The safe use of prilocaine has not been established with respect to possible adverse effects upon fetal development. Careful consideration should be given to this fact before administering this drug in pregnancy. The safety and effectiveness of prilocaine depends on proper dosage, correct technique, adequate precautions, and readiness for emergencies. The lowest dose that results in effective anesthesia should be used to avoid high plasma levels and serious undesirable adverse effects. Injection of repeated doses of prilocaine may cause significant increases in blood levels with each repeated dose due to slow accumulation of the drug or its metabolites.
Tolerance varies with the status of the patient.
Debilitated, elderly patients, acutely ill patients, and children should be given reduced doses commensurate with their age and physical status. Prilocaine should be used with caution in the presence of diseases which may adversely affect the patient's cardiovascular system. The drug should be used with caution in persons with known drug sensitivities. Serious cardiac arrhythmias may occur if preparations containing a vasoconstrictor are employed in patients during or following the administration of chloroform, halothane, cyclopropane, trichloroethylene, or other related agents. Care should be taken to avoid intravascular injection, and the rate of injection should be slow in an attempt to avoid systemic reactions.