

Prescription during pregnancy and lactation

Before prescribing Novocaine to a pregnant or breastfeeding woman, the doctor must calculate the possible risks in advance. During the postpartum period, careful administration is necessary: ​​injections are given under the supervision of a doctor. If there is a need for a breastfeeding woman to use the drug, then lactation should be stopped.

Interaction with other drugs

Cholinesterase inhibitors can slow down the metabolism of Novocaine. The metabolite of procaine (para-aminobenzoic acid) is considered a sulfonamide antagonist. Under the influence of novocaine, the degree of antimyasthenic effect of some drugs decreases, so adjustment of therapy for myasthenia gravis may be necessary. Vasoconstrictors (methoxamine, epinephrine, phenylephrine) prolong the anesthetic effect.

Under the influence of Novocaine, muscle relaxant drugs increase their bioavailability. The medication has negative compatibility with monoamine oxidase inhibitors due to the high likelihood of a sharp decrease in blood pressure. The injection site cannot be treated with disinfectant solutions: they contain heavy metals, so the risk of hematomas increases.

Novocaine cannot be combined with anticoagulants: internal bleeding may occur. The medicine enhances the effect of analgesics, tranquilizers, sleeping pills and sedatives.

Terms of sale and storage

Novocaine as a local anesthetic can only be purchased with a doctor's prescription written in Latin on a special endorsed form. Approximate cost: from 25 rubles. per package. Opened boxes with ampoules and suppositories must be stored correctly so that the medicine does not lose its properties. Shelf life: no more than 36 months. The storage place should be dry and dark. The drug should be protected from children, fire, sunlight and pets.

Analogs (briefly)

At the pharmacy you can purchase a number of medications that provide the same therapeutic effect as the original drug. These include:

1. Dicaine. A local anesthetic in the form of a solution quickly numbs the mucous membranes, reducing the sensitivity of nerve endings. Used in otolaryngology and ophthalmology. If the patient has contraindications to amide anesthetics, the drug is used for spinal anesthesia. Price - from 45 rubles.
2. Anestezin. The tablet form of the drug provides local anesthesia. Contains benzocaine. The tablets are dissolved in liquid and used as directed. Oral administration is possible for pathologies of the digestive tract. Cost - from 50 rubles.
3. Pyromecaine. Available in gel form, it is used primarily in dentistry. The active ingredients are methyluracil and bumecaine. The medication provides local anesthesia for stomatitis, erythema and periodontitis. Price - from 220 rub.
4. Mepivacaine. The amide anesthetic is sold in the form of a solution. The main element is the substance of the same name in the form of hydrochloride. There are no vasoconstrictor components in the composition. The medication is used in surgery, otolaryngology and dentistry. Cost - from 140 rubles.

Generics have contraindications that the doctor must take into account when prescribing. Independent selection of medication is strictly prohibited.

As well as additional components: hydrochloric acid, water.

Part suppositories active ingredient included procaine hydrochloride and solid fat as an additional component.

Release form

Produced Novocaine solution 0.5% for injection. It is a colorless transparent liquid. Contained in ampoules of 2 ml, 5 ml, 10 ml. The cardboard package contains 10 ampoules, as well as a knife or scarifier.

Also produced Novocaine 0.25%, Novocaine 2%- a transparent solution without color or slightly yellowish.

Novocaine is produced in the form rectal suppositories. In a cardboard package – 10 pcs.

pharmachologic effect

Wikipedia indicates that Novocaine (INN: Procaine) is a local anesthetic that demonstrates moderate anesthetic activity. Name in Latin - Novocaine. Active substance formula - C13H20N2O2. Qualitative reactions to novocaine are described in pharmaceutical textbooks. It has a wide range of therapeutic effects. The active substance blocks Na+ channels, preventing the generation of impulses and their conduction along nerve fibers.

Under the influence of procaine, the action potential in the membranes of nerve cells changes, but there is no pronounced effect on the resting potential. The drug suppresses the conduction of pain impulses and impulses of other modalities in the body.

When administered directly into the bloodstream and during absorption, it reduces the level of excitability of peripheral cholinergic systems, reduces the production and release of acetylcholine from preganglionic endings.

