What drugs contain novocaine. Rules of application, individual feature, doctor's appointment. Use during pregnancy and lactation

All about the terms and conditions of storage of novocaine. The best place for a home first aid kit. How long can you use the drug from an open ampoule. Description of the expired solution and the consequences of its use. Storage conditions according to legislative norms in pharmacies and clinics.

Novocain can be found in almost every home first aid kit, this drug is time-tested and easy to use. In order for anesthesia with this remedy not to harm health, it is necessary to carefully consider the terms and conditions of its storage.

expiration date of novocaine

Like all drugs, novocaine has its own expiration date. Manufacturers of this product indicate on the packaging that it can be used within 3 years from the date of production.

Particular attention should be paid to the storage location of novocaine. Often, consumers prefer to store all medicines in the refrigerator. Novocain can be stored in the mode not higher than +25 degrees, so you can safely leave it in your home first aid kit at room temperature. This method of storage will not affect the shelf life of the drug.

In the case when the house is very hot, you can put novocaine in the refrigerator. The temperature does not drop below +3 - +5 degrees, and will not harm the quality of the medicine. The shelf life with this arrangement of the drug will not change in any way.

Do not be afraid to use novocaine if by the time of its use the expiration date has not expired, but has come to an end. For 5-10 days before the specified date, the drug is fully suitable for use.

The long shelf life of novocaine, subject to all conditions, applies only to unopened ampoules.

In the case of using the drug, the medicine remaining in the ampoule can be used during the day.

Over time, the following physical and chemical processes occur with the drug:

• oxidation under the influence of oxygen;
• hydrolysis (splitting into various components, including poisonous ones);
• reproduction of microorganisms;
• interaction with container glass.

In an open ampoule, these processes proceed quickly. Sealed packaging protects the drug during the specified expiration date.

An expired drug can be identified not only by the date on the package, but also by its appearance:

• Yellow color indicates oxidation and long exposure of the drug to the sun.
• Muddy sediment is left by multiplied microorganisms in the course of their life.
• Sequins or a film on the walls of the ampoule are the result of leaching (the drug reacts with glass).

A spoiled drug can not always be determined by eye. Often, signs of active reactions are not noticeable.

IMPORTANT: Do not use an expired medicine, even if there are no visible signs of deterioration!

In the process of hydrolysis, novocaine releases toxic substances, the presence of microflora in the preparation can cause human disease. The use of expired novocaine, at best, will exclude its analgesic properties, at worst, it will cause serious harm to health.

How to store novocaine

To avoid negative consequences for the body from the use of novocaine, you need to take care of the conditions for its storage.

It's not hard to do this at home.

It is better to store the drug in a medicine cabinet in a dark and dry place.

When choosing a storage location, novocaine should be protected from the following factors:

• heat;
• light and direct sunlight;
• high humidity.

An open ampoule of novocaine can be stored for 24 hours.

At the same time, it is necessary to ensure the most sterile conditions, since the physico-chemical processes in the opened vial pass very quickly:

• cover the cut of the ampoule with a sterile cotton swab moistened with alcohol;
• put the medicine in a dark, dry, cool place.

After a day, the drug can not be used.

Compresses from a solution of demixide and novocaine are best used freshly prepared. It is not recommended to store a pre-diluted composition, as it loses its healing properties.

Ceftriaxone diluted with novocaine can be reused during the day, if the conditions for preparing and storing the solution are observed:

• Remove the metal part of the cork from the ceftriaxone flacon.
• Draw novocaine into a disposable syringe.
• Puncture the rubber cap of ceftriaxone with a needle, inject novocaine.
• Shake the solution and draw the right amount into the syringe.
• Cover the puncture site with a sterile cotton swab moistened with alcohol.
• Store in the refrigerator for no more than a day.
• With the next set of medication, wipe the puncture site with alcohol, and insert the needle.

Storage conditions for novocaine in pharmacies and clinics

According to the classification accepted in medicine, novocaine belongs to drugs of group B (strong). For institutions associated with the use of such drugs, there are special requirements for their storage:

• In pharmacies and medical institutions, medicines from list B are placed in separate lockable cabinets.
• In laboratories, novocaine can be stored together with non-potent drugs.
• In pharmacy warehouses and pharmaceutical enterprises, all potent drugs are located in separate rooms.

