This updated Medicines Q&A explores the clinical significance of potential interactions between dental local anaesthetic preparations and other medicines as listed in the BNF and SPCs.


  • Drug interactions that may occur with local anaesthetic preparations are listed in the BNF and SPCs. Many are theoretical or are associated with higher doses of local anaesthetic preparations than those used for dental procedures in primary care.
  • Reports of serious interactions between medicines and local anaesthetic preparations occurring in dental practice are exceedingly rare.
  • Reports of interactions between medicines and vasoconstrictors (adrenaline) may require additional monitoring.
  • Practitioners can minimise the risk of interactions by using an aspirating syringe, which reduces the likelihood of local anaesthetic being administered directly into a blood vessel.
  • Adhering to dosage recommendations in the product literature will also minimise risk.
  • This Q&A includes tables (see appendix) that discuss all the interactions with local anaesthetics and vasoconstrictors listed in the BNF and SPCs. The relevance of each interaction for the dental practitioner is put into context and any precautions required are addressed.
  • This Q&A does not cover use of local anaesthetics in patients with medical conditions that may contraindicate or require caution in their use.


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