Marcaine (Bupivacaine Hydrochloride and Epinephrine Injection) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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February 9, 2012

Marcaine

Pain Management »

Introduction to pain management

Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:

Interventional procedures
Medication management
Physical therapy or chiropractic therapy
Psychological counseling and support
Acupuncture and other alternative therapies; and
Referral to other medical specialists

All of these skills and services are necessary because pain can involve many aspects of a person's daily life.

How is pain tre...

Read the Pain Management article »

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Marcaine

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Marcaine™
(bupivacaine hydrochloride) Injection, USP

Marcaine™
With Epinephrine 1:200,000 (as bitartrate)
Bupivacaine Hydrochloride and Epinephrine Injection, USP

DRUG DESCRIPTION

Bupivacaine hydrochloride is 2-Piperidinecarboxamide, 1-butyl-N-(2,6-dimethylphenyl)-, monohydrochloride, monohydrate, a white crystalline powder that is freely soluble in 95 percent ethanol, soluble in water, and slightly soluble in chloroform or acetone. It has the following structural formula:

Marcaine(Bupivacaine Hydrochloride) Structural Formula Illustration

Epinephrine is (-)-3,4-Dihydroxy-α-[(methylamino)methyl] benzyl alcohol. It has the following structural formula:

Epinephrine Structural Formula Illustration

MARCAINE (bupivacaine hydrochloride and epinephrine injection) is available in sterile isotonic solutions with and without epinephrine (as bitartrate) 1:200,000 for injection via local infiltration, peripheral nerve block, and caudal and lumbar epidural blocks. Solutions of MARCAINE (bupivacaine hydrochloride and epinephrine injection) may be autoclaved if they do not contain epinephrine. Solutions are clear and colorless.

Bupivacaine is related chemically and pharmacologically to the aminoacyl local anesthetics. It is a homologue of mepivacaine and is chemically related to lidocaine. All three of these anesthetics contain an amide linkage between the aromatic nucleus and the amino, or piperidine group. They differ in this respect from the procaine-type local anesthetics, which have an ester linkage.

MARCAINE (bupivacaine hydrochloride and epinephrine injection) - Sterile isotonic solutions containing sodium chloride. In multiple-dose vials, each mL also contains 1 mg methylparaben as antiseptic preservative. The pH of these solutions is adjusted to between 4 and 6.5 with sodium hydroxide or hydrochloric acid.

MARCAINE (bupivacaine hydrochloride and epinephrine injection) with epinephrine 1:200,000 (as bitartrate) - Sterile isotonic solutions containing sodium chloride. Each mL contains bupivacaine hydrochloride and 0.0091 mg epinephrine bitartrate, with 0.5 mg sodium metabisulfite, 0.001 mL monothioglycerol, and 2 mg ascorbic acid as antioxidants, 0.0017 mL 60% sodium lactate buffer, and 0.1 mg edetate calcium disodium as stabilizer. In multiple-dose vials, each mL also contains 1 mg methylparaben as antiseptic preservative. The pH of these solutions is adjusted to between 3.4 and 4.5 with sodium hydroxide or hydrochloric acid. The specific gravity of MARCAINE (bupivacaine hydrochloride and epinephrine injection) 0.5% with epinephrine 1:200,000 (as bitartrate) at 25°C is 1.008 and at 37°C is 1.008.

What are the possible side effects of bupivacaine (Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have any of these serious side effects:

weak or shallow breathing;
fast heart rate, gasping, feeling unusually hot;
slow heart rate, weak pulse;
feeling restless or anxious, ringing in the ears, metallic taste, speech problems, numbness or...

Read All Potential Side Effects and See Pictures of Marcaine »

Last reviewed on RxList: 3/8/2010
This monograph has been modified to include the generic and brand name in many instances.