Table 1.
| Drug | Maximum |
|---|---|
| Articaine WITH vasoconstrictor | 7 mg/kg (up to 500 mg) |
| 5 mg/kg in children | |
| Bupivacaine WITH vasoconstrictor | 2 mg/kg (up to 200 mg) |
| Lidocaine WITH vasoconstrictor | 7 mg/kg (up to 500 mg) |
| Mepivacaine WITH vasoconstrictor | 6.6 mg/kg (up to 400 mg) |
| Prilocaine WITH vasoconstrictor | 8 mg/kg (up to 500 mg) |
| Mepivacaine WITHOUT vasoconstrictor | 6.6 mg/kg (up to 400 mg) |
| Prilocaine WITHOUT vasoconstrictor | 8 mg/kg (up to 500 mg) |
The maximum recommended dose may vary from country to country. The maximum dosage means ‘a single volume administered’; if additional cartridges are administered at a later time in the procedure then the calculation is no longer valid as one must incorporate redistribution and drug half-lives into current systemic dose. Many schools and organisations teach the maximum dose of lidocaine 2% with 1:100,000 epinephrine as 4.4 mg/kg but there is no consensus on the issue.61,62 There have been some investigators who advocate for abandoning the idea of maximum recommended doses63 and instead taking patient and clinician factors into consideration such as the patient's age, the site of injection, the speed of injection, and the existence of other comorbidities.64