Mepivacaine

Mepivacaine Brand Names

Carbocaine | Polocaine | Polocaine MPF

What is Mepivacaine

Mepivacaine is a local anesthetic of the amide type with an intermediate duration of action.

Mepivacaine is used for infiltration and transtracheal anesthesia, and peripheral, sympathetic, regional (Bier’s method), and epidural nerve blocks in surgical and dental procedures.

It is not recommended for subarachnoid use. It is available with and without levonordefrin.

Compared with lidocaine, mepivacaine produces less vasodilation and has a more rapid onset and longer duration of action.

Mepivacaine received FDA approval in 1960.

Indications

  1. brachial plexus block
  2. caudal anesthesia
  3. cervical nerve block
  4. dental anesthesia
  5. epidural anesthesia
  6. infiltration anesthesia
  7. intercostal nerve block
  8. local anesthesia
  9. paracervical block
  10. pudendal nerve block
  11. regional anesthesia
  12. severe pain

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. anxiety
  4. arrhythmia exacerbation
  5. back pain
  6. bradycardia
  7. cardiac arrest
  8. chondrolysis
  9. decreased uterine contractility
  10. diaphoresis
  11. dizziness
  12. drowsiness
  13. dysgeusia
  14. fecal incontinence
  15. fetal acidosis
  16. fetal bradycardia
  17. fever
  18. headache
  19. hypotension
  20. injection site reaction
  21. meningitis
  22. methemoglobinemia
  23. miosis
  24. muscle paralysis
  25. nausea
  26. neonatal depression
  27. paresthesias
  28. pruritus
  29. rash
  30. respiratory depression
  31. restlessness
  32. seizures
  33. shivering
  34. sinus tachycardia
  35. sneezing
  36. syncope
  37. tinnitus
  38. tremor
  39. urinary incontinence
  40. urinary retention
  41. urticaria
  42. vomiting
  43. weakness

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • amide local anesthetic hypersensitivity
  • anticoagulant therapy
  • AV block
  • breast-feeding
  • cardiac disease
  • coagulopathy
  • continuous intraarticular infusion administration
  • dehydration
  • eclampsia
  • fetal distress
  • fetal prematurity
  • G6PD deficiency
  • geriatric
  • head and neck anesthesia
  • hepatic disease
  • hypotension
  • hypovolemia
  • infants
  • infection
  • intraarterial administration
  • intrathecal administration
  • intravenous administration
  • labor
  • methemoglobinemia
  • myasthenia gravis
  • neonates
  • neurological disease
  • obstetric delivery
  • ocular surgery
  • paraben hypersensitivity
  • paracervical nerve block
  • pregnancy
  • pudendal nerve block
  • pulmonary disease
  • QT prolongation
  • sepsis
  • shock
  • thrombocytopenia

Interactions

  • Acebutolol
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Alfentanil
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Ambenonium Chloride
  • Ambrisentan
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amyl Nitrite
  • Articaine; Epinephrine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atracurium
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzocaine
  • Benzocaine; Butamben; Tetracaine
  • Benzonatate
  • Betaxolol
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Brimonidine; Timolol
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Caffeine; Ergotamine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carteolol
  • Carvedilol
  • Chloroprocaine
  • Chloroquine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cholinesterase inhibitors
  • Cisatracurium
  • Clomipramine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclophosphamide
  • Dapsone
  • Daratumumab; Hyaluronidase
  • Desipramine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxacurium
  • Doxepin
  • Edrophonium
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Erythromycin; Sulfisoxazole
  • Esmolol
  • Fentanyl
  • Flutamide
  • Fosphenytoin
  • Galantamine
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyurea
  • Ibuprofen; Oxycodone
  • Ifosfamide
  • Iloprost
  • Imipramine
  • Isocarboxazid
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Labetalol
  • Levomethadyl
  • Levorphanol
  • Lidocaine
  • Lidocaine; Prilocaine
  • Magnesium Salts
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methylergonovine
  • Methysergide
  • Metoclopramide
  • Metoprolol
  • Minocycline
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Neostigmine
  • Neuromuscular blockers
  • Nitrates
  • Nitrofurantoin
  • Nitroglycerin
  • Nortriptyline
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Penbutolol
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Pergolide
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phenytoin
  • Physostigmine
  • Pindolol
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primaquine
  • Primidone
  • Procarbazine
  • Propoxyphene
  • Propranolol
  • Protriptyline
  • Pyridostigmine
  • Pyrimethamine; Sulfadoxine
  • Quinine
  • Rapacuronium
  • Rasburicase
  • Remifentanil
  • Rituximab; Hyaluronidase
  • Rivastigmine
  • Rocuronium
  • Ropivacaine
  • Succinylcholine
  • Sufentanil
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Tacrine
  • Tetracaine
  • Timolol
  • Tranylcypromine
  • Trastuzumab; Hyaluronidase
  • Tricyclic antidepressants
  • Trimipramine
  • Tubocurarine
  • Valproic Acid, Divalproex Sodium
  • Vecuronium