Mepivacaine


Generic Medicine Info
Indications and Dosage
Injection
Dental infiltration and dental nerve block
Adult: 2% with vasoconstrictor or 3% solution. Single site in the jaw: 36 mg (2% solution) or 54 mg (3% solution). Entire oral cavity: 180 mg (2% solution) or 270 mg (3% solution). Max 400 mg in a single dental procedure.
Elderly: Dosage may need to be reduced.

Parenteral
Epidural anaesthesia
Adult: 150-300 mg (1% solution), 150-375 mg (1.5% solution) or 200-400 mg (2% solution). Solutions for epidural use must not contain preservatives.
Elderly: Dosage may need to be reduced.

Parenteral
Peripheral nerve block
Adult: Peripheral nerve block: 50-400 mg (1% solution) or 100-400 mg (2% solution). Pudendal block: ½ dose on each side. Paracervical block: Up to 100 mg (1% solution) on each side. Combined paracervical and pudendal block: Up to 150 mg (1% solution). Therapeutic nerve block in the management of pain: 10-50 mg (1% solution) or 20-100 mg (2% solution).
Elderly: Dosage may need to be reduced.
Contraindications
Complete heart block. Porphyria. Do not inject through infected skin when using for epidural anaesthesia.
Special Precautions
Rate of injection should not be too rapid. Avoid prolonged use. Elderly, child, debilitated patients, epilepsy, impaired respiratory function or cardiac conduction, shock, hepatic impairment, renal disease. Pregnancy and lactation.
Adverse Reactions
Restlessness, excitement, nervousness, paraesthesias; dizziness, tinnitus, blurred vision; nausea, vomiting; muscle twitching, tremors, convulsions; numbness of the tongue and perioral region; lightheadedness, drowsiness, respiratory failure, coma, hypotension.
Potentially Fatal: Myocardial depression, bradycardia, cardiac arrhythmias, cardiac arrest.
Dental/Epidural/Parenteral/Perineural: C
Overdosage
Maintain a patent airway and use assisted or controlled ventilation with 100% oxygen. If necessary, use drugs to control convulsions.
Drug Interactions
Potentially Fatal: Administration of mepivacaine solutions containing epinephrine or norepinephrine to patients receiving MAOIs or TCAs may lead to severe hypertension. Antiarrhythmics (risk of myocardial depression).
Action
Description: Mepivacaine produces reversible loss of function or sensation by preventing or diminishing the conduction of nerve impulses near to the application or injection site.
Onset: Epidural block: 7-15 min (2% solution). Dental anesthesia: 0.5-2 min in the upper jaw, 1-4 min in the lower jaw.
Duration: Epidural block: 115-150 min (2% solution). Caudal block: 105-170 min (1-2% solution). Dental anesthesia: 10-17 mins (0.7-1 mL of 3% solution). Soft tissue anaesthesia: 60-100 mins.
Pharmacokinetics:
Distribution: 60-85% plasma protein bound.
Metabolism: Undergoes N-demethylation and aromatic hydroxylation in the liver.
Excretion: Excreted in urine as metabolites and unchanged drug (5-10%). Small amounts excreted in faeces and via lungs.
Storage
Store at 15-30°C.
MIMS Class
Anaesthetics - Local & General
Disclaimer: This information is independently developed by MIMS based on Mepivacaine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com
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