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Vivacaine 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 Vivacaine.

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.


  • 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

For Healthcare Professionals

Applies to bupivacaine/epinephrine: injectable solution


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]


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]


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]


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]


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


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


Uncommon (0.1% to 1%): Muscle twitch
Frequency not reported: Backache[Ref]


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


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


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


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


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


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


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

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

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

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

Some side effects of Vivacaine 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.