Bupivacaine
Generic name: bupivacaine (bue PIV a kane)
Brand name: Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF, Sensorcaine-MPF Spinal
Dosage forms: injectable solution (0.0625%-0.9%; 0.1%-NaCl 0.9%; 0.1%-NaCl 0.9% preservative-free; 0.125%-0.9%; 0.125%-NaCl 0.9% preservative-free; 0.2%-NaCl 0.9%; 0.25%; 0.25% preservative-free; 0.25%-NaCl 0.9%; 0.375%-NaCl 0.9%; 0.5%; 0.5% preservative-free; 0.5%-NaCl 0.9%; 0.75% preservative-free); intrathecal solution (0.75%-D8.25% preservative-free); intravenous solution (0.063%-NaCl 0.9%; 0.1%-NaCl 0.9%)
Drug class: Local injectable anesthetics
Bupivacaine is an anesthetic (numbing medicine) that is used as a local (in only one area) anesthetic.
Bupivacaine is given as an epidural injection into the spinal column to produce numbness during labor, surgery, or certain medical procedures.
Bupivacaine is also used as an anesthetic for dental procedures.
Bupivacaine may also be used for purposes not listed in this medication guide.
Warnings
Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine.
Some epidural numbing medications can have long-lasting or permanent effects on certain body processes such as sexual function, bowel or bladder control, and movement or feeling in your legs or feet. Talk with your doctor about your specific risk of nerve damage from bupivacaine.
Before taking this medicine
Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine, or if you've ever had:
- anemia (lack of red blood cells);
- kidney or liver disease;
- a bleeding or blood clotting disorder;
- syphilis, polio, a brain or spinal cord tumor;
- numbness or tingling;
- chronic back pain, headache caused by surgery;
- low or high blood pressure;
- abnormal curvature of the spine; or
- arthritis.
It is not known whether bupivacaine will harm an unborn baby. If you are not receiving bupivacaine during childbirth, tell your doctor if you are pregnant.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
How is bupivacaine given?
Bupivacaine is injected through a needle directly into or near the area to be numbed. You will receive this injection in a dental or hospital setting.
For an epidural, bupivacaine is given as an injection through a needle placed into an area of your middle or lower back near your spine.
Your breathing, blood pressure, oxygen levels, or other vital signs will be watched closely.
For a dental procedure, bupivacaine is injected directly into the mouth near the tooth or teeth your dentist will be working on.
Some epidural numbing medications can have long-lasting or permanent effects on certain body processes such as sexual function, bowel or bladder control, and movement or feeling in your legs or feet. Talk with your doctor about your specific risk of nerve damage from bupivacaine.
What happens if I miss a dose?
Since bupivacaine is given as needed before a surgery or dental procedure, you are not likely to be on a dosing schedule.
What happens if I overdose?
Since bupivacaine is given in a medical setting, you will be watched closely to make sure you do not receive too much of bupivacaine. Your caregivers will quickly treat you if you have overdose symptoms.
What should I avoid after receiving bupivacaine?
This medicine can cause numbness over a large portion of your body. After an epidural you not be able to feel or move your lower body. Take care to avoid injury while you are still numb.
After a dental procedure, avoid eating, chewing gum, or drinking a hot beverage until your mouth is no longer numb.
Bupivacaine side effects
Get emergency medical help if you have signs of an allergic reaction: hives, red rash, itching; sneezing, difficulty breathing; severe dizziness, vomiting; swelling of your face, lips, tongue, or throat.
Tell your caregivers at once if you have any of these serious side effects:
- feeling anxious, restless, confused, dizzy, drowsy, or like you might pass out;
- ringing in your ears, problems with speech or vision;
- metallic taste in your mouth, numbness or tingling around your mouth;
- muscle twitching, tremors, seizure (convulsions);
- weak or shallow breathing;
- fast heart rate, gasping, feeling unusually hot;
- slow heart rate, weak pulse; or
- little or no urination.
Seek medical attention right away if you develop a serious condition called methemoglobinemia. Symptoms include headache, fast heartbeats, shortness of breath, feeling tired or light-headed, or skin that looks pale, gray, or blue-colored.
Common side effects include:
- weakness, long-lasting numbness or tingling;
- feeling restless or drowsy;
- tremors;
- headache, blurred vision;
- fast or slow heartbeats;
- breathing problems;
- chills or shivering;
- back pain; or
- nausea, vomiting.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect bupivacaine?
Tell your doctor about all other medicines you use, especially:
- an antidepressant or antipsychotic medication;
- anti-nausea medicine such as prochlorperazine (Compazine) or promethazine (Phenergan);
- blood pressure medicine--carteolol, carvedilol, labetalol, nadolol, propranolol, sotalol, timolol;
- a blood thinner such as warfarin (Coumadin, Jantoven);
- ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine; or
- an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
This list is not complete. Other drugs may affect bupivacaine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.