Prilocaine and epinephrine injection, USP. When you need a fast-onset (1-2 minutes) anesthetic agent for short or intermediate procedures. 4% Citanest Forte Dental provides an intermediate pulpal duration anesthesia in the maxilla (approximately 40 minutes), and intermediate pulpal duration anesthesia in mandibular nerve blocks (50-70 minutes) using low epinephrine which is desirable for high risk patients. The lowest dosage that results in effective anesthesia should be used to avoid high plasma levels and serious adverse effects.