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mepivacaine (Rx)Brand and Other Names:Carbocaine, Polocaine, more...Polocaine-MPF

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1%
  • 1.5%
  • 2%
  • 3%
more...

Infiltration Anesthesia

Up to 400 mg (80 mL of 0.5% or 40 mL of 1% solution)

Cervical/Brachial/Intercostal or Pudendal Block

50-400 mg (5-40 mL) of 1% or 100-400 mg (5-20 mL) 2% solution

Postherpetic Neuropathy (Orphan)

Orphan indication sponsor

  • Cinergen, LLC; 146 Medinah Drive; Blue Bell, PA 19422-3212

HIV-Associated Neuropathy (Orphan)

Orphan indication sponsor

  • Cinergen, LLC; 146 Medinah Drive; Blue Bell, PA 19422-3212

Administration

Usually no more than 400 mg/dose; doses up to 550 mg has been used but rare & given no more frequently than q1.5hr; no more than 1000 mg in 24 hours

Use preservative-free preparations for spinal or epidural anesthesia

Other Indications & Uses

Epidural/caudal anesthesia; peripheral/sympathetic nerve block

Dosage Forms & Strengths

injectable solution

  • 1%
  • 1.5%
  • 2%
  • 3%
more...

Administration

<13.6 kg: No more than 5-6 mg/kg/dose 

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Interactions

Interaction Checker

mepivacaine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Systemic dose-related toxicity

            • Underventilation/apnea ("Total or High Spinal"),
            • Hypotension
            • Acidosis
            • Systemic diseases which alter protein production/competition of other drugs for protein binding sites

            Angioneurotic edema (including laryngeal edema), syncope, depression of the myocardium, decreased cardiac output, heart block, hypotension (or sometimes hypertension), bradycardia, ventricular arrhythmias, and possibly cardiac arrest

            Excitation and/or depression, restlessness, anxiety, dizziness, tinnitus, blurred vision, tremors (possible convulsions), chills, constriction of the pupils, elevated temperature, paralysis of the of consciousness, persistent anesthesia, paresthesia, weakness, paralysis of the lower extremities/sphincter control, headache, septic meningitis, meningismus, cranial nerve palsies due to traction on nerves from of cerebrospinal fluid

            Urticaria, pruritus, erythema, excessive sweating

            Nausea, vomiting

            Backache

            Urinary retention, fecal/urinary incontinence

            Sneezing, respiratory paralysis (secondary to spinal block)

            Loss of perineal sensation and sexual function

            Anaphylactoid-like symptomatology (including severe hypotension)

            Slowing of labor; increased incidence of forceps delivery

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            Warnings

            Contraindications

            Hypersensitivity to mepivacaine or amide anesthetics, sensitivity to parabens

            Cautions

            Some formulations may contain sulfites

            History of malignant hyperthermia

            DO NOT use solutions with epinephrine in distal areas of body (eg, digit, nose, ear)

            Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action

            Risk of chondrolysis if receiving intra-articular injection following arthroscopic or other surgical procedures

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Half-life: 1.9-3.2 hr (adults); 8.7-9 hr (neonates)

            Duration: 2-2.5 hr

            Onset: 3-20 min

            Protein Bound: 75%

            Metabolism: liver

            Metabolites: two phenols, which are excreted almost exclusively as their glucuronide conjugates, and the N-demethylated compound (2',6'-pipecoloxylidide)

            Excretion: urine (principally)

            Mechanism of Action

            Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Select a class to view formulary status for similar drugs

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