Skip to Content

Bupivacaine Injection

Last Updated: March 14, 2018
Status: Current

Bupivacaine Injection

Products Affected - Description
  • Marcaine solution for injection, Pfizer
    0.25%, 10 mL preservative-free vial, 10 count (NDC 00409-1559-10)
    0.25%, 30 mL preservative-free vial, 10 count (NDC 00409-1559-30)
    0.25%, 50 mL multiple dose vial, 1 count (NDC 00409-1587-50)
    0.5%, 10 mL preservative-free vial, 10 count (NDC 00409-1560-10)
    0.5%, 30 mL preservative-free vial, 10 count (NDC 00409-1560-29)
    0.5%, 50 mL multiple dose vial, 1 count (NDC 00409-1610-50)
    0.75%, 10 mL preservative-free vial, 10 count (NDC 00409-1582-10)
    0.75%, 30 mL preservative-free vial, 10 count (NDC 00409-1582-29)

 
Sensorcaine solution for injection, Fresenius Kabi
0.25%, 50 mL multiple dose vial, 25 count (NDC 63323-0465-57)
0.5%, 50 mL multiple dose vial, 25 count (NDC 63323-0467-57)

Sensorcaine-MPF solution for injection, Fresenius Kabi
0.25%, 30 mL preservative-free vial, 25 count (NDC 63323-0464-37)
0.5%, 10 mL preservative-free vial, 25 count (NDC 63323-0466-17)
0.5%, 30 mL preservative-free vial, sterile pack, 25 count (NDC 63323-0466-31)
 
Bupivacaine solution for injection, AuroMedics
0.25%, 10 mL preservative-free vial, 25 count (NDC 55150-0167-10)
0.25%, 30 mL preservative-free vial, 25 count (NDC 55150-0168-30)
0.5%, 10 mL preservative-free vial, 25 count (NDC 55150-0169-10)
0.5%, 30 mL preservative-free vial, 25 count (NDC 55150-0170-30)
 
Bupivacaine solution for injection, Pfizer
0.25%, 10 mL preservative-free vial, 25 count (NDC 00409-1159-01)
0.25%, 30 mL preservative-free vial, 25 count (NDC 00409-1159-02)
0.5%, 10 mL preservative-free vial, 25 count (NDC 00409-1162-01)
0.5%, 30 mL glass ampule, 25 count (NDC 00409-1161-01) - discontinued
0.5%, 30 mL preservative-free vial, 25 count (NDC 00409-1162-02)
Reason for the Shortage
    • AuroMedics has not provided a reason for the shortage.
    • Fresenius Kabi had Sensorcaine on shortage due to increased demand for the product.
    • Pfizer has bupivacaine on shortage due to manufacturing delays. Pfizer discontinued 0.5% bupivacaine 30 mL glass ampules in December 2017.
Available Products
  • Sensorcaine-MPF solution for injection, Fresenius Kabi

0.25%, 10 mL preservative-free vial, 25 count (NDC 63323-0464-17)
0.25%, 30 mL preservative-free vial, sterile pack, 25 count (NDC 63323-0464-31)
0.5%, 30 mL preservative-free vial, 25 count (NDC 63323-0466-37
0.75%, 10 mL preservative-free vial, 25 count (NDC 63323-0472-17)
0.75%, 30 mL preservative-free vial, 25 count (NDC 63323-0472-37)
 
Bupivacaine solution for injection, AuroMedics
0.75%, 10 mL preservative-free vial, 25 count (NDC 55150-0171-10)
0.75%, 30 mL preservative-free vial, 25 count (NDC 55150-0172-30)
 
Bupivacaine solution for injection, Pfizer
0.25%, 50 mL multiple dose vial, 25 count (NDC 00409-1160-01)
0.5%, 20 mL glass ampule, sterile pack, 5 count (NDC 00409-4273-01)
0.5%, 50 mL multiple dose vial, 25 count (NDC 00409-1163-01)
0.75%, 10 mL preservative-free vial, 25 count (NDC 00409-1165-01)
0.75%, 30 mL preservative-free vial, 25 count (NDC 00409-1165-02)

