Although allergic reactions to injectable amide local anesthetics are rare, patients may exhibit a reaction to the bisulfite preservative added to anesthetics containing epinephrine. Patients with a sulfa allergy should not receive articaine. Patients may also exhibit allergic reactions to benzocaine topical anesthetics. Allergies can manifest in a variety of ways including urticaria, dermatitis, angioedema, fever, photosensitivity and anaphylaxis. If the patient exhibits an allergic reaction to a local anesthetic or any of its additives, follow the protocol for management of allergic reactions.