BUPIVACAINE HCL

Indications & Dose:

Surgical anaesthesia, lumbar epidural block

• BY REGIONAL ADMINISTRATION

Adult: 75–150 mg, dose administered using a 5 mg/mL (0.5%) solution

Surgical anaesthesia, field block

• BY REGIONAL ADMINISTRATION

Adult: Up to 150 mg, dose administered using a 2.5 mg/mL (0.25%) or 5 mg/mL (0.5%) solution

Surgical anaesthesia, thoracic epidural block

• BY THORACIC EPIDURAL

Adult: 12.5–50 mg, dose administered using a 2.5 mg/mL (0.25%) or 5 mg/mL (0.5%) solution

Surgical anaesthesia, caudal epidural block

• BY REGIONAL ADMINISTRATION

Adult: 50–150 mg, dose administered using a 2.5 mg/mL (0.25%) or 5 mg/mL (0.5%) solution

Surgical anaesthesia, major nerve block

• BY REGIONAL ADMINISTRATION

Adult: 50–175 mg, dose administered using 5 mg/ mL (0.5%) solution

Acute pain, intra-articular block

• BY INTRA-ARTICULAR INJECTION

% Adult: Up to 100 mg, dose administered using a 2.5 mg/mL (0.25%) solution; when co-administered with bupivacaine by another route, total max. 150mg

Acute pain, thoracic epidural block

•  BY CONTINUOUS EPIDURAL INFUSION

Adult: 6.3–18.8 mg/hour, dose administered using a 1.25 mg/mL (0.125%) or 2.5 mg/mL (0.25%) solution; maximum 400 mg per day

Acute pain, labour

• BY CONTINUOUS EPIDURAL INFUSION

Adult: 6.25–12.5 mg/hour, dose administered using a 1.25 mg/mL (0.125%) solution; maximum 400 mg per day

Acute pain, lumbar epidural block

• INITIALLY BY LUMBAR EPIDURAL

Adult: 15–37.5 mg, then (by lumbar epidural) 15– 37.5 mg, repeated when required at intervals of at least 30 minutes, dose administered by intermittent injection using a 2.5 mg/mL (0.25%) solution, alternatively (by continuous epidural infusion) 12.5–18.8 mg/hour, dose administered using a 1.25 mg/mL (0.125%) or 2.5 mg/mL (0.25%) solution; maximum 400 mg per day

Acute pain, field block

• BY REGIONAL ADMINISTRATION

Adult: Up to 150 mg, dose administered using a 2.5 mg/mL (0.25%) solution 

Contraindications:

Obstetrical paracervical block anesthesia

CONTRA INDICTED for epidural use in obstetrics.

Important: the licensed doses stated above may not be appropriate in some settings and expert advice should be sought.

Side Effects:

Cautions:

Precautions:

 Obstetrical  anesthesia (0.75% concentration), intravenous regional anesthesia, hypotension, heart block, hepatic disease, impaired cardiovascular function, use in head and neck area, retrobulbar blocks, elderly, anaphylaxis 

Interaction:

Drugs

ß blockers: Hypertensive reactions possible, especially with local anesthetics containing epinephrine; acute discontinuation of ß blockers before local anesthesia may increase the risk of side effects due to anesthetic 

Warnings:

Adverse Effects:

Lactations:

Excretion into breast milk unknown; regional use may prolong labor and delivery 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Anxiety, disorientation, drowsiness, loss of consciousness, restlessness, seizures, shivering, tremors

CV: Bradycardia, cardiac arrest, dysrhythmias, fetal bradycardia, hypertension, hypotensaon, myocardial depression

EENT: Blurred vision, miosis, tinnitus

GI: Nausea, vomiting

RESP: Respiratory arrest

SKIN: Allergic reactions, burning, edema, rash, skin discoloration at injection site, tissue necrosis, urticaria 

Patient And Carer Advice: