Definition Methemoglobinemia can occur following use or prilocaine in adults. In adults, the toxic dose is ~ 600 mg IV. Prilocaine is metabolized by the liver to O-toluidine, which oxidizes hemoglobin (Fe2+) to methemoglobin (Fe3+). This can also occur with EMLA cream, especially in neonates 3 months or younger (although still safe in the vast majority of neonates). Treatment […]