Restlessness, anxiety, tinnitus, dizziness, blurred vision, tremor, depression, or drowsiness) may be early warning signs of CNS toxicity. Methemoglobinemia reported. Local anesthetics associated with rare occurrences of sudden respiratory arrest. Convulsions due to systemic toxicity leading to cardiac arrest reported, presumably following unintentional intravascular injection. Use with caution in cardiovascular disease, in hepatic impairment, in acutely ill or debilitated patients, in the elderly, and in children. Intravascular injections should be avoided.