Comparative Pharmacology
Head-to-head clinical analysis: POLOCAINE W LEVONORDEFRIN versus RAVOCAINE AND NOVOCAIN W NEO COBEFRIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: POLOCAINE W LEVONORDEFRIN versus RAVOCAINE AND NOVOCAIN W NEO COBEFRIN.
POLOCAINE W/ LEVONORDEFRIN vs RAVOCAINE AND NOVOCAIN W/ NEO-COBEFRIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Polocaine (mepivacaine) is an amide local anesthetic that blocks sodium ion channels in nerve cell membranes, inhibiting the initiation and conduction of nerve impulses. Levonordefrin is a vasoconstrictor that acts as an alpha-adrenergic agonist, causing local vasoconstriction to reduce systemic absorption of mepivacaine and prolong duration of action.
Ravocaine (propoxycaine) and Novocain (procaine) are ester-type local anesthetics that block voltage-gated sodium channels, inhibiting nerve impulse conduction. Neo-Cobefrin (levonordefrin) is a vasoconstrictor that acts on alpha-adrenergic receptors, causing local vasoconstriction to prolong anesthesia.
Dental local anesthesia: 1:100,000 epinephrine equivalent. For Polocaine (mepivacaine) 2% with levonordefrin 1:20,000, typical adult dose: 1-3 mL infiltrations or 2-4 mL nerve blocks; maximum 6.8 mg/kg (mepivacaine) or about 5.8 mL of 2% solution for a 70 kg adult. Maximum per session: 20 mL of 2% mepivacaine.
Local infiltration or nerve block: 1-7 mL of 2% solution (20 mg/mL lidocaine equivalent) with epinephrine 1:100,000, maximum dose 7 mg/kg (actual lidocaine) or 500 mg per procedure, not to exceed 3.5 mg/kg plain or 7 mg/kg with epinephrine in adults.
None Documented
None Documented
Terminal elimination half-life of prilocaine is approximately 1.5 hours (range 1-2 hours); clinically, this correlates with duration of anesthesia for infiltration and nerve block procedures.
Procaine: 40–84 seconds (plasma ester hydrolysis); 2-(diethylamino)ethanol metabolite: 2–4 hours; Levonordefrin: ~2 hours
Renal excretion of unchanged drug and metabolites accounts for >90% of elimination; <2% excreted unchanged in urine; major metabolites are glucuronide and sulfate conjugates excreted renally; biliary excretion is minor.
Renal excretion of metabolites (>90% as para-aminobenzoic acid and other conjugates); <10% unchanged
Category C
Category C
Local Anesthetic Combination
Local Anesthetic Combination