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Marcaine HCl with Epinephrine Side Effects

Generic Name: bupivacaine / epinephrine

Note: This document contains side effect information about bupivacaine / epinephrine. Some of the dosage forms listed on this page may not apply to the brand name Marcaine HCl with Epinephrine.

For the Consumer

Applies to bupivacaine / epinephrine: injection solution

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

For all uses of this drug:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat the does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
  • Feeling hot or cold.
  • Dizziness or passing out.
  • Restlessness.
  • Anxiety.
  • Change in speech.
  • Numbness or tingling in the mouth.
  • Metallic taste.
  • Blurred eyesight.
  • Ringing in ears.
  • Shakiness.
  • Twitching.
  • Low mood (depression).
  • Feeling sleepy.
  • Seizures.
  • Trouble breathing, slow breathing, or shallow breathing.
  • A burning, numbness, or tingling feeling that is not normal.
  • Very nervous and excitable.
  • Very bad headache.
  • Slow heartbeat.

Spinal:

  • Trouble passing urine.
  • Loss of bladder or bowel control.
  • Not able to get or keep an erection.
  • Long-lasting burning, numbness, tingling, or paralysis in the lower half of the body.
  • Headache.
  • Backache.
  • Fever or chills.
  • Very upset stomach or throwing up.
  • Stiff neck.
  • If bright lights bother your eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

For Healthcare Professionals

Applies to bupivacaine/epinephrine: injectable solution

General

Reactions to this drug are characteristic of those associated with other amide-type local anesthetics. A major cause of side effects can me associated with excessive plasma levels which may be due to overdose, unintentional intravascular injection, or slow metabolic degradation.[Ref]

Cardiovascular

Very common (10% or more): Hypotension

Common (1% to 10%): Bradycardia, hypertension

Rare (less than 0.1%): Cardiac arrest, cardiac arrhythmia

Frequency not reported: Severe hypotension, cardiovascular collapse, tachycardia, maternal hypotension, ventricular fibrillation, ventricular tachycardia, ventricular arrhythmia, heart block, depression of myocardium[Ref]

Gastrointestinal

Very common (10% or more): Nausea

Common (1% to 10%): Vomiting

Frequency not reported: Difficulty swallowing, fecal incontinence, loss of bowel control[Ref]

Nervous system

Common (1% to 10%): Paresthesia, dizziness

Uncommon (0.1% to 1%): Central nervous system toxicity, convulsions, circumoral paresthesia, numbness of tongue, hyperacusis, loss of consciousness, tremor, light-headedness, dysarthria

Rare (less than 0.1%): Neuropathy, peripheral nerve injury, arachnoiditis, paresis, paraplegia

Frequency not reported: Unconsciousness, grand mal convulsion, drowsiness, convulsion, slurred speech, syncope, headache, persistent anesthesia, weakness, paralysis, loss of sphincter control, cranial nerve palsie[Ref]

Genitourinary

Common (1% to 10%): Urinary retention

Frequency not reported: Urinary incontinence, loss of perineal sensation, loss of sexual function, loss of bladder control, labor slowed[Ref]

Other

Frequency not reported: Tinnitus, sensations of heat, sensations of cold, numbness, edema, death, septic meningitis, meningismus, forcep delivery increased[Ref]

Dermatologic

Frequency not reported: Cutaneous lesion, urticaria, excessive sweating, pruritus, erythema, angioedema, laryngeal edema[Ref]

Musculoskeletal

Uncommon (0.1% to 1%): Muscle twitch

Frequency not reported: Backache[Ref]

Metabolic

Frequency not reported: Hyperkalemia, hypocalcemia, acidosis, hypocalcemia[Ref]

Hepatic

Frequency not reported: Hepatic dysfunction, ALT increased, AST increased[Ref]

Ocular

Uncommon (0.1% to 1%): Vision disturbed

Rare (less than 0.1%): Diplopia

Frequency not reported: Vision blurred, pupils constricted[Ref]

Psychiatric

Frequency not reported: Nervousness, apprehension, euphoria, confusion, agitation, excitation, depression, restlessness, anxiety[Ref]

Respiratory

Rare (less than 0.1%): Respiratory depression

Frequency not reported: Apnea, hypoxia, hypercarbia, respiratory arrest, sneezing[Ref]

Immunologic

Rare (less than 0.1%): Allergic reaction, anaphylactic reaction/shock[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Marcaine HCl with Epinephrine (bupivacaine-epinephrine)." Hospira Inc, Lake Forest, IL.

4. "Product Information. Sensorcaine-MPF with Epinephrine (bupivacaine-epinephrine)." Astra-Zeneca Pharmaceuticals, Wilmington, DE.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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