All institutions should follow the principle of storage of drugs in accordance with the state of aggregation, scope, avoid finding nearby products that are consonant in name. Novocaine can coexist with liquid medicines for subcutaneous or intramuscular administration.

At least 1 time per month, it is necessary to monitor external changes in the medicinal product, the state of the container.

Institutions storing novocaine as a group B drug must ensure compliance with the requirements for the premises and the availability of special equipment:

• The room must be equipped with air conditioning, vents or transoms to maintain the temperature no higher than 25 degrees and air humidity no more than 40%.
• Temperature control equipment.
• Racks (cabinets) for storage must be marked, have rack cards. It is allowed to use an electronic data processing system instead of rack cards. When using an electronic data processing system, identification using codes is allowed.
• Pallets are required for storage areas to avoid placing the drug on the floor.

Storage of novocaine and other medicines is regulated at the legislative level:

• Order of the Ministry of Health and Social Development of the Russian Federation dated August 23, 2010 No. 706n "On Approval of the Rules for the Storage of Medicines"
• Order of the Ministry of Health of the Russian Federation of August 31, 2016 No. 646n “On Approval of the Rules for Good Practice in the Storage and Transportation of Medicinal Products for Medical Use”

For the transportation of medicines, including novocaine, vehicles and equipment are used to ensure their safety. Medicines are transported in a shipping container that does not harm the integrity of the package and provides reliable protection against environmental factors.

It is important to ensure not only the safety of the drug, but also the possibility of confirming its quality. To do this, at the request of the recipient, information must be provided on compliance with the temperature regime during transportation.

Scope of novocaine

Novocain is a drug of domestic production. Produced in glass ampoules of 2, 5, 10 ml. in a carton box with a leaflet.

Novocaine is used for local anesthesia. When introduced into tissues, it prevents the cells from conducting pain impulses. The analgesic effect does not last long, about one hour. therefore, novocaine is often used to dilute various drugs administered intramuscularly.

In addition, they are used for pain relief during childbirth, in dentistry, for epidural and spinal anesthesia.

Novocain as a potent substance is dispensed by prescription.

It is not difficult to comply with all requirements for the storage of novocaine. It is important to always monitor the expiration date of the drug, do not use expired or spoiled medicine.

Novocaine is used as a local anesthetic and is included in the list of the most important medical pharmaceuticals. This drug has an average anesthetic effect, reduces the conductivity of the motor areas of the brain, myocardium, relieves spasms of smooth muscles. When the drug is administered intravenously, it is able to lower blood pressure, is taken with arrhythmias, and removes from shock. In case of an overdose, Novocain disrupts muscle conduction and causes convulsions. Intramuscularly, the drug is effective for disorders of the nervous system in the elderly.

The drug is produced in the form of a solution for injections in ampoules of rectal suppositories, Novocain5 ointment.

Indications

The medication is prescribed for the following types of anesthesia:

• retrobulbar;
• epidural conduction;
• spinal terminal;
• infiltration.

And also for vagosympathetic or pararenal neck blockade. Rectal suppositories are prescribed for the treatment of anal fissures and hemorrhoids. The ointment is effective for relieving itching in dermatosis, neurodermatitis, eczema.

Instructions for use

1. Infiltration anesthesia - solution 0.25-0.5% - 350-600 mg.
2. Tight creeping infiltration according to Vishnevsky - a solution of 0.125-0.25%.
3. Conduction anesthesia - a solution of 1-2% - is injected up to 25 ml.
4. Epidural anesthesia - solution 2% 20-25ml.
5. Spinal anesthesia - solution Novocain 5% 2 or 3 ml.
6. Otorhinolaryngology. Local anesthesia - solution 10-20%.
7. Electrophoresis with novocaine - solution 10%.
8. Blockade according to Vishnevsky - solution 0.25% up to 100-150 ml or 0.5% up to 50-80 ml.
9. Vagosympathetic blockade - solution 0.25% up to 100 ml.
10. Children - no more than 15 mg per kg of body weight.
11. Suppositories are administered rectally after defecation or cleansing by means of an enema 1-2 times a day.
12. The ointment is applied to areas of the skin prone to disease up to two times a day.

