Drug interactions with local anaesthetic preparations used by primary care dental practitioners.
A number of drug interactions that may potentially occur with local anaesthetic preparations are listed in the British National Formulary (BNF) and Summaries of Product Characteristics (SmPC). Many are theoretical or are associated with higher doses of local anaesthetic preparations than those used for dental procedures in primary care. Reports of serious interactions between medicines and local anaesthetic preparations occurring in dental practice are exceedingly rare. Practitioners can minimize the risk of interactions by using an aspirating syringe, which reduces the likelihood of the local anaesthetic being administered directly into a blood vessel. Adhering to the dosage recommendations in the product literature will also minimize the risk. This paper will explore the clinical significance of potential interactions between dental local anaesthetic preparations used in primary care and other medicines as listed in the BNF and SmPCs.These are summarized in Tables 1 and 2.


CONCLUSIONS
A knowledge of potential drug interactions with local anaesthetic preparations is essential for clinicians.
North West Medicines Information Centre and National Dental Medicines Information Service, Pharmacy Practice Unit, 70 Pembroke Place, Liverpool L69 3GF, UK.
Simone
S
Henderson
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D000998:Antiviral Agents / Q000009:adverse effects; D003729:Dental Care; D004232:Diuretics / Q000009:adverse effects; D018491:Dopamine Agonists / Q000009:adverse effects; D004347:Drug Interactions; D006801:Humans; D007267:Injections / Q000009:adverse effects; D009407:Nerve Block / Q000009:adverse effects; D011320:Primary Health Care; D014662:Vasoconstrictor Agents / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D000779:Anesthetics, Local; D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D000998:Antiviral Agents; D004232:Diuretics; D018491:Dopamine Agonists; D014662:Vasoconstrictor Agents