Mepivacaine

Your doctor or pharmacist can provide more information about mepivacaine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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This is not a complete list of Mepivacainedrug interactions. Ask your doctor or pharmacist for more information.

For an epidural or spinal block, mepivacaine is injected into an area of your lower back near your spine. You will receive this injection in a hospital or surgical setting.

For a dental procedure, mepivacaine is injected into the gum area inside your mouth. You will receive this injection in a dentist's office or oral surgery setting.

Your breathing, blood pressure, oxygen levels, and other vital signs may be watched closely while you are receiving mepivacaine.

Spinal numbing medications can have long-lasting or permanent effects on certain body processes. This includes sexual function, bowel or bladder control, and movement or feeling in your legs or feet. Talk with your doctor about your specific risk of nerve damage from mepivacaine.

Get emergency medical help if you have any of these signs of an allergic reaction: hives, itching, skin redness; nausea, vomiting, sweating, feeling hot; fast heartbeats; sneezing, difficult breathing; dizziness, fainting; swelling of your face, lips, tongue, or throat.

Tell your caregiver right away if you have:

• numbness and tingling in your mouth or lips, metallic taste in your mouth;

• ringing in your ears, blurred vision, slurred speech, headache;

• confusion, depression, severe drowsiness, feeling like you might pass out;

• slow heart rate, weak pulse, weak or shallow breathing;

• fever, neck stiffness, increased sensitivity to light;

• tremors or muscle twitching, feeling anxious or restless;

• ongoing numbness, weakness, or loss of movement in your legs or feet;

• loss of bladder or bowel control;

• loss of feeling in your lower stomach, groin, or genitals;

• painful or difficult urination; or

• fast heart rate, rapid breathing, feeling hot.

Common side effects may include:

• anxiety, feeling restless or excited;

• depression, dizziness;

• tremors; or

• blurred vision, ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

For all uses of mepivacaine:

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how mepivacaine affects you.
• If you are 65 or older, use this medicine with care. You could have more side effects.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using mepivacaine while you are pregnant.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Epidural:

• This medicine may cause short-term loss of feeling and motor activity in the lower half of your body. Do not try to get out of bed or do other tasks or actions until feeling and motor activity have returned to normal.

Mouth:

• Do not eat while your mouth feels numb. You may bite your tongue.

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 http://www.fda.gov/medwatch.

• If you need to store this medicine at home, talk with your doctor, nurse, or pharmacist about how to store it.

Mepivacaine Hydrochloride, a tertiary amine used as a local anesthetic, is 1-methyl-2', 6' - pipecoloxylidide monohydrochloride with the following structural formula:

It is a white, crystalline, odorless powder soluble in water, but very resistant to both acid and alkaline hydrolysis.

Levonordefrin, a sympathomimetic amine used as a vasoconstrictor in local anesthetic solution, is (-)-α-(1-Aminoethyl)-3, 4-dihydroxybenzyl alcohol with the following structural formula:

It is a white or buff-colored crystalline solid, freely soluble in aqueous solutions of mineral acids, but practically insoluble in water;

DENTAL CARTRIDGES MAY NOT BE AUTOCLAVED.

Mepivacaine hydrochloride injection 3% and Mepivacaine hydrochloride 2% with levonordefrin 1:20,000 injection are sterile solutions for injection.

• Mepivacaine HCl
• Mepivacaine Hydrochloride

Route and dose dependent: Range: 3 to 20 minutes; Dental: Upper jaw: 30 to 120 seconds; Lower jaw: 1 to 4 minutes

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Beta-Blockers: May increase the serum concentration of Mepivacaine. Monitor therapy

Bupivacaine (Liposomal): Local Anesthetics may enhance the adverse/toxic effect of Bupivacaine (Liposomal). Management: Liposomal bupivacaine should not be administered with local anesthetics. Liposomal bupivacaine may be administered 20 minutes or more after the administration of lidocaine, but the optimal duration of dose separation for other local anesthetics is unknown Avoid combination

Hyaluronidase: May enhance the adverse/toxic effect of Local Anesthetics. Monitor therapy

Neuromuscular-Blocking Agents: Local Anesthetics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy

Technetium Tc 99m Tilmanocept: Local Anesthetics may diminish the diagnostic effect of Technetium Tc 99m Tilmanocept. Management: Avoid mixing and simultaneously co-injecting technetium Tc 99m tilmanocept with local anesthetics. This interaction does not appear to apply to other uses of these agents in combination. Monitor therapy