Side effects

After taking Novocain, the following may appear:

• headache;
• convulsions;
• drowsiness;
• dizziness;
• loss of consciousness;
• weaknesses;
• tremor;
• paresthesia;
• pain in the sternum;
• respiratory paralysis;
• bradycardia;
• paralysis of the legs;
• collapse;
• pressure surges;
• arrhythmias;
• involuntary bowel movements;
• skin rashes;
• vomiting;
• hypothermia;
• impotence.

Overdose manifests itself:

• pale skin and mucous membranes;
• nausea;
• dizziness;
• rapid breathing;
• hallucinations;
• motor excitement;
• convulsions;
• apnea;
• vomiting.

Eliminate the consequences by administering short-acting general anesthesia drugs intravenously, maintain ventilation of the lungs artificially with the help of oxygen inhalation. If intoxication is severe enough, detoxification and symptomatic treatment is carried out.

When using novocaine ointment, local allergic manifestations may develop.

Contraindications

When anesthetizing according to the method of creeping infiltrate, the existing fibrotic changes are a contraindication. With subarachnoid anesthesia, the following contraindications are septicemia, shock, hypotension, bleeding.

The instructions for the drug warns to use it with caution during operations when the patient has acute blood loss, as well as in renal failure and progressive cardiovascular insufficiency. Care should be taken to prescribe the drug in the presence of inflammatory diseases and in conditions accompanied by a violation of the blood supply to the liver. Enhanced medical supervision requires the use of the drug by the elderly over 65 years of age and children under 18 years of age, as well as by weakened, severe patients during pregnancy or during childbirth.

Interaction with certain drugs

The combination of Novocain with anticoagulants increases the risk of bleeding. Anticoagulants: danaparoid, warfarin, ardeparin, dalteparin, enoxaparin, heparin. If you take the drug simultaneously with trimetafan, mecamylamine, guanadrel, guanethidine, bradycardia and pressure reduction may develop. The following drugs lower blood pressure in combination with Novocain: furazolidone, procarbazine, selegiline. The local anesthetic effect of Novocain is increased by epinephrine, methoxamine, phenylephrine.

It is important to remind readers that this drug, like other medicinal pharmaceutical preparations, as well as the appropriate treatment for them, is prescribed only by a qualified doctor according to indications. Self-medication can greatly harm not only health, but also life.

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Tradename: Novocaine

International non-proprietary name:

Pharmacodynamics
A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of other modalities. With absorption and direct intravascular administration, it reduces the excitability of peripheral cholinergic receptors, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. When administered intravenously, it has an analgesic, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automatism and conductivity), in large doses it can disrupt neuromuscular conduction. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour).

Pharmacokinetics
Undergoes complete systemic absorption. The degree of absorption depends on the site (the degree of vascularization and the rate of blood flow in the injection site), the route of administration and the total dosage. It is rapidly hydrolyzed by plasma and liver esterases with the formation of 2 main pharmacologically active metabolites: diethylaminoethonol (has a moderate vasodilating effect) and para-aminobenzoic acid (it is a competitive antagonist of sulfanilamide chemotherapy drugs and can weaken their antimicrobial effect). The half-life is 30-50 seconds, in neonotal period -54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications for use

• infiltration, conduction and epidural anesthesia;
• vagosympathetic cervical, pararenal, circular and paravertebral blockades.

Contraindications
Hypersensitivity (including to para-aminobenzoic acid and other local anesthetics), children under 12 years of age.
For anesthesia by the creeping infiltrate method: pronounced fibrotic changes in the tissues. For epidural anesthesia: atrioventricular block, marked decrease in blood pressure, shock, infection of the lumbar puncture site, septicemia.

Carefully
Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, in chronic heart failure, liver diseases); pseudocholinesterase deficiency; kidney failure; children's age from 12 to 18 years and in elderly patients (over 65 years); weakened patients; pregnancy and childbirth.