As the pharmacopoeia testifies, Novocaine relieves spasms of smooth muscles, reduces the level of excitability of the myocardium and motor areas of the cerebral cortex. Under its influence, polysynaptic reflexes are inhibited and the descending inhibitory effects of the reticular formation of the brain stem are eliminated. When taking large doses of the drug, the patient may develop seizures.

There is a short anesthetic activity of the drug. In this case, the duration of infiltration anesthesia is from 0.5 to 1 hour.

Pharmacokinetics and pharmacodynamics

The body experiences complete systemic absorption of the active substance.

The level of absorption depends on the route of administration, the site of administration, and the dose of the drug. The substance is quickly hydrolyzed in the body, resulting in the formation of two main metabolites that are pharmacologically active. This diethylaminoethanol , which produces a moderate vasodilator effect, and para-aminobenzoic acid (a competitive antagonist of sulfonamide drugs, weakening their antimicrobial effect). The half-life is 30-50 s, the half-life in the neonatal period is 54-114 s. It is mainly excreted from the body through the kidneys, about 2% is excreted unchanged. It is poorly absorbed through mucous membranes.

Indications for use

The use of Novocaine is practiced for infiltration, intraosseous, epidural, conduction, spinal . It is also used for anesthesia of mucous membranes in the treatment of ENT diseases. This remedy is also used for perinephric, vagosympathetic cervical, paravertebral and circular blockade.

Novocaine IV is administered to potentiate the effect of the main drugs used for ; It is also administered intravenously to relieve pain of various origins.

Intramuscularly used to dissolve penicillin to prolong its action. It is also noted that such a remedy is an auxiliary drug for the following diseases:

• endarteritis ;
• spasms of cerebral and coronary vessels;
• arterial hypertension ;
• joint diseases of infectious and rheumatic origin.

Suppositories with Novocaine are used rectally for and, in case of spasms of intestinal smooth muscles.

Contraindications

There are some contraindications to the use of the medicine. Novocaine should not be used intravenously or intramuscularly if there is a high sensitivity to the drug, as well as to other local anesthetic esters and para-aminobenzoic acid. The drug is not prescribed to children under 12 years of age.

For local anesthesia, the drug is not used in the presence of pronounced fibrous changes in the tissues.

Novocaine is used with caution for:

• emergency surgical interventions that accompany acute blood loss ;
• conditions characterized by decreased hepatic blood flow;
• cardiovascular failure progressive;
• lack pseudocholinesterase ;
• inflammatory diseases or infection of the injection site;
• renal failure;
• under the age of 18 and after 65 years.

Side effects

During use, the following side effects may occur:

• central and peripheral NS: headache , , manifestations drowsiness , lockjaw , weakness;
• hematopoiesis: methemoglobinemia ;
• the cardiovascular system: increase or decrease in blood pressure, bradycardia , peripheral vasodilation , arrhythmias , collapse , pain in the chest;
• allergy symptoms: skin rash , itching , other anaphylactic manifestations, .

If the negative manifestations described above or other side effects develop, you should immediately inform your treating specialist.

Instructions for use of Novocaine (Method and dosage)

Novocaine 0.5% is used for infiltration anesthesia in a dose of 350-600 mg. At the beginning of surgery, adults are given a dose of no more than 0.75 g (150 ml), then, during each hour of surgery, no more than 2 g (400 ml) of solution.

Carrying out perinephric block involves the introduction of 50-80 ml of solution into the perinephric tissue.

Carrying out circular And paravertebral blockade involves the intradermal administration of 5-10 ml of solution. In the case of vagosympathetic blockade, 30-40 ml should be administered.

In order to reduce absorption and prolong the effect during local anesthesia, an additional solution is administered at the rate of 1 drop per 2-5-10 ml of solution procaine .

When used in adolescents over 12 years of age, the highest dose is 15 mg per 1 kg of weight.

Novocain suppositories, instructions for use

The use of suppositories is carried out according to an individual scheme, depending on the disease. The suppository should be inserted into the anus 3-4 cm. The insertion is carried out after a bowel movement or after an enema. As a rule, the suppository is administered 1-2 times a day. The treatment period is up to 1 month.

Overdose

In case of an overdose of the drug, the patient may experience pallor of the mucous membranes and skin, nausea , dizziness , vomit , the appearance of “cold” sweat, , increased breathing, decreased blood pressure until collapse, methemoglobinemia , . The drug affects the nervous system, which is manifested by a feeling of fear, convulsions , hallucinations , motor excitement.

