Generic name: lidocaine hydrochloride and bupivacaine hydrochloride
Dosage form: injection
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For retrobulbar injection, 2–5 mL of Duocaine™ solution (20–50 mg of lidocaine and 7–18 mg of bupivacaine) is injected; a portion of the dose is injected retrobulbarly and the remainder may be used to block the facial nerve.
For peribulbar block, the usual dose is 6–12 mL of Duocaine™ solution (60–120 mg of lidocaine and 22–45 mg of bupivacaine), and this technique produces akinesia of the superior oblique muscle, the eyelids and the orbicularis oculi muscle.
Maximum recommended dosage
Maximum dosage limit must be individualized in each case after evaluating the size and physical status of the patients, as well as the usual rate of systemic absorption from a particular injection site.
For normal healthy adults, the individual maximum recommended dose of Duocaine™ without epinephrine should not exceed 0.18 mL/kg (0.08 mL/lb) of body weight, and in general it is recommended that the maximum total dose not exceed 12 mL(120 mg of lidocaine and 45 mg of bupivacaine). When used with epinephrine the maximum individual dose should not exceed 0.28 mL/kg (0.14 mL/lb) of body weight, and in general it is recommended that the maximum total dose does not exceed 20 mL(200 mg of lidocaine and 75 mg of bupivacaine).
NOTE: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. The Injection is not to be used if it is cloudy or contains a precipitate.
Unused portions of solutions in single dose containers should be discarded, since this product form contains no preservatives.