Skip to Content

bupivacaine

Generic Name: bupivacaine (bue PIV a kane)
Brand Name: Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF, Sensorcaine-MPF Spinal

What is bupivacaine?

Bupivacaine is an anesthetic (numbing medicine) that blocks the nerve impulses that send pain signals to your brain.

Bupivacaine is used as a local (in only one area) anesthetic.

Bupivacaine is given as an epidural injection into the spinal column to produce numbness during labor, surgery, or certain medical procedures.

Bupivacaine is also used as an anesthetic for dental procedures.

Bupivacaine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about bupivacaine?

Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine.

Some epidural numbing medications can have long-lasting or permanent effects on certain body processes such as sexual function, bowel or bladder control, and movement or feeling in your legs or feet. Talk with your doctor about your specific risk of nerve damage from bupivacaine.

What should I discuss with my healthcare provider before receiving bupivacaine?

Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine.

To make sure bupivacaine is safe for you, tell your doctor if you have:

  • anemia (lack of red blood cells);

  • kidney or liver disease;

  • a bleeding or blood clotting disorder;

  • syphilis, polio, a brain or spinal cord tumor;

  • numbness or tingling;

  • chronic back pain, headache caused by surgery;

  • low or high blood pressure;

  • abnormal curvature of the spine; or

  • arthritis.

It is not known whether bupivacaine will harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether bupivacaine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is bupivacaine given?

Bupivacaine is injected through a needle directly into or near the area to be numbed. You will receive this injection in a dental or hospital setting.

For an epidural, bupivacaine is given as an injection through a needle placed into an area of your middle or lower back near your spine.

For a dental procedure, bupivacaine is injected directly into the mouth near the tooth or teeth your dentist will be working on.

Your breathing, blood pressure, oxygen levels, or other vital signs will be watched closely while you are receiving bupivacaine.

Some epidural numbing medications can have long-lasting or permanent effects on certain body processes such as sexual function, bowel or bladder control, and movement or feeling in your legs or feet. Talk with your doctor about your specific risk of nerve damage from bupivacaine.

What happens if I miss a dose?

Since bupivacaine is given as needed before a surgery or dental procedure, you are not likely to be on a dosing schedule.

What happens if I overdose?

Since bupivacaine is given in a medical setting, you will be watched closely to make sure you do not receive too much of this medicine. Your caregivers will quickly treat you if you have overdose symptoms.

What should I avoid after receiving bupivacaine?

This medicine can cause numbness over a large portion of your body. Take care to avoid injury before the feeling has returned completely.

After a dental procedure, avoid eating, chewing gum, or drinking a hot beverage until your mouth is no longer numb.

Bupivacaine side effects

Get emergency medical help if you have signs of an allergic reaction: hives, red rash, itching; sneezing, difficulty breathing; severe dizziness, vomiting; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have any of these serious side effects:

  • feeling anxious, restless, confused, or like you might pass out;

  • problems with speech or vision;

  • ringing in the ears, metallic taste, numbness or tingling around your mouth, or tremors;

  • seizure (convulsions);

  • weak or shallow breathing;

  • fast heart rate, gasping, feeling unusually hot;

  • slow heart rate, weak pulse;

  • urinating less than usual or not at all.

Common side effects include:

  • nausea, vomiting;

  • chills or shivering;

  • headache; or

  • back pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Bupivacaine dosing information

Usual Adult Dose for Local Anesthesia:

Local Infiltration:
0.25% concentration: Inject up to the maximum dose of 175 mg

Epidural Block:
0.75% concentration: Inject 75 to 150 mg (10 to 20 mL) once for complete motor block; not for obstetrical anesthesia
0.5% concentration: Inject 50 to 100 mg (10 to 20 mL) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 25 to 50 mg (10 to 20 mL) for partial to moderate motor block; repeat doses increase the degree of motor block

Epidural Anesthesia: 0.5% and 0.75% solutions should be administered in 3 to 5 mL increments with sufficient time between doses to detect toxicity or accidental intravascular or intrathecal injection

Epidural Anesthesia in Obstetrics: Only 0.5% and 0.25% concentrations should be used; 0.5% solution should be administered in 3 to 5 mL increments not exceeding 50 to 100 mg at any dosing interval; repeat doses should follow a test dose containing epinephrine if not contraindicated; only preservative-free products should be used

Caudal Block:
0.5% concentration: Inject 75 to 150 mg (15 to 30 mL) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 37.5 to 75 mg (15 to 30 mL) for moderate motor block; repeat doses increase the degree of motor block

Peripheral Nerve Block:
0.5% concentration: Inject 25 mg up to the maximum dose (5 mL up to the maximum dose) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 12.5 mg up to the maximum dose (5 mL up to the maximum dose) for moderate to complete motor block; repeat doses increase the degree of motor block

Retrobulbar Block:
0.75% concentration: Inject 15 to 30 mg (2 to 4 mL) for complete motor block; repeat doses increase the degree of motor block

Sympathetic Block:
0.25% concentration: Inject 50 to 125 mg (20 to 50 mL)

Comments:
-Most experience to date is with single doses up to 175 mg.
-Doses may be repeated up to once every 3 hours; not to exceed 400 mg in 24 hours.
-A test dose should be given prior to caudal and lumbar epidural blocks; the manufacturer product information should be consulted for further information
-These recommendations are to serve as a guide for use in the average adult.
-Standard textbooks should be consulted for specific techniques and procedures.

