Septocaine (Articaine) with 1:100,000/1:200,000 Epinephrine: Pregnancy Category C Concentration/carpule: 68mg in 1.7mL single use carpule Lasts: 45–75 minutes Recommended dose: 3.2mg/lb Healthy adult: Max. 6 carpules Has 1.5 times Lidocaine potency. Action occurs within 1–3 minutes. Avoid use in all conditions listed under Citanest Forte.
Septocaine (Articaine) is unique among amide-type local anesthetics in the way that it is metabolized. Septocaine is actually a hybrid of both an amide and an ester class anesthetic because of the presence of both an amide and an ester intermediate chain in its chemical composition. Biotransformation of 90–95% of septocaine begins immediately upon the drug entering the blood stream where the plasma carboxyesterase enzymes initiate the metabolic breakdown process via hydrolysis of the ester chain to its primary metabolite, articainic acid, which is inactive. The remainder of septocaine (5–10%) is metabolized in the liver by the hepatic microsomal enzymes. Amides have a high rate of first pass metabolism as the local anesthetic (LA) passes through the liver. Slow absorption from tissue is less likely to result in toxicity. If toxicity occurs, it often results from accidental parenteral injection or due to LA overdose.