Bupivacaine Hydrochloride/Epinephrine, Injection

What are other names for this medicine?

Type of medicine: anesthetic; nerve block

Generic and brand names: bupivacaine; epinephrine; Sensorcaine with Epinephrine; Marcaine HCl/Epinephrine; Sensorcaine-MPF with Epinephrine

What is this medicine used for?

This medicine is given by injection to cause loss of feeling before and during surgery, dental procedures (including dental surgery), or labor and delivery. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a blood disorder such as methemoglobinemia or G6PD
• high or low blood pressure
• kidney disease.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is given by a healthcare provider or dentist trained in the use of local anesthesia.

What should I watch out for?

This medicine may cause lightheadedness, dizziness, drowsiness, or numbness. Do not drive or operate machinery unless you are fully alert.

Since this medicine stops all feeling on your skin, be careful not to injure your skin by scratching, rubbing, or exposing it to extreme hot or cold temperatures. If you have received an injection in your mouth, do not chew gum or food while your mouth feels numb. The numbing effect of the medicine goes away after a few hours.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat), seizures.

Serious (report these to your healthcare provider right away): Irregular or rapid heartbeat, unusual weakness or tiredness, nausea, vomiting, ringing in the ears, slurred speech.

Other: Constipation, diarrhea, shivering, tingling, blurred vision, restlessness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as enalapril (Vasotec), lisinopril (Prinivil, Zestril), fosinopril (Monopril), captopril (Capoten), quinapril (Accupril), ramipril (Altace), and benazepril (Lotensin)
• beta blockers such as atenolol (Tenormin), pindolol, metoprolol (Lopressor, Toprol), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), and propranolol (Inderal)
• calcium channel blockers such as diltiazem (Cardizem, Cartia XT), felodipine (Plendil), nifedipine (Adalat CC, Procardia XL), and verapamil (Calan, Covera, Isoptin, Verelan)
• ergotamine (Cafergot, Ergomar)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other)
• oxytocin (Pitocin)
• phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), prochlorperazine (Compazine), and thioridazine
• St. John's wort
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan).

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.