Skip to Content

Marcaine Spinal Side Effects

Generic Name: bupivacaine

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

For the Consumer

Applies to bupivacaine: injection injectable, injection kit, injection solution

Along with its needed effects, bupivacaine (the active ingredient contained in Marcaine Spinal) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

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
  • cough
  • difficulty swallowing
  • discouragement
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • excitement
  • fast or irregular heartbeat
  • feeling sad or empty
  • general feeling of illness
  • hives, itching, skin rash
  • inability to breathe without assistance
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • nausea
  • 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 of bupivacaine 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
  • continuing ringing or buzzing or other unexplained noise in the ears
  • decrease in frequency and amount of urine
  • decreased sexual performance or desire
  • difficulty in passing urine [dribbling]
  • hearing loss
  • no sensation in the legs
  • numbness
  • painful urination
  • unable to move the legs

For Healthcare Professionals

Applies to bupivacaine: compounding powder, injectable kit, injectable solution, intrathecal solution, intravenous solution


The most frequently reported side effects are acute adverse experiences which demand immediate countermeasures are related to the central nervous system and the cardiovascular system. A major cause of adverse reactions is excessive plasma levels, which may be due to overdose, unintentional intravascular injection, or slow metabolic degradation. It is also difficult to distinguish adverse reactions caused by the drug per se from the physiological effects of the nerve block (e.g. decrease in blood pressure, bradycardia, temporary urinary retention), events caused directly (e.g. spinal hematoma) or indirectly (e.g. meningitis, epidural abscess) by needle puncture or events associated to cerebrospinal leakage (e.g. postdural puncture headache).[Ref]


Very common (10% or more): Hypotension, bradycardia
Common (1% to 10%): Hypertension
Rare (less than 0.1%): Cardiac arrest, cardiac arrhythmia
Frequency not reported: Cardiac output decreased, heart block, ventricular tachycardia, ventricular fibrillation, myocardium depression, cardiovascular collapse, maternal hypotension[Ref]

Nervous system

Common (1% to 10%): Paresthesia, postdural puncture headache, dizziness
Uncommon (0.1% to 1%): Paresis, dysesthesia, convulsion, circumoral paresthesia, unconsciousness, tremor, lightheadedness, dysarthria
Rare (less than 0.1%): Paraplegia, paralysis, neuropathy, arachnoiditis, total unintentional spinal block, peripheral nerve injury
Frequency not reported: Loss of sphincter control, meningismus, cranial nerve palsies, syncope, high/total spinal block, slurred speech, drowsiness, spinal hematoma[Ref]


Very common (10% or more): Nausea
Common (1% to 10%): Vomiting
Frequency not reported: Fecal incontinence, swallowing difficult, numbness of tongue[Ref]


Frequency not reported: Persistent anesthesia[Ref]


Common (1% to 10%): Urinary retention, urinary incontinence
Frequency not reported: Loss of perineal sensation, loss of sexual function[Ref]


Rare (less than 0.1%): Respiratory depression
Frequency not reported: Respiratory arrest, laryngeal edema, sneezing, respiratory paralysis, hypoxia, hypercarbia[Ref]


Uncommon (0.1% to 1%): Hyperacusis, tinnitus
Frequency not reported: Alkaline phosphatase increased, bilirubin increased, chills, weakness, septic meningitis, labor delayed, temperature elevated, forceps delivery increased, sensation of heat, cold/numbness[Ref]


Rare (less than 0.1%): Allergic reaction, anaphylactic shock
Frequency not reported: Anaphylaxis[Ref]


Uncommon (0.1% to 1%): Vision disturbed
Rare (less than 0.1%): Diplopia
Frequency not reported: Blurred vision, pupils constricted[Ref]


Frequency not reported: Restlessness, anxiety, depression, agitation, nervousness, apprehension, euphoria, confusion[Ref]


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


Frequency not reported: Urticaria, pruritus, erythema, angioedema, excessive sweating, cutaneous lesion[Ref]


Uncommon (0.1% to 1%): Muscle weakness, back pain, muscle twitching
Frequency not reported: Joint pain, stiffness, loss of motion
Postmarketing reports: Chondrolysis[Ref]


1. "Product Information. Marcaine HCl (bupivacaine)." Hospira Inc, Lake Forest, IL.

2. "Product Information. Bupivacaine Hydrochloride, Spinal (bupivacaine)." Claris Lifesciences Inc, North Brunswick, NJ.

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

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

Some side effects of Marcaine Spinal may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.