Dosage and administration
For infiltration anesthesia: use 0.25-0.5% solutions; for anesthesia according to the Vishnevsky method (tight creeping infiltration) - 0.125-0.25% solutions. To reduce absorption and prolong the action during local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is administered - 1 drop per 2-5-10 ml of procaine solution. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation - no more than 500 ml for a 0.25% solution or 150 ml for a 0.5% solution. In the future, during each hour of the operation - no more than 1000 ml for a 0.25% solution or 400 ml for a 0.5% solution.
The maximum dose for use in children over 12 years old is 15 mg / kg.
For conduction anesthesia: 1-2% solutions (up to 25 ml); for epidural - 2% solution (20-25 ml). With pararenal blockade (according to A.V. Vishnevsky), 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution are injected into the perirenal tissue, and with vagosympathetic blockade - 30-100 ml of a 0.25% solution.
For circular or paravertebral blockades, a 0.25% - 0.5% solution is injected intradermally.

Side effect
Headache, dizziness, drowsiness, weakness, cauda equina syndrome, convulsions, increased or decreased blood pressure, collapse, peripheral vasodilation, bradycardia, arrhythmia, chest pain, involuntary urination or defecation, impotence, methemoglobinemia, allergic reactions (up to anaphylactic shock).
From the digestive system: nausea, vomiting.
Other: return of pain, persistent anesthesia, hypothermia, with anesthesia in dentistry: numbness and paresthesia of the lips and tongue, prolongation of anesthesia.

Overdose
Symptoms: pale skin and mucous membranes. Dizziness, nausea, vomiting, "cold" sweat, increased severity of side effects. Treatment: maintaining adequate pulmonary ventilation, detoxification and sympathetic therapy.

Interaction
Enhances the inhibitory effect on the central nervous system of general anesthesia, hypnotics and sedatives, narcotic analgesics and tranquilizers.
When using local anesthetic drugs for spinal and epidural anesthesia with guanadrel, guanethidine, mecamylamine, trimethaphan, the risk of a sharp decrease in blood pressure and bradycardia increases.
Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) increase the risk of bleeding. When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.
Use with MAO inhibitors (furazolidone, procarbazine, selegeline) increases the risk of hypotension.
Strengthen and lengthen the action of muscle relaxants.
When prescribing procaine together with narcotic analgesics, an additive effect is noted, which is used during spinal and epidural anesthesia, while respiratory depression is enhanced.
Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.
Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.
Cholinesterase inhibitors (anti-myasthenic JIC, cyclophosphamide, demecarine, ecothiophate, thiotepa) reduce the metabolism of procaine.
The procaine metabolite (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions
Patients require control of the functions of the cardiovascular, respiratory and central nervous systems. It is necessary to cancel MAO inhibitors 10 days before the introduction of a local anesthetic. During the period of treatment, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions. Before use, mandatory testing for individual sensitivity to the drug. It should be borne in mind that when conducting local anesthesia using the same total dose, the toxicity of novocaine is the higher, the more concentrated the solution is used. Not absorbed from mucous membranes; does not provide superficial anesthesia when applied to the skin.

Release form:

Storage conditions
List B. In a dark place.

Best before date
3 years. Do not use after the expiry date stated on the packaging.

Terms of dispensing from pharmacies
Released by prescription.

Manufacturer / Organization accepting claims:
FSUE "Armavir Biological Factory"
352212. Russia, Krasnodar Territory, Novokubansky district, Progress settlement, st. Mechnikova, 11

Clear, colorless or slightly yellowish liquid.

Indications for use

For conduction and infiltration anesthesia.

Contraindications

- hypersensitivity to the components of the drug (including PABA and other local anesthetics - esters);

myasthenia;

Treatment with sulfonamides;

Children's age up to 15 years.

Do not use for spinal and epidural anesthesia.

Carefully

In violation of the function of the cardiovascular system;

With heart failure.

Dosage and administration

Individual, depending on the type of anesthesia, route of administration, indications. It is used in adolescents over 15 years of age and adults, the dose is calculated on the average body weight. Basically, when used, the minimum doses of the drug for conduction anesthesia are sufficient.

For conduction anesthesia - up to 25 ml of solution.

For infiltration anesthesia - at a dose of 25 ml of the drug diluted with 25 - 50 ml of a solution of 9 g / l of sodium chloride with layer-by-layer impregnation of tissues.

In patients with occlusive vascular lesions, arteriosclerosis or impaired innervation, diabetes mellitus, the dose should be reduced by one third. In case of impaired liver or kidney function, especially with repeated use of the drug, it is recommended to reduce the dose.

