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Carbocaine

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Carbocaine

Indications
Dosage
How Supplied

INDICATIONS

CARBOCAINE (mepivacaine) is indicated for production of local or regional analgesia and anesthesia by local infiltration, peripheral nerve block techniques, and central neural techniques including epidural and caudal blocks.

The routes of administration and indicated concentrations for CARBOCAINE (mepivacaine) are:

local infiltration 0.5% (via dilution) or 1%
peripheral nerve blocks 1% and 2%
epidural block 1%, 1.5%, 2%
caudal block 1%, 1.5%, 2%

See DOSAGE AND ADMINISTRATION for additional information. Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of CARBOCAINE (mepivacaine) .

DOSAGE AND ADMINISTRATION

The dose of any local anesthetic administered varies with the anesthetic procedure, the area to be anesthetized, the vascularity of the tissues, the number of neuronal segments to be blocked, the depth of anesthesia and degree of muscle relaxation required, the duration of anesthesia desired, individual tolerance and the physical condition of the patient. The smallest dose and concentration required to produce the desired result should be administered. Dosages of CARBOCAINE (mepivacaine) should be reduced for elderly and debilitated patients and patients with cardiac and/or liver disease. The rapid injection of a large volume of local anesthetic solution should be avoided and fractional doses should be used when feasible.

For specific techniques and procedures, refer to standard textbooks.

There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. CARBOCAINE is not approved for this use (see WARNINGS).

The recommended single adult dose (or the total of a series of doses given in one procedure) of CARBOCAINE (mepivacaine) for unsedated, healthy, normal-sized individuals should not usually exceed 400 mg. The recommended dosage is based on requirements for the average adult and should be reduced for elderly or debilitated patients.

While maximum doses of 7 mg/kg (550 mg) have been administered without adverse effect, these are not recommended, except in exceptional circumstances and under no circumstances should the administration be repeated at intervals of less than 1 &fract12; hours. The total dose for any 24-hour period should not exceed 1,000 mg because of a slow accumulation of the anesthetic or its derivatives or slower than normal metabolic degradation or detoxification with repeat administration (see CLINICAL PHARMACOLOGY and PRECAUTIONS).

Pediatric patients tolerate the local anesthetic as well as adults. However, the pediatric dose should be carefully measured as a percentage of the total adult dose based on weight, and should not exceed 5 mg/kg to 6 mg/kg (2.5 mg/lb to 3 mg/lb) in pediatric patients, especially those weighing less than 30 lb. In pediatric patients under 3 years of age or weighing less than 30 lb concentrations less than 2% (e.g., 0.5% to 1.5%) should be employed.

Unused portions of solutions not containing preservatives, i.e., those supplied in single-dose vials, should be discarded following initial use.

This product should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Solutions which are discolored or which contain particulate matter should not be administered.

Recommended Concentrations and Doses of Carbocaine (mepivacaine)

Procedure Concentration Total Dose Comments
mL mg
Cervical, brachial, intercostal, pudendal
nerve block
1% 5-40 50-400 Pudendal block: one half of total dose injected each side.
2% 5-20 100-400
Transvaginal block (paracervical plus pudendal) 1% up to 30 (both sides) up to 300 (both sides) One half of total dose injected each side.See PRECAUTIONS.
Paracervical block 1% up to 20 (both sides) up to 200 (both sides) One half of total dose injected each side. This is maximum recommended dose per 90minute period in obstetrical and non-obstetrical patients. Inject slowly, 5 minutes between sides. See PRECAUTIONS.
Caudal and epidural block 1% 15-30 150-300 Use only single-dose vials which do not contain a preservative.
1.5% 10-25 150-375
2% 10-20 200-400
Infiltration 1% up to 40 up to 400 An equivalent amount of a 0.5% solution (prepared by diluting the 1% solution with Sodium Chloride Injection, USP) may be used for large areas.
Therapeutic block (pain management) 1% 1-5 10-50  
2% 1-5 20-100

Unused portions of solutions not containing preservatives should be discarded.

HOW SUPPLIED

Single-dose vials and multiple-dose vials of CARBOCAINE (mepivacaine) may be sterilized by autoclaving at 15 pound pressure, 121°C (250°F) for 15 minutes. Solutions of CARBOCAINE (mepivacaine) may be reautoclaved when necessary. Do not administer solutions which are discolored or which contain particulate matter.

THESE SOLUTIONS ARE NOT INTENDED FOR SPINAL ANESTHESIA OR DENTAL USE

NDC No. Container Concentration Fill
0409-1036-30 Single-dose vials 1% 30 mL
0409-1038-50 Multiple-dose vials 1% 50 mL
0409-1041-30 Single-dose vials 1.5% 30 mL
0409-1067-20 Single-dose vials 2% 20 mL
0409-2047-50 Multiple-dose vials 2% 50 mL

Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]

Revised: November, 2009. Hospira, Inc., Lake Forest, IL 60045 USA.

Last reviewed on RxList: 3/4/2010
This monograph has been modified to include the generic and brand name in many instances.

Indications
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