Articaine Hydrochloride + epinephrine is indicated for local, infiltrative, or conductive anesthesia in both simple and complex dental procedures.

Dental Surgery

Infiltrative Dental Anesthesia

For dental injection by submucosal infiltration and/or nerve block:

• For infiltration: 0.5 mL-2.5 mL (20 mg-100 mg articaine HCl) 
• 0.5 mL-3.4 mL (20 mg-136 mg articaine HCl) 
• For oral surgery: 1 ml-5.1 mL (40 mg-204 mg articaine HCl)
• For most routine dental procedures, Articaine containing epinephrine 1:200,000 is preferred.  However, when more pronounced homeostasis or improved visualization of the surgical field are required, Articaine containing epinephrine 1:100,000 may be used. 
• Dosages should be reduced in pediatric patients, elderly patients, and patients with cardiac or liver disease.

The most common adverse reactions are headache and pain.

Headache

Pain at injection site

• Accidental Intravascular Injection: May be associated with convulsions followed by coma and respiratory arrest.  Resuscitative equipment, oxygen and other resuscitative drugs should be available. 
• Systemic Toxicity
• Vasoconstrictor Toxicity: Local anesthetic solutions like Articaine that contain a vasoconstrictor should be used cautiously, especially in patients with impaired cardiovascular function or vascular disease.
• Articaine, like other local anesthetic solutions containing a vasoconstrictor, can cause methemoglobinemia, particularly in conjunction with methemoglobin-inducing agents.