Estimated Resupply Dates

    • AuroMedics has 0.25% bupivacaine 10 mL and 30 mL preservative-free vials on intermittent back order and the company is releasing product as it becomes available. The 0.5% bupivacaine 10 mL and 30 mL preservative-free vials are on intermittent back order and the company is releasing product as it becomes available.
    • Pfizer has 0.25% bupivacaine 10 mL preservative-free vials and 30 mL preservative-free vials on back order and the company estimates a release date in late-March 2018. The 0.5% bupivacaine 10 mL preservative-free vials and 30 mL preservative-free vials are on back order and the company estimates a release date of early-May 2018 for the 10 mL preservative-free vials and early-April 2018 for the 0.5% 10 mL preservative-free vials.
    • Pfizer has all Marcaine presentations on back order and the company estimates a release date of March 2019.
    • Fresenius Kabi has 0.25% Sensorcaine 30 mL preservative-free vials on back order and the company estimates a release date in mid- to late-March 2018. The 0.25% 50 mL vials are on back order and the company estimates a release date in mid-April 2018. The 0.5% Sensorcaine 10 mL preservative-free vials are on back order and the company estimates a release date of late-April 2018. The 0.5% Sensorcaine 50 mL vials are on back order and the company estimates a release date of early-April 2018. The 0.5% Sensorcaine 30 mL preservative-free vials in sterile packs are on back order and the company cannot estimate a release date.

Alternative Agents & Management

  • Bupivacaine and lidocaine are amide-type local anesthetics commonly used in clinical practice. The following table compares their pharmacodynamic and pharmacokinetic properties. Key differences between the products are onset of action, duration of action, and dose. In general, bupivacaine is a longer-acting local anesthetic, while lidocaine has a more rapid onset, but shorter duration of action.1-2

    Table 1. Table. Comparison of Bupivacaine and lidocaine for Local Anesthesia1-6 

    Property

    Bupivacaine

    Lidocaine

    Onset of Action

    Infiltration: 2-10 min
    Epidural: 4-7 min
    Spinal: 1-15 min

    Not well-defined for anesthetic use as a single agent.
    In general local analgesia 1 to 3 min
    Spinal and Epidural rapid onset

    Duration of action:
    As a single agent

    Infiltration: 2-8 h
    Nerve block, minor: 3-6 h
    Epidural: 3-9 h
    Spinal: 1.5-3.5 h

    Infiltration: 0.5-2 h
    Nerve block, minor: 1-2 h
    Epidural: 100 min
    Spinal: 0.5-2 h

    Duration of action: Combined with epinephrine*

    Infiltration: 3-4 h
    Nerve block, minor: 4-7 h

    Infiltration: 2 h
    Nerve block, minor: 2-3 h

    Maximum Dose

    Single injections up to 175 mg without epinephrine or 225 mg with epinephrine; may repeat up to once every 3 hours.
    Maximum dosage: 400 mg/24 hours.

    Maximum: 4.5 mg/kg/dose not to exceed 300 mg without epinephrine or 7mg/kg/dose not to exceed 500 mg with epinephrine; do not repeat within 2 hours.
    Maximum dose for spinal anesthesia is 100 mg.

    Protein binding

    82%-96%

    60%-80%

    Volume of distribution

    ~2.5 L/kg

    1.5 + 0.6 L/kg

    Half-life, terminal

    Adults: 1.5-5 h
    Neonates: 8.1 h

    Adults: 1.5-2 h
    Premature infants: 3.2 h

    Metabolism

    Undergoes N-dealkylation in the liver.

    Extensive hepatic metabolism (90%) with active metabolites.

    Elimination

    Excreted in urine as metabolites and 5% as unchanged drug.

    Excreted in urine as metabolites (90%) and unchanged drug (<10%).

* Duration of effect is prolonged by use of local anesthetics in combination with epinephrine, although mangitude of effect is not well-defined for all routes.

References

    1. Berde CB, Strichartz GR. Local anesthetics. In: Miller RD, ed. Miller's Anesthesia. 8th ed. Philadelphia, PA: Elsevier Saunders;2015:1028-1054.e4.
    2. Drasner K. Local anesthetics. In: Miller RD, Pardo MC, ed. Basics of Anesthesia. 6th ed. Philadelphia, PA: Elsevier Saunders;2011:130-142.
    3. Drugdex system. Micromedex 2.0 [database online]. http://www.micromedexsolutions.com. Updated March 13, 2018. Greenwood Village, CO: Truven Health Analytics; Accessed March 13, 2018.
    4. Lexi-Drugs Online. Hudson, OH: Lexi-Comp, Inc; 2018.
    5. Bupivacaine hydrochloride and epinephrine injection, solution [package insert]. Lake Forest, IL: Hospira Inc; 2017.
    6. McEvoy GK, Snow EK, Kester L, Litvak K, Miller J, Welsh OH, eds. AHFS DI (Lexi-Comp Online). Bethesda, MD: American Society of Health-System Pharmacists; 2018.

Updated

Updated March 14, 2018 by Leslie Jensen, PharmD, Drug Information Specialist. Created November 16, 2011 by Leslie Jensen, PharmD, Drug Information Specialist. Copyright 2018, Drug Information Service, University of Utah, Salt Lake City, UT.

Hide