Health Library

Bupivacaine (By injection)

Bupivacaine (bue-PIV-a-kane)

Numbs an area of your body during or after surgery or other procedures, including childbirth, shoulder surgery, or dental work. This medicine is a local anesthetic.

Brand Name(s):

BUPivacaine HCl Novaplus, BUPivacaine Spinal, Marcaine, Marcaine HCl, Marcaine Spinal, Posimir, PremierPro RX Sensorcaine-MPF, Sensorcaine, Sensorcaine-MPF

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• A nurse or other trained health professional will give you this medicine in a medical facility. Marcaine™ is sometimes given through a catheter placed into your lower back for an epidural or a spinal block. You may also receive the injection into your rib cage, chest, or other body areas. This medicine may also be injected directly into your gums for dental work. Posimir® is usually given in the shoulder area.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how bupivacaine works. Tell your doctor if you are taking any of the following:
  • Acetaminophen, chloroquine, metoclopramide, primaquine, quinine, sulfasalazine
  • Blood pressure medicine (including atenolol, doxazosin, lisinopril, metoprolol, terazosin)
  • Cancer medicine (including cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase)
  • Ergot medicine or other medicines for headaches or migraines
  • Medicine to treat depression (including an MAO inhibitor, tricyclic antidepressant)
  • Medicine to treat an infection (including dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides)
  • Medicine to treat seizures (including phenobarbital, phenytoin, sodium valproate)
  • Nitrate or nitrite medicine (including nitric oxide, nitroglycerin, nitroprusside, nitrous oxide)
  • Other local anesthetics
  • Phenothiazine medicine (including chlorpromazine, promethazine)
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, blood or blood clotting problems (including methemoglobinemia), asthma, diabetes, seizures, myasthenia gravis, thyroid problems, high blood pressure, low blood pressure, lasting back pain, arthritis, spinal problems, lung or breathing problems, G6PD, or mental illness.
• This medicine may cause the following problems:
  • Methemoglobinemia (blood disorder)
  • Chondrolysis (a bone or joint problem)
  • Low blood pressure
  • Hyperthermia (a dangerous increase in body temperature)
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine should cause numbness only to the area where it is injected. It is not meant to cause you to fall asleep or become unconscious.
• You may experience temporary loss of sensation and movement, usually in the lower half of your body, if you receive this medicine into your lower back (epidural).
• If you are receiving this medicine as an epidural to ease labor pains, it may take longer than normal for you to push your baby out. It is also possible that the baby may have unwanted effects after birth (including sleepiness, slow responses). Talk to your doctor if you have questions about how this medicine might affect your baby.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, depression, restlessness, drowsiness, ringing in your ears, blurred vision
• Bone or joint pain or stiffness, inability to move
• Change in how much or how often you urinate, difficult or painful urination
• Chest pain, fast, pounding, slow, or uneven heartbeat, trouble breathing
• Dry mouth, increased thirst, muscle cramps
• Fever, chills, cough, sore throat, body aches
• Lightheadedness, dizziness, or fainting
• Nausea, vomiting, metallic taste in your mouth or other changes in taste
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Pale, gray, or blue lips, nails, or skin, dark urine, headache, tiredness
• Seizures, shivering, shaking, or tremors
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Back pain
• Constipation, diarrhea, stomach pain or upset
• Pain, redness, or swelling where the needle was placed

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 9/6/2024