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An anesthetic and aminobenzoic acid ester. Administered locally by subcutaneous or intramuscular infiltration (not absorbed by contact with skin or mucous membranes: AEMPS 2007).
Used in skin sutures, dental procedures and for peripheral and spinal block. It is also used to prolong the effect and reduce the pain of the intramuscular administration of penicillin.
Since the last update we have not found published data on its excretion in breastmilk.
It is rapidly hydrolyzed by intestinal and hepatic esters (Inoue 1980) to inactive metabolites (AEMPS 2007, Hospira 2007). Its rapid elimination (half-life of less than 8 minutes: AEMPS 2007, Hospira 2007, Seifen 1979) makes transfer to blood in significant amounts unlikely, so excretion in breastmilk is very unlikely.
Topical anesthetics (well applied ophthalmological, dermatological and stomatological preparations, as creams, subcutaneous injection for infiltration or spinal anesthesia) have virtually no systemic absorption.
Procaine, applied ophthalmologically, poses no risks during breastfeeding.
As there is less published information than for other drugs in the same group, safer known alternatives may be preferable, especially during the neonatal period and in cases of prematurity.
List of essential medicines WHO: Penicillin-Procaine is compatible with breastfeeding (WHO 2002).