Class Name(s):

• 72:00 Local Anesthetics

Pronunciation:

• (bue piv' a kane)

Brand Name(s):

• Marcaine^®
• Sensorcaine^®

IMPORTANT WARNING:

Bupivacaine in a certain concentration may cause cardiac arrest (heart stops beating) when used as an epidural injection for surgery or delivery during pregnancy. It is not recommended for these uses in that concentration.

WHY is this medicine prescribed?

Bupivacaine is used to manage pain during surgery or medical procedures. Bupivacaine is in a class of medications called local anesthetics. It works by blocking nerves from sending pain signals.

HOW should this medicine be used?

Bupivacaine comes as a solution (liquid) to be injected by a healthcare provider. It is usually given just before surgery.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before receiving bupivacaine,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had glucose-6- phosphate dehydrogenase deficiency (an inherited disease that affects red blood cells); methemoglobinemia (a condition that affect how the red blood cells work to carry oxygen); or lung, liver, heart or blood vessel disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
• you should know that you may have a temporary loss of feeling and ability to move (usually the lower half of your body) after you receive bupivacaine injection in or around your spine.
• you should know that after receiving bupivacaine injection for dental procedures, you should not try to chew solid foods until feeling returns in the mouth. It may take up to 7 hours after you receive bupivacaine for the feeling to return.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Bupivacaine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• pain or redness at the site of injection

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

• itching, redness, hives, swelling of the tongue and/or throat, difficulty breathing, fast heartbeat, fainting, excessive sweating, or fever
• restlessness, anxiety, incoherent speech, lightheadedness, numbness and tingling of the mouth and lips, metallic taste, ringing in the ears, dizziness, blurred vision, tremors, twitching, depression, drowsiness, or seizures
• fast or irregular heartbeat
• pale, gray, or blue colored skin; headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue

Bupivacaine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: June 15, 2025.