Children: there is no experience with the use of this drug in children. The maximum dose for use in children is up to 15 mg / kg.

Repeated use of the drug may cause the development of tachyphylaxis (rapid development of tolerance to the drug) or a reversible loss of efficacy. The drug should be used immediately after opening the ampoule. Unused balances are removed.

Side effect

From the side of the cardiovascular system: when using high doses of the drug, blood pressure slightly increases. Novocaine can lead to changes in the ECG (terminal sections of the gastric complex).

A drop in blood pressure is the first sign of a drug overdose.

From the side of the central and peripheral nervous system: paresthesia in the mouth, anxiety, delirium, clonic-tonic convulsions.

Allergic reactions: urticaria, angioedema, bronchospasm, respiratory syndrome is described as a reaction of the circulatory system (rarely less than 0.01% of cases). Local allergic and pseudo-allergic reactions in the form of contact dermatitis with erythema, itching on contact with the solution up to the formation of bubbles.

Overdose

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, "cold" sweat, paresthesia around the mouth, numbness of the tongue, increased respiration, tachycardia, lowering blood pressure, up to collapse, apnea, methemoglobinemia. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation.

Treatment: maintaining adequate pulmonary ventilation with oxygen inhalation, intravenous administration of short-acting drugs for general anesthesia, in severe cases, detoxification and symptomatic therapy.

Interaction with other drugs

The following drug interactions are known:

Anticoagulants increase the risk of bleeding;

Increases the duration of action of non-depolarizing muscle relaxants;

Enhances the action of physostigmine;

The metabolite of Novocaine reduces the effect of sulfonamides. Novocaine should not be used concomitantly with cholinesterase inhibitors due to increased toxicity. Small doses of atropine prolong anesthesia with Novocaine.

When treating the injection site of a local anesthetic with antiseptic solutions containing salts of heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.

Application features

With an increase in the concentration of the drug, the total dose is reduced. To reduce absorption and prolong the action during local anesthesia, 1 mg / ml of epinephrine hydrochloride solution is added to the Novocaine solution, 1 drop for every 2-10 ml of the drug solution.

For patients with a history of hypersensitivity to Novocain, it is advisable to do a subcutaneous test for sensitivity. With a positive reaction, Novocaine is not used.

Before local anesthesia, it is important to ensure good blood circulation, eliminate hypovolemia.

When performing injections, it is necessary to ensure the availability of instruments for cardiopulmonary resuscitation and medicines for emergency treatment of toxic reactions, as well as the implementation of all measures for resuscitation, ventilation of the lungs and anticonvulsant therapy.

When using the drug in the head and neck area, it increases the risk of developing a toxic effect on the central nervous system.

The combined use of Novocain with anticoagulants (for example, heparin), non-steroidal anti-inflammatory drugs or plasma substitutes in the treatment of pain can lead to increased bleeding, vascular damage and massive bleeding. In patients at risk, before the use of Novocain, the blood clotting time and active partial thromboplastin time (APTT) should be determined. Injections with the simultaneous appointment of Novocaine and unfractionated heparin for the prevention of thrombosis should be performed with extreme caution.

Name:

Novocain (Novocainum)

Pharmacological
action:

Local anesthetic with moderate anesthetic activity and a wide breadth of therapeutic action.
Being a weak base, it blocks sodium channels, displaces calcium from receptors located on the inner surface of the membrane and, thus, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers.
Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of a different modality.
When released into the systemic circulation reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (has a weak ganglion-blocking effect), eliminates spasm of smooth muscles, reduces the excitability of the myocardium and motor areas of the cerebral cortex.
Compared with lidocaine and bupivacaine, procaine has a less pronounced anesthetic effect and, therefore, has a relatively low toxicity and a greater therapeutic breadth.

Pharmacokinetics
Poorly absorbed through mucous membranes.
When administered parenterally, it is well absorbed, rapidly hydrolyzed by plasma and tissue esterases with the formation of two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and PABA. T1 / 2 - 0.7 min.
It is excreted mainly by the kidneys in the form of metabolites - 80%.

Indications for
application:

Infiltration, conduction, epidural and spinal anesthesia;
- intraosseous anesthesia;
- anesthesia of mucous membranes (in ENT practice); vagosympathetic and pararenal blockade;
- circular and paravertebral blockade for eczema, neurodermatitis, ischalgia.

