Ropivacaine Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 19, 2025.

Applies to ropivacaine: injection solution.

Precautions

It is very important that your doctor check your progress closely while you are receiving this medicine to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

If you receive this medicine into your lower back (epidural), you may experience temporary loss of sensation and movement, usually in the lower half of your body. Talk with your doctor if you have concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of ropivacaine

Along with its needed effects, ropivacaine 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 ropivacaine:

Other side effects of ropivacaine

Some side effects of ropivacaine 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:

For healthcare professionals

Applies to ropivacaine: injectable solution.

General adverse events

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 (up to 54.6%), bradycardia (up to 19.5%), fetal bradycardia (12.1%)
• Common (1% to 10%): Hypertension, tachycardia, chest pain, fetal tachycardia, fetal distress
• Uncommon (0.1% to 1%): Syncope, severe hypotension
• Rare (less than 0.1%): Cardiac arrest, cardiac arrhythmia
• Frequency not reported: Vasovagal reaction, postural hypotension, non-specific ECG abnormalities, extrasystole, nonspecific arrhythmia, atrial fibrillation, ST segment changes, myocardial infarction, deep vein thrombosis, phlebitis, pulmonary embolism^[Ref]

Nervous system

• Common (1% to 10%): Paresthesia, headache, dizziness, hypoesthesia
• Uncommon (0.1% to 1%): CNS toxicity, convulsion, grand mal convulsions, seizure, lightheadedness, circumoral paresthesia, numbness of the tongue, hyperacusis, dysarthria, tremor
• Frequency not reported: Horner's syndrome, paresis, dyskinesia, neuropathy, coma, convulsion, hypokinesia, hypotonia, ptosis, stupor, spinal cord dysfunction, anterior spinal artery syndrome, arachnoiditis, cauda equine, total spinal block, persistent anesthesia, weakness, paralysis of lower extremities, loss of sphincter control, septic meningitis^[Ref]

Local

• Frequency not reported: Injection site pain^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 29.4%), vomiting (up to 14.6%)
• Common (1% to 10%): Neonatal vomiting
• Frequency not reported: Fecal incontinence, tenesmus^[Ref]

Other

• Common (1% to 10%): Fever, pain, postoperative complication, rigors, neonatal complication, Apgar score low, neonatal fever, neonatal infection, temperature elevation, chills
• Uncommon (0.1% to 1%): Tinnitus, hypothermia, neonatal sepsis
• Frequency not reported: Malaise, asthenia, accident/injury, hearing abnormal, vertigo^[Ref]

Genitourinary

• Common (1% to 10%): Urinary retention, oliguria, urinary tract infection, progression of labor poor/failed
• Frequency not reported: Uterine atony, urinary incontinence, micturition disorder^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus
• Rare (less than 0.1%): Angioedema, urticaria
• Frequency not reported: Rash^[Ref]

Hematologic

• Common (1% to 10%): Anemia^[Ref]

Hepatic

• Common (1% to 10%): Neonatal jaundice
• Frequency not reported: Jaundice^[Ref]

Metabolic

• Common (1% to 10%): Hypokalemia, neonatal hypoglycemia
• Uncommon (0.1% to 1%): Fetal acidosis
• Frequency not reported: Hypomagnesemia^[Ref]

Musculoskeletal

• Very common (10% or more): Back pain (up to 16.4%)
• Common (1% to 10%): Cramps
• Uncommon (0.1% to 1%): Muscular twitch, muscular rigidity, hypotonia
• Frequency not reported: Myalgia^[Ref]

Ocular

• Frequency not reported: Vision abnormal, vision blurred, pupil constriction^[Ref]

Psychiatric

• Common (1% to 10%): Anxiety, insomnia
• Frequency not reported: Agitation, confusion, somnolence, nervousness, amnesia, hallucination, emotional lability, nightmares, restlessness, drowsiness, unconsciousness^[Ref]

Respiratory

• Common (1% to 10%): Dyspnea, rhinitis, neonatal respiratory disorder, neonatal tachypnea, hypoxia, hypercapnia, apnea
• Frequency not reported: Bronchospasm, coughing, underventilation, apnea, respiratory paralysis^[Ref]

Endocrine

• Common (1% to 10%): Breast disorder/breastfeeding disorder^[Ref]

Immunologic

• Rare (less than 0.1%): Allergic reaction, anaphylactic reaction^[Ref]

See also:

Further information

Ropivacaine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer