Anesthesia and Sedation

Color Coding of Local Anesthetic Cartridges

This color-coding system, adopted by the ADA Council on Scientific Affairs in 2003, has been incorporated into ISO standard 11499, “Dentistry – Single-use cartridges for local anaesthetics.” Each single-use cartridge should have two indelible bands indicating the name and concentration of both the anesthetic ingredient (Table 1) and the vasoconstrictor (Table 2).

The tables below, which utilize the Pantone Matching System (PMS) for color identification, illustrate the appropriate colors for both ingredients. Although color-coding is a useful adjunct for anesthetic identification, it is prudent for dentists to read the labels of all drugs they administer.

Table 1. Local anaesthetic agent and concentration colors (Band 1)
Product	Band color (PMS)
Articaine - 4%	Gold 871	Gold 872	Gold 873	Gold 874	Gold 875
Bupivacaine - 0.5%	Blue 300	Blue 301
Lidocaine - 2%	Red 185	Red 186	Red 199	Red 200
Lidocaine - 3%	Purple 266	Purple 267
Mepivacaine - 2%	Brown 477	Brown 478	Brown 498	Brown 499
Mepivacaine - 3%	Tan 406	Tan 407	Tan 408
Prilocaine - 3%	Orange 136	Orange 137

Table 2. Vasoconstrictor and concentration colors (Band 2)
Product	Band color (PMS)
No vasoconstrictor	White	None
Epinephrine < 1:200 000	Yellow 108	Yellow 109	Yellow 110	Yellow 115	Yellow 116
Epinephrine < 1:100 000 to 1:200 000	Orange 136	Orange 137
Epinephrine < 1:50 000 to 1:100 000	Brown 477	Brown 478	Brown 498	Brown 499
Epinephrine 1:50 000	Green 347	Green 348	Green 355	Green 356
Levonordefrin	Black	None
Nor-epinephrine 1:100 000	Tan 406	Tan 407	Tan 408
Nor-epinephrine 1:25 000	Purple 266	Purple 267
Octapressin (felypressin)	Blue 300	Blue 301

ISO standard 11499 outlines additional criteria required of single-use cartridge labels applicable to size and placement of the colored bands:

Band 1 shall be 3.0 ± 0.5 mm wide and commence between 8 mm and 20 mm from the plunger end of the cartridge.
Band 2 shall be 1,5 ± 0,5mm wide and commence at (2 ± 0.5) mm from the cartridge disc end of Band 1.

A detailed diagram of a single-use cartridge can be found in Figure 1.

Diagram of the side of a human head indicating the locations of various regions of the oropharynx

Source: ISO standard 11499

ADA Resources

Prepared by: Center for Scientific Information, ADA Science Institute
Last Updated: January 29, 2019

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