Prilocaine: What It Is, How It's Used, and What You Need to Know

When you get a dental filling or a minor skin procedure, you might not think about the numbing agent used—but prilocaine, a fast-acting local anesthetic commonly used in medical and dental settings. Also known as Citanest, it works by blocking nerve signals in your body to prevent pain without making you unconscious. Unlike some other anesthetics, prilocaine is often chosen because it has a lower risk of causing allergic reactions and doesn’t usually lead to the same level of heart-related side effects as lidocaine.

Prilocaine is frequently mixed with epinephrine to make the numbing effect last longer and reduce bleeding at the injection site. It’s a top pick in dentistry for root canals, extractions, and gum work. But it’s also used in skin procedures like mole removal or minor surgeries where precision matters. One key difference from lidocaine is that prilocaine is less likely to cause methemoglobinemia—a rare condition where oxygen delivery to tissues gets disrupted—but it’s still something doctors watch for, especially in kids or people with certain blood disorders. People who’ve had reactions to other anesthetics often tolerate prilocaine better, which makes it a go-to alternative when other options aren’t suitable.

It’s not just about the drug itself—it’s about how it fits into the bigger picture of pain management. For example, if you’ve ever had a numbing shot that didn’t last long enough, or felt tingling after a dental visit, that’s often tied to how the anesthetic was formulated or how your body metabolizes it. Prilocaine breaks down quickly in the liver, which is why it’s sometimes preferred for shorter procedures or in patients with slower metabolism. It’s also used in topical creams for things like laser hair removal or IV insertions, especially when you need a gentle, non-irritating option.

What you’ll find in the articles below are real-world insights into how prilocaine compares to other anesthetics like lidocaine and bupivacaine, what side effects actually matter, and why some patients respond differently. You’ll also see how it’s used in combination with other drugs, what doctors look out for when prescribing it, and how patient safety has shaped its modern use. This isn’t just a list of facts—it’s a practical guide to understanding why prilocaine is in your doctor’s toolkit, and what it means for you.