Bupivacaine and Epinephrine

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Marcaine/Epinephrine; Marcaine/Epinephrine PF; Sensorcaine-MPF/EPINEPHrine; Sensorcaine/EPINEPHrine

Brand Names: Canada

Marcaine; Marcaine E; Sensorcaine/Epinephrine PF; Vivacaine

What is this drug used for?

• It is used to numb an area before a procedure.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Bleeding, a heartbeat that is not normal, an infection in the blood or where this drug will be given, or low blood pressure.
• If you are taking certain drugs used for depression like isocarboxazid, phenelzine, or tranylcypromine, or drugs used for Parkinson’s disease like selegiline or rasagiline.
• If you are taking any of these drugs: Amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, or trimipramine.
• If you are taking any of these drugs: Nadolol, propranolol, sotalol, or timolol.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

For all uses of this drug:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until the effects of this drug wear off and you feel fully awake.
• If you are allergic to sulfites, talk with your doctor. Some products have sulfites.
• A severe blood problem called methemoglobinemia has happened with drugs like this one. The risk may be raised in people who have glucose-6-phosphate dehydrogenase (G6PD) deficiency, heart problems, or lung problems. The risk may also be raised while taking certain other drugs and in infants younger than 6 months of age. Tell your doctor if you have ever had methemoglobinemia.
• If you are 65 or older, use this drug with care. You could have more side effects.
• Not all products are meant for use in children. Talk with the doctor.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

Mouth:

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

Spinal:

• This drug 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.

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 that 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.
• Signs of methemoglobinemia like a blue or gray color of the lips, nails, or skin; a heartbeat that does not feel normal; seizures; severe dizziness or passing out; severe headache; feeling very sleepy; feeling tired or weak; or shortness of breath. This effect is rare but may be deadly if it happens.
• Feeling hot or cold.
• Dizziness or passing out.
• Feeling lightheaded, sleepy, confused, or having blurred eyesight.
• Change in balance.
• Restlessness.
• Anxiety.
• Change in speech.
• Numbness or tingling in the mouth.
• Metallic taste.
• Ringing in ears.
• Shakiness.
• Twitching.
• Seizures.
• Trouble breathing, slow breathing, or shallow breathing.
• A burning, numbness, or tingling feeling that is not normal.
• Feeling nervous and excitable.
• Headache.
• Severe upset stomach or throwing up.
• Fast, slow, or abnormal heartbeat.
• Chest pain or pressure.
• Fever or chills.
• Sneezing.
• Sweating a lot.
• Burning, color changes, pain, skin breakdown, or swelling where this drug was given.

Spinal:

• 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.
• Backache.
• 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 your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• It is given as a shot.

What do I do if I miss a dose?

• This drug will be given on an as needed basis in a health care setting.

How do I store and/or throw out this drug?

• This drug will be given in a hospital or doctor’s office. You will not store it at home.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-10-03

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