Uses: For the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures (only 0.25% and 0.5% concentrations indicated for obstetrical anesthesia)

Usual Adult Dose for Cesarean Section:

7.5 to 10.5 mg (1 to 1.4 mL) of preservative free 0.75% bupivacaine in 8.25% dextrose has been used has been used for Cesarean section under spinal anesthesia

Comments:
-At recommended doses, 0.75% bupivacaine in 8.25% dextrose produces complete motor and sensory block.
-These recommendations are to serve as a guide for use in the average adult.
-Standard textbooks should be consulted to determine accepted procedure and techniques for the administration of spinal anesthesia

Usual Adult Dose for Anesthesia:

Spinal Anesthesia for Lower Extremity and Perineal Procedures: 7.5 mg (1 mL) of preservative free 0.75% bupivacaine in 8.25% dextrose has been used

Comments: Procedures include vaginal hysterectomy and transurethral resection of the prostate (TURP).

Spinal Anesthesia for Lower Abdominal Procedures: 12 mg (1.6 mL) of preservative free 0.75% bupivacaine in 8.25% dextrose has been used

Comments:
-Procedures include abdominal hysterectomy, tubal ligation, and appendectomy.
-At recommended doses, 0.75% bupivacaine in 8.25% dextrose produces complete motor and sensory block.
-These recommendations are to serve as a guide for use in the average adult.
-Standard textbooks should be consulted to determine accepted procedure and techniques for the administration of spinal anesthesia.

Usual Pediatric Dose for Local Anesthesia:

The following recommendations are for pediatric patients 12 years or older:

Local Infiltration:
0.25% concentration: Inject up to the maximum dose of 175 mg

Epidural Block:
0.75% concentration: Inject 75 to 150 mg (10 to 20 mL) once for complete motor block; not for obstetrical anesthesia
0.5% concentration: Inject 50 to 100 mg (10 to 20 mL) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 25 to 50 mg (10 to 20 mL) for partial to moderate motor block; repeat doses increase the degree of motor block

Epidural Anesthesia: 0.5% and 0.75% solutions should be administered in 3 to 5 mL increments with sufficient time between doses to detect toxicity or accidental intravascular or intrathecal injection

Epidural Anesthesia in Obstetrics: Only 0.5% and 0.25% concentrations should be used; 0.5% solution should be administered in 3 to 5 mL increments not exceeding 50 to 100 mg at any dosing interval; repeat doses should follow a test dose containing epinephrine if not contraindicated; only preservative-free products should be used

Caudal Block:
0.5% concentration: Inject 75 to 150 mg (15 to 30 mL) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 37.5 to 75 mg (15 to 30 mL) for moderate motor block; repeat doses increase the degree of motor block

Peripheral Nerve Block:
0.5% concentration: Inject 25 mg up to the maximum dose (5 mL up to the maximum dose) for moderate to complete motor block; repeat doses increase the degree of motor block
0.25% concentration: Inject 12.5 mg up to the maximum dose (5 mL up to the maximum dose) for moderate to complete motor block; repeat doses increase the degree of motor block

Retrobulbar Block:
0.75% concentration: Inject 15 to 30 mg (2 to 4 mL) for complete motor block; repeat doses increase the degree of motor block

Sympathetic Block:
0.25% concentration: Inject 50 to 125 mg (20 to 50 mL)

Comments:
-Most experience to date is with single doses up to 175 mg.
-Doses may be repeated up to once every 3 hours; not to exceed 400 mg in 24 hours.
-A test dose should be given prior to caudal and lumbar epidural blocks; the manufacturer product information should be consulted for further information
-These recommendations are to serve as a guide for use in the average adult.
-Standard textbooks should be consulted for specific techniques and procedures.

Uses: For the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures (only 0.25% and 0.5% concentrations indicated for obstetrical anesthesia)

What other drugs will affect bupivacaine?

Tell your doctor about all other medicines you use, especially:

  • an antidepressant or antipsychotic medication;

  • anti-nausea medicine such as prochlorperazine (Compazine) or promethazine (Phenergan);

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine; or

  • an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

This list is not complete. Other drugs may interact with bupivacaine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about bupivacaine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01.

Date modified: December 03, 2017
Last reviewed: July 29, 2016

Hide