chloroprocaine (Rx)

Brand and Other Names:Nesacaine
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1%
  • 2%
  • 3%
more...

Caudal & Lumbar Epidural Block

Use chloroprocaine without preservatives

Caudal/epidural block: 2%-3% (preservative-free) total dose 300-750 mg q40-60min

Lumbar/sacral region: 40-75 mg for each segment to be anesthetized

Infiltration & Peripheral Nerve Block

Infiltration/peripheral nerve block: 1%-2%

Mandibular (2% solution): 40-60 mg (2-3 mL)

Infraorbital (2% solution): 10-20 mg (0.5-1 mL)

Brachial plexus (2% solution): 600-800 mg (30-40 mL)

Digital: 1% without epinephrine; 3-4 mL (30-40 mg total dose)

Pudendal (2% solution): 10 mL (400 mg total dose)

Paracervical (1% solution): 30 mg (3 mL) per site

Single doses should not exceed 800 mg; single dose with epinephrine should not exceed 1000 mg

Cervical/thoracic region: 30-60 mg for each segment to be anesthetized

Dosage Forms & Strengths

injectable solution

  • 1%
  • 2%
  • 3%
more...

Infiltration

< 3 years

  • Safety and efficacy not established

> 3 years

  • 0.5 - 1% concentration recommended; not to exceed 11 mg/kg

Nerve Block

< 3 years

  • Safety and efficacy not established

> 3 years

  • 1 - 1.5% concentration recommended; not to exceed 11 mg/kg
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Interactions

Interaction Checker

and chloroprocaine

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

            Common

            • Anxiety
            • Dizziness
            • Restlessness
            • Tremor
            • Tinnitus
            • Blurred vision

            Rare (serious)

            • Bradyarrhythmia
            • Cardiac arrest
            • Hypotension
            • Excitation
            • Depression
            • Seizure
            • Anaphylaxis
            • Respiratory arrest
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            Warnings

            Contraindications

            Hypersensitivity to para-aminobenzoic acid (PABA) or parabens

            Subarachnoid administration

            Cautions

            Use extreme caution with lumbar & caudal epidural anesthesia in person w/existing neurological disease, spinal deformities, septicemia, severe HTN

            Use preservative-free preparations for spinal or epidural anesthesia

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

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

            Monitor patient's state of consciousness following the injection; anxiety, dizziness, restlessness, tremors, depression, or blurred vision may be signs of CNS toxicity

            Chondrolysis associated with intra-articular infusions following arthroscopic and other surgical procedures (off-label use)

            Respiratory arrest reported with local anesthetics

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            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.

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            Pharmacology

            Mechanism of Action

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

            Pharmacokinetics

            Duration: 30-60 min; the greater the degree of vasodilation produced by the local anesthetic, the faster the rate of absorption & shorter the duration of action

            Protein bound: highly

            Vd: Depends on route of administration

            Onset of action: 6-12 min

            Metabolism: Plasma cholinesterases

            Metabolites: Ester- & amide-type local anesthetics

            Excretion: Urine (principally)

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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

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            • View the formulary and any restrictions for each plan.
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            • 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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