Mepivacaine (injection route)


    Brand Name

    US Brand Name

    Carbocaine

    Polocaine

    Polocaine Dental

    Polocaine-MPF


    Description

    Mepivacaine injection is used to cause numbness or loss of feeling and prevention of pain for patients having certain medical procedures.

    This medicine is to be given only by or under the direct supervision of your doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Because of this medicine's toxicity, it should be used with extreme caution in children younger than 6 months of age. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mepivacaine injection in the elderly. However, elderly patients are more likely to have kidney problems, which may require caution and an adjustment in the dose for patients receiving mepivacaine injection.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Bupivacaine
    • Bupivacaine Liposome
    • Hyaluronidase
    • Propranolol
    • St John's Wort
    • Verapamil

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Clonidine

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Blood vessel disease or
    • Heart disease or
    • Hypertension (high blood pressure)—Use with caution. The chance of side effects may be increased.
    • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
    • Heart problems or
    • Lung or breathing problems or
    • Methemoglobinemia (blood disorder), hereditary or idiopathic (unknown cause)—Use with caution. May increase risk of having methemoglobinemia.
    • Kidney disease or
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
    • Swelling or sepsis (serious infection) in the treatment area—Use with caution.

    Proper Use

    A nurse or other trained health professional will give you this medicine. It is given through a needle injected into the surgical site or through a catheter placed into your lower back for an epidural or a spinal block. You may also receive the injection into your rib cage, chest, or other body areas.

    This medicine should cause numbness only to the area where it is injected. You may experience temporary loss of sensation or movement in the injected area. This type of numbing procedure is called local anesthesia. It is not meant to cause you to fall asleep or become unconscious.

    You may experience temporary loss of sensation and movement, usually in the lower half of your body, if you receive this medicine into your lower back (epidural). It may be easier to hurt yourself while your treated body area is still numb. Be careful to avoid injury until you have regained all the feeling and are no longer numb.

    If you are receiving this medicine as an epidural to ease labor pains, it may take longer than normal for you to push your baby out. It is also possible that the baby may have unwanted effects after birth (including sleepiness, slow responses). Talk to your doctor if you have questions about how this medicine might affect your baby.


    Precautions

    It is very important that your doctor check your or your child's progress closely while receiving this medicine to see if it is working properly. Blood tests may be needed to check for any unwanted effects.

    This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

    Tell your doctor or nurse right away if you have the following symptoms with this medicine: anxiety, blurred vision, depression, drowsiness, lightheadedness, nausea or vomiting, numbness and tingling of the mouth or lips, restlessness, ringing in the ears, speech problems, or tremors.

    This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat after receiving this medicine.

    This medicine may also increase your risk of having serious heart and blood vessel problems such as a heart attack, heart rhythm changes, or low blood pressure. Check with your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, pounding, slow heartbeat, troubled breathing, or unusual tiredness or weakness.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    Incidence not known

    • Anxiety
    • blurred vision
    • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
    • chest pain or discomfort
    • cold, clammy, pale skin
    • confusion
    • continuing ringing or buzzing or other unexplained noise in the ears
    • cough
    • decrease in the frequency and amount of urine
    • difficulty in passing urine (dribbling)
    • difficulty swallowing
    • discouragement
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • drowsiness
    • excitement
    • false or unusual sense of well-being
    • fast or irregular heartbeat
    • feeling sad or empty
    • general feeling of illness
    • hearing loss
    • hives, itching, skin rash
    • inability to breathe without assistance
    • irritability
    • lack of appetite
    • loss of interest or pleasure
    • nausea
    • painful urination
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • restlessness
    • seizures
    • severe headache
    • shivering
    • slow heart rate
    • slowing of labor
    • stiff neck or back
    • sweating
    • tightness in the chest
    • trouble concentrating
    • trouble sleeping
    • unusual tiredness or weakness
    • vomiting
    • weakness of the muscles in your face

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Incidence not known

    • Abnormal ejaculation
    • decreased sexual performance or desire
    • feeling of heat
    • loss of bladder and bowel control
    • loss of genital sensation and sexual function
    • no sensation in the legs
    • numbness
    • unable to move the legs

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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