Procaine
JFDA label: Retarpen 6:3:3 Vial
Indications
Approved
- Hemorrhoids — hemorrhoid
Class profile
| gramStatus | Gram+ |
|---|---|
| spectrumBreadth | Narrow |
| atypicalCoverage | No |
| isBactericidal | 1 |
| moaCategory | Cell wall synthesis inhibitor (beta-lactam, depot penicillin formulation) |
| pdIndex | Time-dependent |
| postAntibioticEffect | None |
| mrsaCoverage | 0 |
| resistanceMechanisms | Beta-lactamase production,PBP mutations |
Adverse Reactions
Cardiac disorders (6)
Not Known Atrioventricular block · Bradycardia · Cardiac arrest · Cardiac output decreased · Tachycardia · Ventricular arrhythmia
Vascular disorders (2)
Not Known Hypertension · Hypotension
Nervous system disorders (7)
Not Known Convulsion · Dizziness · Loss of consciousness · Paralysis · Somnolence · Syncope · Tremor
Immune system disorders (2)
Not Known Anaphylactic shock · Hypersensitivity
Gastrointestinal disorders (2)
Not Known Nausea · Vomiting
Skin and subcutaneous tissue disorders (5)
Not Known Angioedema · Erythema · Hyperhidrosis · Pruritus · Urticaria
Psychiatric disorders (2)
Not Known Agitation · Anxiety
Eye disorders (1)
Not Known Vision blurred
Ear and labyrinth disorders (1)
Not Known Tinnitus
Investigations (1)
Not Known Body temperature increased
General disorders and administration site conditions (12)
Not Known Acidosis · Anaphylactoid reaction · Arachnoiditis · Meningism · Nervousness · Oedema · Post lumbar puncture syndrome · Pseudocholinesterase deficiency · Shock · Sneezing · Tension · Vasodilation procedure
Respiratory, thoracic and mediastinal disorders (3)
Not Known Apnoea · Laryngeal oedema · Respiratory arrest
Pregnancy & Lactation
Lactation
However, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Monitoring
| Efficacy | Culture and susceptibility testing; clinical resolution (temperature, WBC, CRP, procalcitonin) |
|---|---|
| Toxicity | Renal function (dose adjustment in renal impairment); hepatic function for hepatically cleared agents; signs of C. difficile infection (diarrhoea) |
| Clinical pearl | Culture results guide de-escalation to narrower-spectrum therapy. Review antibiotic appropriateness at 48–72 h (antimicrobial stewardship). |
| Counseling | Complete the full course. Report persistent diarrhoea, rash, or lack of improvement after 48–72 h. |
Chemistry & Properties
| Formula | C13H20N2O2 |
|---|---|
| Molecular weight | 236.31 g/mol |
| IUPAC name | 2-(diethylamino)ethyl 4-aminobenzoate |
| CAS | 59-46-1 |
| PubChem CID | 4914 |
| InChIKey | MFDFERRIHVXMIY-UHFFFAOYSA-N |
| logP | 1.77 (XLogP 1.9) |
| Polar surface area | 55.56 Ų |
| H-bond acceptors / donors | 4 / 1 |
| Drug-likeness (QED) | 0.60 |
| Lipinski violations | 0 |
SMILES
CCN(CC)CCOC(=O)c1ccc(N)cc1Biology & Pharmacokinetics
Pharmacokinetics
| BBB penetrant | Yes (logBB 0.05) |
|---|
Enzyme interactions
| Enzyme | Role | Detail |
|---|---|---|
| CYP2B6 | Inhibitor | — |
| CYP2D6 | Inhibitor | — |
Transporters
BCRP (Inhibitor)BSEP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)
Drug–drug interactions (15, DDInter)
| Interacting drug | Severity | Management |
|---|---|---|
| Nitrous acid | major | |
| Benzocaine (topical) | moderate | |
| Cinchocaine (topical) | moderate | |
| Cocaine (nasal) | moderate | |
| Cocaine (topical) | moderate | |
| Lidocaine (ophthalmic) | moderate | |
| Lidocaine (topical) | moderate | |
| Oxybuprocaine (ophthalmic) | moderate | |
| Sulfasalazine | moderate | |
| Tetracaine (ophthalmic) | moderate | |
| Tetracaine (topical) | moderate | |
| Doxorubicin | minor | |
| Doxorubicin (liposomal) | minor | |
| Hyaluronidase | minor | |
| Laronidase | minor |
Registered Products (2)
| Brand | Form / strength | Pack | Agent | Citizen (JOD) |
|---|---|---|---|---|
| Retarpen 6:3:3 Vial | Vial 300000 IU, 600000 IU, 300000 IU | 5 ml | Nabulsi Drug Store | 1.220 |
| Cardioplegia INF | Ampoule 5.965 %, Hexahydrate 16.265 %, 1.364 % | 10 amp | AL Razi Drug Store | — |