Generic Name: Bupivacaine hydrochloride Brand Name(s): Generics only. No brands available.

Uses

What is bupivacaine hydrochloride used for?

Bupivacaine solution is an anesthetic. It works by blocking the generation and conduction of nerve impulses.

Bupivacaine hydrochloride is commonly used for inducing spinal anesthesia in certain medical or surgical procedures, in adults and children above 12 years of age.

How should I take bupivacaine hydrochloride?

Bupivacaine solution is usually given as an injection at your doctor’s office, hospital, or clinic.

How do I store bupivacaine hydrochloride?

Bupivacaine is usually handled and stored by a health care provider.

Precautions & warnings

What should I know before using bupivacaine hydrochloride?

Before using this drug, tell your doctor if:

  • You are allergic to any ingredient in bupivacaine solution or other similar medicines (e.g., amide-type anesthetics, such as lidocaine).
  • You have severe bleeding, severely low blood pressure or shock, irregular heartbeat, an infection in your bloodstream (e.g., septicemia), or an infection at the injection site.

Also, you should notice that:

  • Bupivacaine solution may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use bupivacaine solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • If you are going home before the numbness wears off, protect the treated area from injury until you regain feeling. If you received bupivacaine solution for a dental procedure, do not chew gum or eat until the feeling comes back. Also be careful not to bite your tongue or the inside of your mouth.
  • Some of these products contain sulfites. Sulfites may cause an allergic reaction in some patients (e.g., asthma patients). If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.
  • Use bupivacaine solution with caution in the elderly, because they may be more sensitive to its effects, especially low blood pressure.
  • Bupivacaine solution is not recommended for use in children younger than 18 years old. Safety and effectiveness in this age group have not been confirmed.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using bupivacaine hydrochloride during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking bupivacaine hydrochloride. Bupivacaine hydrochloride is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from bupivacaine hydrochloride?

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most common side effects persist or become bothersome:

  • Mild dizziness
  • Drowsiness

Seek medical attention right away if any of these severe side effects occur:

  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Tightness in the chest
  • Swelling of the mouth, face, lips, throat, or tongue
  • Unusual hoarseness
  • Anxiety
  • Backache
  • Blurred vision
  • Changes in hearing
  • Chest pain
  • Confusion
  • Depression
  • Excitement
  • Fainting
  • Fast, slow, or irregular heartbeat
  • Fever or chills
  • Headache
  • Inability to control bowels or urine
  • Metallic taste
  • Nausea
  • Persistent numbness
  • Paralysis
  • Restlessness
  • Ringing in the ears
  • Seizures
  • Severe or persistent dizziness, drowsiness, headache, or light-headedness
  • Shivering
  • Slow, fast, shallow, or difficult breathing
  • Speech problems
  • Tremors
  • Trouble urinating
  • Vomiting

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with bupivacaine hydrochloride?

Bupivacaine hydrochloride may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Especially, if you are taking anticoagulants (e.g., warfarin, heparin), beta-blockers (e.g., atenolol), or digoxin because the risk of side effects, such as abnormal heartbeat or bleeding, may be increased.

Does food or alcohol interact with bupivacaine hydrochloride?

Bupivacaine hydrochloride may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with bupivacaine hydrochloride?

Bupivacaine hydrochloride may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

These health conditions may include:

  • Heart disease
  • Liver or kidney problems
  • Nervous system problems
  • Pernicious anemia
  • Polio
  • Syphilis
  • Unusual growths (tumors) in the brain or spine
  • Blood or bleeding problems
  • Blood pressure problems
  • Persistent backache
  • Spine problems (e.g., arthritis, deformity)
  • A mental illness (e.g., psychosis)
  • A headache right before the procedure

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using bupivacaine hydrochloride.

What is the dose of bupivacaine hydrochloride for an adult?

Local Anesthesia

Infiltration: 0.25% infiltrated locally: 175 mg maximum

Caudal Block

Preservative free: 15-30 ml of 0.25% or 0.5%

Epidural Block Other Than Caudal Block

Preservative free: 10-20 ml of 0.25% or 0.5%; administer in 3-5 ml increments allowing sufficient time to detect toxic manifestations of inadvertent IV or IT administration.

Surgical procedures requiring high degree of muscle relaxation and prolonged effects: 10-20 ml of 0.75%; not to be used in obstetrical cases.

Peripheral Nerve Block

The recommended dose is 5 ml of 0.25-0.5%; 400 mg/day maximum.

Sympathetic Nerve Block

The recommended dose is 20-50 ml of 0.25%.

Retrotubular Anesthesia

The recommended dose is 2-4 ml of 0.75%.

Spinal Anesthesia

Preservative free: The recommended dose is 0.75% bupivacaine in 8.25% dextrose.

What is the dose of bupivacaine hydrochloride for a child?

Caudal Block, Epidural Block, Local Block

>12 years

  • Local Anesthesia: Infiltration 0.25% infiltrated locally: 175 mg maximum
  • Caudal Block: 15-30 mL of 0.25% or 0.5% (preservative free)
  • Epidural Block Other Than Caudal Block: 10-20 mL of 0.25% or 0.5%; administer in 3-5 ml increments allowing sufficient time to detect toxic manifestations of inadvertent IV or IT administration (preservative free); for surgical procedures requiring high degree of muscle relaxation and prolonged effects administer10-20 ml of 0.75%; not to be used in obstetrical cases.

Peripheral or Sympathetic Nerve Block

>12 years

  • Peripheral Nerve Block: 5 ml of 0.25-0.5%; 400 mg/day maximum
  • Sympathetic Nerve Block: 20-50 mL of 0.25%

Retrotubular Anesthesia

>12 years

  • The recommended dose is 2-4 mL of 0.75%.

How is bupivacaine hydrochloride available?

Bupivacaine hydrochloride is available in the following dosage forms and strengths:

  • Bupivacaine hydrochloride injectable solution 0.25%
  • Bupivacaine hydrochloride injectable solution 0.5%
  • Bupivacaine hydrochloride injectable solution 0.75%

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of bupivacaine hydrochloride, contact to your doctor as soon as possible.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 19, 2017 | Last Modified: March 19, 2017

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