Background Articaine is one of the most widely used local anesthetics in dentistry. It is formulated with epinephrine in a 1:100,000 or 1:200,000 concentration as a vasoconstrictor. The addition of epinephrine gives the drug an extensive list of formal contraindications.
Objective To review the literature on the chemistry and safety of articaine with epinephrine, and to review the validity of each of the contraindications.
Data sources The base knowledge was the result of reading a handbook on local anesthesia. Afterward, a literature search was made for publications between 1990 and 2019 concerning contraindications to articaine and dental epinephrine. Some articles about the pharmacological properties of articaine were also used. Finally, what was used was the list of contraindications in the package leaflet of articaine in Belgium as stated on 11/11/2019.
Study selection Articles of good quality and with clear information discussing and explaining these contraindications were included.
Data extraction Information about which contraindications, which drug interactions, and what physiological reasoning is behind them was extracted.
Data synthesis This information was synthesized in an extensive overview. First, the profile, safety and pharmacological properties of articaine with epinephrine were reviewed. Afterwards, an overview of the contraindications and drug interactions was given as stated in the package leaflet and each of them was explained.
Articaine; Epinephrine; Pharmacology; Contraindications; Pregnancy.