What Is Citanest? Uses, Dosage, and What You Need to Know in 2026

If your dentist has used — or plans to use — Citanest (prilocaine) during a dental procedure, you may have questions about what it is, how it works, and what to expect. This guide covers everything you need to know about Citanest in plain language, including its current availability in 2026.

What Is Citanest?

Citanest is the brand name for

prilocaine hydrochloride, an amide-type local anesthetic used in dentistry to numb the mouth before and during dental procedures. It belongs to the same family of drugs as lidocaine, mepivacaine, and articaine — all of which are commonly used for dental pain control.

Citanest was available in two formulations:

• Citanest Plain Dental (4% prilocaine, no vasoconstrictor): Discontinued in the US.
• Citanest Forte Dental (4% prilocaine with epinephrine 1:200,000): May still be available from some dental supply distributors.

What Is Citanest Used For?

Citanest is FDA-approved for the production of local anesthesia in dentistry using nerve block and infiltration techniques. Common dental procedures that use local anesthetics like Citanest include:

• Tooth fillings and cavity treatment
• Tooth extractions
• Root canal (endodontic) treatment
• Crown preparation and placement
• Scaling and root planing (deep cleaning)
• Dental implant placement

Citanest Plain was especially suited for

short procedures on the maxillary anterior teeth (the front upper teeth) where a brief anesthetic window of 15-20 minutes was sufficient. It was also the preferred choice for patients who could not receive epinephrine.

Citanest Dosage: How Much Is Used?

Citanest comes as a 4% solution (40 mg/mL) in 1.8 mL single-dose cartridges. Each cartridge contains 72 mg of prilocaine. Standard dosing:

• Standard adult dose: 40-80 mg (1-2 mL) per injection site
• Maximum adult dose: 600 mg (8 cartridges, or 8 mg/kg) within 2 hours for patients weighing ≥150 lbs; 4 mg/lb (8 mg/kg) for patients under 150 lbs
• Pediatric dose: Rarely more than one-half cartridge (40 mg) per procedure for children under 10; calculated by Clark's rule based on body weight

How Quickly Does Citanest Work?

Citanest has a fast onset:

• Infiltration injection: under 2 minutes to onset; approximately 10-20 minutes pulpal anesthesia (plain) or 45 minutes (Forte); 1-2 hours soft tissue numbness (plain) or 2-3 hours (Forte)
• Inferior alveolar nerve block: under 3 minutes to onset; approximately 40-60 minutes pulpal anesthesia; 2-3 hours soft tissue numbness

Is Citanest a Controlled Substance?

No. Citanest (prilocaine) is

not a controlled substance and has no DEA scheduling. It does not have abuse potential and is not subject to the refill limitations or tracking requirements that apply to Schedule II-V medications.

What Has Changed in 2026?

The most important update for 2026 is that Citanest Plain Dental has been discontinued in the United States. This is a permanent market withdrawal, not a temporary shortage. Citanest Forte may still be available through some dental supply distributors but its supply is not reliable.

For patients and dentists who need guidance on what to use instead, see our guide: Alternatives to Citanest if You Can't Fill Your Prescription.

If you need help finding Citanest or an alternative, medfinder contacts supply sources near you to confirm availability and texts you the results.