Mepivacaine

Mepivacaine
Black Box Warning
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]

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Black Box Warning

Black Box warning See full prescribing information for complete Boxed Warning. * These solutions are not intended for spinal anesthesia or dental use

Overview

Mepivacaine is a local anesthetic that is FDA approved for the {{{indicationType}}} of epidural anesthesia, epidural block, injection of anesthetic agent into brachial plexus, injection of anesthetic agent into pudendal nerve, local anesthesia, local anesthesia, by infiltration, local anesthetic intercostal nerve block. local anesthetic nerve block, transvaginal, local anesthetic nerve block in cervical region. pain management, paracervical block anesthesia, regional anesthesia. There is a Black Box Warning for this drug as shown here. Common adverse reactions include cardiovascular: bradyarrhythmia, cardiac arrest, fetal bradycardia, with paracervical block, heart block, hypotension, ventricular arrhythmia, immunologic: bacterial meningitis, septic, immune hypersensitivity reaction (rare ), musculoskeletal: chondrolysis of articular cartilage, neurologic: cranial nerve disorder, seizure, respiratory: respiratory arrest.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

• Dosage varies with anesthetic procedure, area to be anesthetized, vascularity of tissues, number of neuronal segments to be blocked, depth of anesthesia and degree of muscle relaxation required, and duration of anesthesia required.

Epidural anesthesia, epidural block

• 15 to 30 mL (150 to 300 mg) of 1% solution.
• 10 to 25 mL (150 to 375 mg) of 1.5% solution.
• 10 to 20 mL (200 to 400 mg) of 2% solution

Injection of anesthetic agent into brachial plexus

• 5 to 40 mL (50 to 400 mg) of 1% solution
• 5 to 20 mL (100 to 400 mg) of 2% solution
• 5 to 40 mL (50 to 400 mg) of 1% solution; one-half of total dose injected into each side

Injection of anesthetic agent into pudendal nerve

• 5 to 20 mL (100 to 400 mg) of 2% solution; one-half of total dose injected into each side

Local anesthesia

• Doses vary with anesthetic procedure, MAX single adult dose is 400 mg

• Local anesthesia, by infiltration

• 0.5% or 1% solution; MAX dose 400 mg

• Local anesthetic intercostal nerve block

• 5 to 40 mL (50 to 400 mg) of 1% solution
• 5 to 20 mL (100 to 400 mg) of 2% solution

• Local anesthetic nerve block, Transvaginal

• Max 30 mL (300 mg) of 1% solution; one-half of total dose injected into each side

• Local anesthetic nerve block in cervical region

• 5 to 40 mL (50 to 400 mg) of 1% solution
• 5 to 20 mL (100 to 400 mg) of 2% solution

Pain management: therapeutic block

• 1 to 5 mL (10 to 50 mg) of 1% solution
• 1 to 5 mL (20 to 100 mg) of 2% solution

Paracervical block anesthesia

• Max 20 mL (200 mg) of 1% solution every 90 min; one half of total dose injected each side; inject slowly, with 5 min between sides

Regional anesthesia

• Doses vary with anesthetic procedure, MAX single adult dose is 400 mg

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information about Off-Label Guideline-Supported Use of Mepivacaine in adult patients.

Non–Guideline-Supported Use

There is limited information about Off-Label Non–Guideline-Supported Use of Mepivacaine in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Epidural anesthesia, epidural block

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Injection of anesthetic agent into brachial plexus

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Injection of anesthetic agent into pudendal nerve

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Local anesthesia

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Local anesthesia, by infiltration

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Local anesthetic intercostal nerve block

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Local anesthetic nerve block, Transvaginal

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Local anesthetic nerve block in cervical region

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Pain management

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Paracervical block anesthesia

• Dose not to exceed 5-6 mg/kg
• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Regional anesthesia

• Dose not to exceed 5-6 mg/kg

• Age under 3 yr, weight less than 30 pounds use concentrations of 0.5-1.5%

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information about Off-Label Guideline-Supported Use of Mepivacaine in pediatric patients.

Non–Guideline-Supported Use

There is limited information about Off-Label Non–Guideline-Supported Use of Mepivacaine in pediatric patients.

Contraindications

There is limited information regarding Mepivacaine Contraindications in the drug label.

Warnings

Black Box warning See full prescribing information for complete Boxed Warning. * These solutions are not intended for spinal anesthesia or dental use

There is limited information regarding Mepivacaine Warnings' in the drug label.

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Mepivacaine Clinical Trials Experience in the drug label.

Postmarketing Experience

There is limited information regarding Mepivacaine Postmarketing Experience in the drug label.

Drug Interactions

There is limited information regarding Mepivacaine Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Mepivacaine in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Mepivacaine in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Mepivacaine during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Mepivacaine in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Mepivacaine in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Mepivacaine in geriatric settings.

Gender

There is no FDA guidance on the use of Mepivacaine with respect to specific gender populations.

Race

There is no FDA guidance on the use of Mepivacaine with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Mepivacaine in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Mepivacaine in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Mepivacaine in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Mepivacaine in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Mepivacaine Administration in the drug label.

Monitoring

There is limited information regarding Mepivacaine Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Mepivacaine and IV administrations.

Overdosage

There is limited information regarding Mepivacaine overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Mepivacaine Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Mepivacaine Mechanism of Action in the drug label.

Structure

There is limited information regarding Mepivacaine Structure in the drug label.

Pharmacodynamics

There is limited information regarding Mepivacaine Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Mepivacaine Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Mepivacaine Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Mepivacaine Clinical Studies in the drug label.

How Supplied

There is limited information regarding Mepivacaine How Supplied in the drug label.

Storage

There is limited information regarding Mepivacaine Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Mepivacaine Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Mepivacaine interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Mepivacaine Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Mepivacaine Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.