Bupivacaine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: Parenteral Surgical anaesth Local infiltration: 0.25% soln: Up to 150 mg. Peripheral nerve block: 0.25% soln: 12.5 mg; 0.5% soln: 25 mg; doses of up to 150 mg may also be given. Retrobulbar block in ophth surgery: 0.75% soln: 15-30 mg. Sympathetic nerve block: 0.25% soln: 50-125 mg. Lumbar epidural block: 0.25% soln: 25-50 mg; 0.5% soln: 50-100 mg; 0.75% soln in non-obstetric surgery: 75-150 mg as single dose. Caudal block: 0.25% soln: 37.5-75 mg; 0.75% soln: 75-150 mg. Spinal block: 0.5% soln: 10-20 mg. Acute pain Lumbar block in labour pain: 0.25% soln: 15-30 mg; 0.375% soln: 22.5-45 mg; 0.5% soln: 30-60 mg. Alternatively, 0.1% soln: 10-15 mg /hr; 0.125% soln: 10-15 mg/hr via infusion. Caudal block in labour pain: 0.25% soln: 25-50 mg; 0.375% soln: 37.5-75 mg; 0.5% soln: 50-100 mg. Post-op pain As 0.1% soln: 4-15 mg/hr; 0.125% soln: 5-15 mg/hr via epidural infusion. 1.3% liposomal susp: Bunionectomy: 106 mg as single dose; haemorrhoidectomy: 266 mg as single dose.
Contraindications
Patient w/ active CNS disease (e.g. meningitis, intracranial haemorrhage), TB of the spine, pyogenic infection on inj site, pre-anaesth elevated intracranial pressure. Not intended for IV regional anaesth (Bier's block) and paracervical block in obstetrics; obstetric epidural block (0.75% soln).
Special Precautions
Patient w/ partial or complete heart block, impaired CV function and hypovolaemia; marked obesity, senility, cerebral atheroma, myocardial degeneration, toxaemia (epidural and spinal anaesth). May cause chondrolysis when given via intra-articular continuous infusion. Severe hepatic impairment. Pregnancy and lactation. Patient Counselling May temporarily impair locomotion and alertness. Monitoring Parameters Monitor CV and resp vital signs, state of consciousness, signs of CNS toxicity.
Adverse Reactions
Bradycardia, hypotension, HTN, nausea, vomiting, diplopia, neuropathy, peripheral nerve injury, arachnoiditis, paresis and paraplegia, signs of CNS toxicity (e.g. convulsions, paraesthesia, tremor), dizziness, allergic reactions.
Potentially Fatal: Cardiac arrhythmia, cardiac and resp arrest.
Drug Interactions
Additive systemic toxic effect w/ other local anaesth or agents structurally related to amide-type local anaesth (e.g. lidocaine and mexiletine). Increased risk of myocardial depression w/ antiarrhythmics. Enhanced adverse effects w/ hyaluronidase. Decreased clearance resulting to increased plasma concentrations w/ cimetidine and ranitidine. Increased risk of adverse effects w/ β-blockers and Ca channel blockers.
ATC Classification
N01BB01 - bupivacaine ; Belongs to the class of amides. Used as local anesthetics.
Disclaimer: This information is independently developed by CIMS based on bupivacaine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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