Co-Phenylcaine Forte Special Precautions

Elderly and debilitated patients should be given reduced dosages.
Eating and drinking: the use of topical anaesthetic agents in the oral cavity and upper airway tissues may interfere with swallowing and thus enhance the danger of aspiration of food or drink. For this reason, food or drink should not be ingested within 2 hours of using local anaesthetics in the mouth area. Numbness of the tongue or buccal mucosa may increase the risk of trauma from hot drinks or biting.
Patients with cardiovascular diseases: CoPhenylcaine Forte should be given with caution to patients with cardiovascular disease, especially those suffering from hypertension, severe bradycardia, conduction disturbances or severe digitalis intoxication.
There is a small but transient increase in pulse (up to 12 beats per minute) and blood pressure (average 8.2 mmHg systolic and 7.5 mmHg diastolic) lasting for 10 minutes after the administration of this medication to healthy individuals. This must be taken into account if this medication is given to hypertensive patients.
Patients with impaired kidney or liver function: Lignocaine is metabolized in the liver and must be given with caution to patients with hepatic insufficiency. Metabolites of lignocaine may accumulate in patients with renal impairment.
Asthmatic patients: This preparation contains Sodium metabisulfite. A sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than non-asthmatic people.
General precautions: genetic predisposition to malignant hyperthermia and pre-existing abnormal neurological conditions.
Use in pregnancy and lactation: CoPhenylcaine Forte should not be used in pregnancy (see Contraindications). Lignocaine is classified in category A, but Phenylephrine is in category B2. CoPhenylcaine Forte Spray may be used as directed in breast-feeding mothers.