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This combination drug consists of the enzyme hyaluronidase, the local anesthetic mepivacaine, and the vasoconstrictor epinephrine. Hyaluronidase acts as a spreading factor by depolymerizing hyaluronic acid in the extracellular matrix, thereby increasing tissue permeability and facilitating the diffusion of the anesthetic. Mepivacaine provides regional anesthesia by blocking voltage-gated sodium channels, while epinephrine induces local vasoconstriction to prolong the duration of action and minimize systemic toxicity. This specific formulation was evaluated by Mauricio Jose Tornelli in a Phase 4 clinical trial (NCT03141580) for its hemodynamic and electrocardiographic safety during dental surgical procedures, such as third molar extractions.
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