In case of overdose, it is necessary to maintain adequate pulmonary ventilation and carry out symptomatic and detoxification treatment.

Interaction

Novocaine potentiates the effect on the central nervous system of drugs used for general anesthesia, sedatives and hypnotics, tranquilizers and narcotic analgesics.

When taken simultaneously anticoagulants the likelihood of bleeding increases.

If the injection site has been treated with disinfectant solutions that contain heavy metals, the risk of swelling and tenderness as a local reaction increases.

The use of Novocaine simultaneously with inhibitors monoamine oxidases increases the likelihood of a sharp decline .

Novocaine prolongs and increases the effect of muscle relaxant drugs.

The local anesthetic effect is prolonged by vasoconstrictors ( phenylephrine , epinephrine , methoxamine ).

Under the influence of procaine, the antimyasthenic effect of the drugs decreases. Therefore, additional therapy adjustments may be required. .

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

When taking cholinesterase inhibitors simultaneously, the metabolism of local anesthetic drugs decreases.

Terms of sale

You can purchase Novocaine 0.5% 5.0 with a prescription, the doctor writes a prescription in Latin.

Storage conditions

Novocain should be stored at room temperature, in a dry and dark place, out of reach of children.

Best before date

Can be stored for 3 years; cannot be used after the expiration date.

special instructions

Before using the product, you need to conduct an individual sensitivity test to the drug.

During treatment, it is necessary to monitor the functions of blood vessels, heart, central nervous system, and respiratory system.

Monoamine oxidase inhibitors should be discontinued 10 days before the local anesthetic is administered.

It is important to take into account that when using the same dose of novocaine, the toxicity of procaine is higher if the solution is more concentrated.

Since procaine penetrates poorly through intact mucous membranes, it is not effective for superficial anesthesia.

During treatment, caution is required when driving, as well as during other activities that require concentration.

Electrophoresis with Novocaine at carried out after diagnosis and under the supervision of the attending physician.

You cannot drip Novocaine solution into your eyes without consulting your doctor.

Analogues

Level 4 ATX code matches:

A number of drugs are produced that are analogues of this medicine. These are the means Novocain Bufus , Novocain-Vial , , Procaine Hydrochloride etc. The most optimal remedy is selected by the doctor, taking into account the patient’s diagnosis.

For children

The medicine is not used for children under 12 years of age. Use with caution in adolescents aged 12 to 18 years.

Novocaine during pregnancy and lactation

If there is a need to use Novocain during pregnancy, experts determine the expected benefits and possible risks. During childbirth, use with caution. If you need to use Novocain during breastfeeding, lactation must be stopped.

Reviews

Novocaine is described as a popular pain reliever. As a rule, it provides effective anesthesia and is well tolerated by patients. Users write about the successful use of Novocaine during surgical interventions, in dental practice, etc.

The effectiveness of other means with procaine – patients use solutions, drops, sprays, etc. The low cost of the medicine is noted as a positive point.

Novocaine price, where to buy

The price of Novocaine in ampoules is from 30 rubles. for 10 pcs. You can buy the product at any pharmacy.

• Online pharmacies in Russia Russia
• Online pharmacies in Ukraine Ukraine
• Online pharmacies in Kazakhstan Kazakhstan

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In this article you can read the instructions for use of the drug Novocaine. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Novocaine in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Novocaine in the presence of existing structural analogues. Use for anesthesia, blockades and dilution of drugs in adults, children, as well as during pregnancy and lactation.

Novocaine- a local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na+ channels, preventing the generation of impulses in 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. When absorbed and directly vascularly introduced into the bloodstream, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (has some ganglion-blocking effect), eliminates spasm of smooth muscles, reduces the excitability of the myocardium and motor zones of the cerebral cortex.

Eliminates descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In large doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour).

Pharmacokinetics

Subject to complete systemic absorption. The extent of absorption depends on the site and route of administration (especially vascularization and blood flow rate of administration) and the final dose (amount and concentration). It is quickly hydrolyzed by plasma and liver esterases to form two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilator effect) and para-aminobenzoic acid (is a competitive antagonist of sulfonamide drugs and can weaken their antimicrobial effect). It is excreted primarily by the kidneys in the form of metabolites; no more than 2% are excreted unchanged.

