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The major disadvantages of this use are cocaine's intense vasoconstrictor activity and the potential for cardiovascular toxicity.

Cocaine has since been largely replaced in Western medicine by synthetic local anesthetics such as benzocaine, proparacaine, lidocaine, and tetracaine though it remains available for use if specified.

Crack cocaine is a smokeable form of cocaine made into small "rocks" by processing cocaine with sodium bicarbonate (baking soda) and water.

Cocaine increases alertness, feelings of well-being and euphoria, energy and motor activity, feelings of competence and sexuality.

First, the drug is partly catabolized by the liver.