I/V: to potentiate the action of fixed drugs for anesthesia; for the relief of pain syndrome of various origins.
V/m: to dissolve penicillin in order to prolong its duration; as an adjuvant for certain diseases that are more common in old age, incl. endarteritis, atherosclerosis, arterial hypertension, spasms of the coronary vessels and brain vessels, diseases of the joints of rheumatic and infectious origin.
Rectally: hemorrhoids, spasms of smooth muscles of the intestine, anal fissures.
As an adjuvant, procaine used intravenously and internally with arterial hypertension, late toxicosis of pregnant women with hypertensive syndrome, spasms of blood vessels, phantom pains, peptic ulcer of the stomach and duodenum, UC, itching, neurodermatitis, eczema, keratitis, iridocyclitis, glaucoma.

Mode of application:

With infiltration anesthesia the highest doses at the beginning of the operation are not more than 500 ml of a 0.25% solution or 150 ml of a 0.5% solution, then every hour up to 1000 ml of a 0.25% solution or 400 ml of a 0.5% solution for every hour.
For conduction anesthesia use 1-2% solutions, with epidural(introduction of a local anesthetic into the epidural space of the spinal canal in order to anesthetize the areas innervated by the spinal nerves) -20-25 ml of a 2% solution, for spinal- 2-3 ml of 5% solution, with pararenal blockade- 50-80 ml of 0.5% solution, with vagosympathetic blockade- 30-100 ml of 0.25% solution, as a local anesthetic and antispasmodic(relieves spasms) means the drug is used in suppositories of 0.1 g.

Side effects:

maybe: arterial hypotension, collapse, dizziness, weakness, urticaria, allergic reactions, anaphylactic shock.

Contraindications:

Individual intolerance.
It should be borne in mind that when conducting local anesthesia with the use of the same total dose the higher the toxicity of procaine the more concentrated the applied solution is.
Procaine penetrates slowly through intact mucous membranes, so it is not very effective for surface anesthesia.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms.
During the period of treatment, it is necessary to be careful when driving and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Interaction
other medicinal
by other means:

Prolongs the neuromuscular blockade caused by suxamethonium (since both drugs are hydrolyzed by plasma cholinesterase).
Use simultaneously with MAO inhibitors (furazolidone, procarbazine, selegelin) increases the risk of arterial hypotension. The toxicity of procaine is increased by anticholinesterase drugs (suppressing its hydrolysis).
The metabolite of procaine (para-aminobenzoic acid) is a competitive antagonist of sulfanilamide drugs and can weaken their antimicrobial effect.
When treating the injection site of local anesthetic with disinfectant solutions containing heavy metals, increased risk of developing a local reaction in the form of pain and swelling.
Potentiates the action of direct anticoagulants.
The drug reduces the effect of anticholinesterase drugs on neuromuscular transmission.
Cross-sensitization is possible.

Pregnancy:

Use during pregnancy is possible subject to good tolerance.
During lactation, the use of the drug is possible after a preliminary thorough assessment of the expected benefit of therapy for the mother and the potential risk to the infant.
When used during childbirth, the development of bradycardia, apnea, and seizures in the newborn is possible.

Overdose:

It is possible only with the use of novocaine in high doses.
Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, increased nervous excitability, "cold" sweat, tachycardia, lowering blood pressure almost to collapse, tremor, convulsions, apnea, methemoglobinemia, respiratory depression, sudden cardiovascular collapse.
The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation. In cases of overdose, the administration of the drug should be stopped immediately. During local anesthesia, the injection site can be punctured with adrenaline.
Treatment: general resuscitation measures, which include oxygen inhalation, if necessary, artificial ventilation of the lungs. If convulsions continue for more than 15-20 seconds, they are stopped by intravenous administration of thiopental (100-150 mg) or diazepam (5-20 mg). With arterial hypotension and / or myocardial depression, ephedrine (15-30 mg) is administered intravenously, in severe cases - detoxification and symptomatic therapy.
In the event of the development of intoxication after the injection of novocaine into the muscles of the leg or arm, an urgent application of a tourniquet is recommended to reduce the subsequent entry of the drug into the general circulation.