Indications

• infiltration (including intraosseous) anesthesia;
• for diluting medications and reducing the pain effect of administered medications;
• vagosympathetic cervical, perinephric, circular and paravertebral blockades.

Release forms

Solution for injection (injections in ampoules) 0.25%, 0.5% and 2%.

Rectal suppositories 100 mg.

Instructions for use and dosage

Only for procaine solution (active ingredient of the drug Novocaine) 5 mg/ml (0.5%).

For infiltration anesthesia, 350-600 mg (70-120 ml) is administered. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation - no more than 0.75 g (150 ml), then during each hour of the operation - no more than 2 g (400 ml) of solution.

With perinephric blockade (according to Vishnevsky), 50-80 ml are injected into the perinephric tissue.

For circular and paravertebral blockade, 5-10 ml is administered intradermally. For vagosympathetic blockade, 30-40 ml is administered.

To reduce absorption and prolong the effect of local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is administered - 1 drop per 2-5-10 ml of procaine solution.

The maximum dose for use in children over 12 years of age is 15 mg/kg.

Side effect

• headache;
• dizziness;
• drowsiness;
• weakness;
• increase or decrease in blood pressure;
• peripheral vasodilation;
• collapse;
• bradycardia;
• arrhythmias;
• chest pain;
• itchy skin;
• skin rash;
• other anaphylactic reactions (including anaphylactic shock);
• urticaria (on the skin and mucous membranes).

Contraindications

• hypersensitivity (including to para-aminobenzoic acid and other local anesthetic esters);
• for anesthesia using the creeping infiltrate method - pronounced fibrous changes in the tissues.

Use during pregnancy and breastfeeding

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

If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided.

special instructions

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

Monoamine oxidase inhibitors should be discontinued 10 days before local anesthetic administration.

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

Impact on the ability to drive vehicles and machinery

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

Drug interactions

Strengthens the inhibitory effect on the central nervous system of drugs for general anesthesia, sleeping pills, sedatives, narcotic analgesics and tranquilizers.

Anticoagulants (ardeparin sodium, dalteparin sodium, danaparoid sodium, enoxaparin sodium, heparin sodium, 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 (furazolidone, procarbazine, selegiline) increases the risk of developing a pronounced decrease in blood pressure. Strengthens and prolongs the effect of muscle relaxants. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.

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

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

The metabolite of procaine (para-aminobenzoic acid) is an antagonist of sulfonamides.

Analogues of the drug Novocain

Structural analogues of the active substance:

• Novocaine Bufus;
• Novocain-Vial;
• Novocaine base;
• Novocaine solution for injection;
• Procaine hydrochloride.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Novocaine- a synthetic drug that belongs to the group of local anesthetics.
Novocaine has a local analgesic effect, after absorption into the blood - anti-inflammatory, analgesic, antihistamine, desensitizing and antitoxic effect, reduces spasms of smooth muscles, reduces the excitability of the heart muscle.
Novocaine differs from cocaine in having less toxicity (7-10 times) and less anesthetic power. The drug does not have a local vasoconstrictor effect.
Novocaine- beta-diethylaminoethyl ester of para-aminobenzoic acid hydrochloride is a colorless, odorless, crystalline powder, bitter taste, highly soluble in water and ethyl alcohol.
Clinical studies show that novocaine, when introduced into the body, also has a resorptive effect, mainly on the functions of the nervous system.
Novocaine is capable of suppressing many interoceptive reflexes (from the circulatory, respiratory, intestinal, bladder) due to blockade of the transmission of excitation in the central links of the corresponding reflex arcs. Novocaine also has an inhibitory effect on the reticular formation of the midbrain and has a ganglion-blocking effect.
In the body, novocaine undergoes enzymatic hydrolysis, breaking down into para-aminobenzoic acid (PABA) and diethylaminoethanol, so the duration of its resorptive effect is short.
Novocaine solutions can be sterilized without decomposition.

Indications for use

Novocaine used for local anesthesia, for infiltration anesthesia, novocaine vagosympathetic and perinephric blockade, anesthesia of Zakharyin-Ged zones, for pain relief during childbirth, for anesthesia in dental practice, for conduction and sacral anesthesia, for anesthesia using the method of tissue infiltration, for epidural and spinal anesthesia , to potentiate the action of basic narcotic drugs during general anesthesia.

