Comparative Pharmacology
Head-to-head clinical analysis: RAVOCAINE AND NOVOCAIN W LEVOPHED versus RAVOCAINE AND NOVOCAIN W NEO COBEFRIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RAVOCAINE AND NOVOCAIN W LEVOPHED versus RAVOCAINE AND NOVOCAIN W NEO COBEFRIN.
RAVOCAINE AND NOVOCAIN W/ LEVOPHED vs RAVOCAINE AND NOVOCAIN W/ NEO-COBEFRIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Stabilizes neuronal membranes by blocking sodium channels, inhibiting initiation and conduction of nerve impulses. Levophed (norepinephrine) is an alpha-adrenergic agonist causing vasoconstriction.
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 infiltration: 1-2 mL of 2% lidocaine with 1:100,000 epinephrine (max 7 mg/kg or 500 mg total). For NOVOCAIN (procaine) with LEVOPHED (levonordefrin): 1-2 mL of 2% procaine with 1:20,000 levonordefrin, max 600 mg procaine per session.
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
Procaine: terminal elimination half-life approximately 40 seconds (rapid plasma hydrolysis); levonordefrin: elimination half-life about 5-10 minutes, clinically brief vasoconstrictor effect.
Procaine: 40–84 seconds (plasma ester hydrolysis); 2-(diethylamino)ethanol metabolite: 2–4 hours; Levonordefrin: ~2 hours
Renal excretion of unchanged drug and metabolites: procaine <2% unchanged, >80% as para-aminobenzoic acid (PABA) and diethylaminoethanol (DEAE); levonordefrin (Levophed) undergoes hepatic metabolism and renal excretion of metabolites, <5% unchanged.
Renal excretion of metabolites (>90% as para-aminobenzoic acid and other conjugates); <10% unchanged
Category C
Category C
Local Anesthetic Combination
Local Anesthetic Combination