Indications: infiltration, regional nerve block and spinal anesthesia and regional intravenous analgesia; dental anesthesia.

Cautions: severe or untreated hypertension, severe heart disease; concomitant drugs which cause methaemoglobinaemia; reduce dose in elderly or debilitated; hepatic impairment; renal impairment;

Contra-indications: anaemia or congenital or acquired methaemoglobinaemia.

Side Effects: ocular toxicity (including blindness) reported with excessively high strengths used for ophthalmic procedures; in high doses, methemoglobinaemia may occur which can be treated by intravenous methylene blue 1% injection using a dose of 75-100 mg.

Dose: adjusted according to the site of operation and response of patient, to a max of 400 mg used alone, or 600 mg if used with adrenaline (epinephrine) or felypressin.