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Procaine

Local Anesthetic · Anesthesia

Local AnestheticAnesthesia
CDSCO approvedSchedule H
EXCRETION
not curated
INTERACTIONS
2 major
SEVERE in our sources
PREGNANCY
not curated
Top interactions
  • Nitrous AcidSevereDatabaseDDInter
  • PrilocaineSevereDatabaseDDInter

Mechanism

Procaine is an ester-type local anesthetic that blocks voltage-gated sodium channels in nerve fibers, preventing action potential generation and propagation. As an ester, it is rapidly hydrolyzed by plasma cholinesterases to para-aminobenzoic acid (PABA) and diethylaminoethanol, giving it the shortest duration of action among injectable local anesthetics. The PABA metabolite can antagonize the antibacterial activity of sulfonamides and is responsible for the higher incidence of allergic reactions compared to amide-type anesthetics.

Indications

Ingredient of some long-acting intramuscular formulations of penicillin

Dosing

Adult
range of doses that are generally regarded as being suitable for adults. Complementary and alternative medicine Prescribing unlicensed medicines An increasing amount of information on complementary and alternative medicine is becoming available.…

Pharmacokinetics

Onset
Slow (may take 15 min for nerve block)
Duration
Short (20- to 45-min) duration of action in mixed peripheral nerves
Protein binding
Negligibly bound to plasma proteins.
Metabolism
Hydrolyzed and inactivated primarily by plasma esterase (plasma cholinesterase). Liver also participates in hydrolysis.

Side effects

Serious
  • CNS stimulation (less potent than cocaine)
  • Hypersensitivity reactions (higher risk than amide-linked LAs)

Drug interactions

Nitrous Acid
Severe
Database

Clinical effect not specified

Source: DDInter

Prilocaine
Severe
Database

Clinical effect not specified

Source: DDInter

10 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Local Anesthetic drugs

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, BNF·Verified: 2026-05-13 · House clinical team