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1. Citanest 1%
2. Citanest 1%

'Other medicTrTes^nd Citanest~~

iTell your doctor or nurse if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal |medicines. This is because Citanest can affect the way some medicines work and some medicines can have an effect on Citanest.

'in particular, tell your doctor if you are taking any of the following medicines:

I* Other local anaesthetics.

•    Medicines called sulphonamides, such as co-trimoxazole (used to treat infections caused by bacteria).

•    Anti-malarial medicines (used to prevent or treat malaria).

I* Nitrate medicines (used to treat heart problems).

•    Medicines to treat an uneven heart beat (arrhythmia), such as amiodarone. Pregnancy, breast-feeding and fertility

|lf you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or nurse for advice before taking this medicine.

Driving and using machines

iCitanest may make you feel sleepy and affect the speed of your reactions. After you have been given Citanest, you should not drive or use tools or machines until the |next day.

iCitanest contains sodium

•    Citanest contains 2.36 mg of sodium per millilitre (ml), equivalent to 118 mg per 50 ml ampoule. Your doctor will take this into account if you are on a sodium controlled diet.

'Citanest contains methyl parahydroxybenzoate (E218) and propyl iparahydroxybenzoate (E216)

Citanest contains methyl parahydroxybenzoate (E218) and propyl Iparahydroxybenzoate (E216). These may cause allergic reactions (possibly delayed) such as a skin rash, and exceptionally bronchospasm (breathlessness). This may happen a while after you have been given the medicine.

3. How to use Citanest

[Always use this medicine exactly as your doctor or nurse has told you. Check with your doctor or nurse if you are not sure. Citanest will be given to you by a doctor. It will |be given to you as an injection. The dose that your doctor gives you will depend on the type of pain relief that you need. It will also depend on your body size, age, and Iphysical condition and the part of your body that the medicine is being injected into.

■You will be given the smallest dose possible to produce the required effect.    ,

Citanest will usually be given near the part of the body to be operated on. It stops the Inerves from being able to pass pain messages to the brain. It will stop you feeling pain.l It will start to work a few minutes after being injected and will slowly wear off when the Imedical procedure is over.

|Use in children and adolescents

Citanest is not recommended for use in children under 6 months old.

If you use more Citanest than you should

[Serious side effects from getting too much Citanest need special treatment and the doctor treating you is trained to deal with these situations. The first signs of being given |too much Citanest are usually as follows:

•    Feeling dizzy or light-headed.

I* Numbness of the lips and around the mouth.

•    Numbness of the tongue.    .

'• Hearing problems.

I* Problems with your sight (vision).    I

To reduce the risk of serious side effects, your doctor will stop giving you Citanest as [soon as these signs appear. This means that if any of these happen to you, or you

think you have received too much Citanest, tell your doctor immediately. l _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ j

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^ore serious side effects from being given too much Citanest include problems iwith your speech, twitching of your muscles, tremors, trembling, fits (seizures), and loss of consciousness, low blood pressure, erratic heart beat, slowing or stopping of |your heart.

4. Possible side effects

iLike all medicines, this medicine can cause side effects, although not everybody gets them.

'if you have any of these side effects, stop taking the medicine and/or seek urgent imedical advice immediately:

•    Swelling of your face, lips, tongue or throat. This may make it difficult to swallow.

|* Severe or sudden swelling of your hands, feet and ankles.

•    Difficulty breathing.

'• Severe itching of the skin (with raised lumps).

|Other possible side effects:

■Very common: may affect more than 1 in 10 people    I

•    Low blood pressure. This might make you feel dizzy or light-headed.

I* Feeling sick (nausea).

■Common: may affect up to 1 in 10 people    ■

Being sick (vomiting).

|* Feeling dizzy.

•    Pins and needles.

|* Slow heart beat.

•    High blood pressure.

Uncommon: may affect up to 1 in 100 people

|* Blurred vision.

•    Ringing in the ears (tinnitus) or being sensitive to sound.

'• Numbness of the lips and around the mouth.

i* Numbness of the tongue.    i

•    Difficulty in speaking.

|* Loss of consciousness.

•    Shakiness.

I* Fits (convulsions).

|Rare: may affect up to 1 in 1,000 people

•    Uneven heart beat (arrhythmias).

I* Heart attack.

.• Nerve damage that may cause changes in sensation or muscle weakness    ,

¹ (neuropathy). This may include peripheral nerve damage.

I* Methaemoglobinaemia (a problem with blood pigment levels). If this happens, the i skin becomes bluish-grey due to a lack of oxygen (this is more likely in infants).

Wt known: frequency cannot be estimated from the available data

I* Double vision.    i

•    Shallow breathing.

bo not be concerned by this list of possible side effects. You may not get any of them. ' ilf any of the side effects get serious, or if you notice any side effects not listed in this i leaflet, please tell your doctor or nurse.

^Reporting of side effects

ilf you get any side effects, talk to your doctor or nurse. This includes any possible side i effects not listed in this leaflet. You can also report side effects directly via the Yellow |Card Scheme at: www.mhra.qov.uk/vellowcard.

By reporting side effects you can help provide more information on the safety of this Imedicine.

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