Ropivacaine hydrochloride injection is available as a preservative-free solution in concentrations of 2 mg/mL (0.2%), 5 mg/mL (0.5%), 7.5 mg/mL (0.75%), and 10 mg/mL (1%) along with sodium chloride for isotonicity and sodium hydroxide and/or hydrochloric acid for pH adjustment in water for injection.3759 The products are packaged in single-dose glass vials and in polypropylene plastic ampuls designed to fit Luer-lock and Luer-slip syringes.3759 The 2- and 5-mg/mL concentrations are also available in 100 and 200-mL infusion bottles and flexible plastic containers.3759; 3760 Sterile-Pak products should be selected when a container having a sterile outside is required.3759
pH
From 4 to 6.5.404
Tonicity
Ropivacaine hydrochloride injection is isotonic.3759
Specific Gravity
The specific gravity of ropivacaine hydrochloride injection ranges from 1.002 to 1.005 at 25°C.3759
Trade Name(s)
Naropin
Ropivacaine hydrochloride injection is administered parenterally by lumbar epidural injection or infusion, by thoracic epidural infusion, by injection for nerve block, and by infiltration.3759
Intact containers of ropivacaine hydrochloride should be stored at controlled room temperature.3759 Ropivacaine hydrochloride injection contains no preservatives; any remaining solution in an opened container should be discarded promptly.3759 The continuous infusion bottles or flexible plastic containers should not be left in place for more than 24 hours.3759; 3760
Autoclaving
Ropivacaine hydrochloride in glass containers may be autoclaved one time to sterilize the container.3759
pH Effects
The solubility of ropivacaine hydrochloride is reduced above pH 6.3759 Consequently, contact with alkaline solutions may result in precipitation.3759
Standardize 4 Safety
One or more standardized concentrations for this drug have been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. (See Standardize 4 Safety in Users Guide.) Recommendations developed to date through this initiative are available at www.ashp.org/pharmacy-practice/standardize-4-safety-initiative.
Table 1: Standardize 4 Safety Epidural Standard Concentrations for Ropivacaine as a Single Drug3990
| Patient Population | Concentration Standards |
|---|---|
| Adults | 0.1% 0.2% |
| Pediatric patients (50 kg) | 0.1% 0.2% |
Table 2: Standardize 4 Safety ADULT Epidural Combination Drug Standard Concentrations for Ropivacaine3990
| Drug Combinations | Anesthetic Concentration | Narcotic Concentration | Alpha Agonist Concentration |
|---|---|---|---|
| Ropivacaine with clonidine | 1.Ropivacaine 0.1% | 1.Clonidine 1 mcg/mL | |
| 2.Ropivacaine 0.1% | 2.Clonidine 2 mcg/mL | ||
| 3.Ropivacaine 0.2% | 3.Clonidine 1 mcg/mL | ||
| 4.Ropivacaine 0.2% | 4.Clonidine 2 mcg/mL | ||
| Ropivacaine with fentanyl | 1.Ropivacaine 0.1% | 1.Fentanyl 2 mcg/mL | |
| 2.Ropivacaine 0.1% | 2.Fentanyl 5 mcg/mL | ||
| 3.Ropivacaine 0.2% | 3.Fentanyl 2 mcg/mL | ||
| 4.Ropivacaine 0.2% | 4.Fentanyl 5 mcg/mL | ||
| Ropivacaine with fentanyl and clonidine | 1.Ropivacaine 0.1% | 1.Fentanyl 2 mcg/mL | 1.Clonidine 0.3 mcg/mL |
| 2.Ropivacaine 0.1% | 2.Fentanyl 2 mcg/mL | 2.Clonidine 0.5 mcg/mL | |
| 3.Ropivacaine 0.2% | 3.Fentanyl 2 mcg/mL | 3.Clonidine 0.3 mcg/mL | |
| 4.Ropivacaine 0.2% | 4.Fentanyl 2 mcg/mL | 4.Clonidine 0.5 mcg/mL | |
| Ropivacaine with hydromorphone | Ropivacaine 0.2% | Hydromorphone 10 mcg/mL | |
| Ropivacaine with morphine | 1.Ropivacaine 0.1% | 1.Morphine 0.5 mg/mL | |
| 2.Ropivacaine 0.2% | 2.Morphine 1 mg/mL |
Table 3: Standardize 4 Safety PEDIATRIC (50 kg) Epidural Combination Drug Standard Concentrations for Ropivacaine3990
| Drug Combinations | Anesthetic Concentration | Narcotic Concentration | Alpha Agonist Concentration |
|---|---|---|---|
| Ropivacaine with clonidine | 1.Ropivacaine 0.1% | 1.Clonidine 0.5 mcg/mL | |
| 2.Ropivacaine 0.1% | 2.Clonidine 1 mcg/mL | ||
| 3.Ropivacaine 0.2% | 3.Clonidine 1 mcg/mL | ||
| Ropivacaine with fentanyl | 1.Ropivacaine 0.1% | 1. Fentanyl 2 mcg/mL | |
| 2.Ropivacaine 0.1% | 2. Fentanyl 5 mcg/mL | ||
| 3.Ropivacaine 0.2% | 3. Fentanyl 2 mcg/mL | ||
| 4.Ropivacaine 0.2% | 4. Fentanyl 5 mcg/mL | ||
| Ropivacaine with fentanyl and clonidine | 1.Ropivacaine 0.1% | 1.Fentanyl 2 mcg/mL | 1.Clonidine 0.3 mcg/mL |
| 2.Ropivacaine 0.1% | 2.Fentanyl 2 mcg/mL | 2.Clonidine 0.5 mcg/mL | |
| 3.Ropivacaine 0.2% | 3.Fentanyl 2 mcg/mL | 3.Clonidine 0.3 mcg/mL | |
| 4.Ropivacaine 0.2% | 4.Fentanyl 2 mcg/mL | 4.Clonidine 0.5 mcg/mL | |
| Ropivacaine with hydromorphone | 1.Ropivacaine 0.1% | 1.Hydromorphone 5 mcg/mL | |
| 2.Ropivacaine 0.1% | 2.Hydromorphone 10 mcg/mL | ||
| 3.Ropivacaine 0.2% | 3.Hydromorphone 5 mcg/mL | ||
| 4.Ropivacaine 0.2% | 4.Hydromorphone 10 mcg/mL | ||
| Ropivacaine with morphine | Ropivacaine 0.1% | Morphine 0.5 mg/mL |
For a list of references cited in the text of this monograph, search the monograph titled References.