Mode of application

For infiltration anesthesia, higher doses Novocaine at the beginning of the operation, no more than 500 ml of a 0.25% solution or 150 ml of a 0.5% solution, then for every hour up to 1000 ml of a 0.25% solution or 400 ml of a 0.5% solution for every hour. For conduction anesthesia, 1-2% solutions are used, for epidural (introduction of a local anesthetic into the epidural space of the spinal canal to anesthetize areas innervated by the spinal nerves) - 20-25 ml of a 2% solution, for spinal anesthesia - 2-3 ml of a 5% solution, for perinephric blockade - 50-80 ml of 0.5% solution, for vagosympathetic blockade - 30-100 ml of 0.25% solution, as a local anesthetic and antispasmodic (relieving spasms) drug is used in suppositories of 0.1 g.

Side effects

Side effects from using the drug Novocaine may occur from the central and peripheral nervous system: headache, dizziness, drowsiness, weakness, trismus.
From the cardiovascular system: increased or decreased blood pressure, peripheral vasodilation, collapse, bradycardia, arrhythmias, chest pain.
From the hematopoietic organs: methemoglobinemia.
Allergic reactions: skin itching, skin rash, other anaphylactic reactions (including anaphylactic shock), urticaria (on the skin and mucous membranes). If, while using the drug, any of the side effects indicated in the instructions appear or they get worse, or you notice any other side effects not listed in the instructions, inform your doctor.

Contraindications

:
Contraindications to the use of the drug Novocaine are: hypersensitivity (including to para-aminobenzoic acid and other local anesthetic esters). Children's age up to 12 years.
For anesthesia using the creeping infiltrate method - pronounced fibrous changes in the tissues.
Carefully. Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, chronic heart failure, liver disease); progression of cardiovascular failure (usually due to the development of heart block and shock); inflammatory diseases or infection of the injection site; pseudocholinesterase deficiency; renal failure; children's age from 12 to 18 years, old age (over 65 years); with caution in seriously ill and/or debilitated patients; during pregnancy and during childbirth.

Pregnancy

:
If necessary, prescribe the drug Novocaine During pregnancy, the expected benefit to the mother should be weighed against the potential risk to the fetus. With caution during childbirth. If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided.

Interaction with other drugs

Novocaine enhances the inhibitory effect on the central nervous system of drugs for general anesthesia, sleeping pills, sedatives, narcotic analgesics and tranquilizers.
Anticoagulants (ardeparin sodium, dalteparin sodium, danaparoid sodium, enoxaparin sodium, heparin sodium, 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 (furazolidone, procarbazine, selegiline) increases the risk of developing a pronounced decrease in blood pressure. Strengthens and prolongs the effect of muscle relaxants. 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 of the treatment of myasthenia gravis. Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecaria bromide, ecothiopathy iodide, thiotepa) reduce the metabolism of local anesthetic drugs. The metabolite of procaine (para-aminobenzoic acid) is an antagonist of sulfonamides.

Overdose

:
Symptoms of drug overdose Novocaine: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, “cold” sweat, increased breathing, tachycardia, decreased blood pressure, up to collapse, apnea, methemoglobinemia. The effect on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, and motor agitation.
Treatment: maintaining adequate pulmonary ventilation, detoxification and symptomatic therapy.

Storage conditions

List B. Powder - in a well-closed dark container, ampoules and candles - in a cool place, protected from light.

Release form

Powder; 0.25% and 0.5% solutions in ampoules of 1; 2; 5; 10 and 20 ml and 1% and 2% solutions, 1; 2; 5 and 10 ml; 0.25% and 0.5% sterile solutions of novocaine in bottles of 200 and 400 ml; 5% and 10% ointment; suppositories containing 0.1 g of novocaine.

Compound

:
Procaine hydrochloride (novocaine) - 2.5 g or 5 g
Hydrochloric acid solution 0.1 M - to pH 3.8 - 4.5
Water for injections - up to 1 l

Additionally

:
Novocaine is part of the combination drugs menovazin, novocindol, syntomycin (1%) liniment with novocaine, solutan and efatin.

Main settings

Name:	NOVOCAINE
ATX code:	N01BA02 -