Bupivacaine Hydrochloride And Epinephrine Bitartrate

Serious dose-related cardiac arrhythmias may occur when epinephrine-containing preparations are used during or following chloroform administration.

Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine 7.6 Potent Inhalation Anesthetics Serious dose-related cardiac arrhythmias may occur if preparations containing a vasoconstrictor such as epinephrine (e.g., MARCAINE WITH EPINEPHRINE) are used in patients during or following the administration of potent inhalation anesthetics [see Warnings and Precautions (5.13) ] .

Serious dose-related cardiac arrhythmias may occur when epinephrine-containing preparations are used during or following cyclopropane administration.

Concurrent administration may cause severe, persistent hypertension or cerebrovascular accidents. Avoid concomitant use.

Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine 7.6 Potent Inhalation Anesthetics Serious dose-related cardiac arrhythmias may occur if preparations containing a vasoconstrictor such as epinephrine (e.g., MARCAINE WITH EPINEPHRINE) are used in patients during or following the administration of potent inhalation anesthetics [see Warnings and Precautions (5.13) ] .

Serious dose-related cardiac arrhythmias may occur when epinephrine-containing preparations are used during or following halothane administration.

Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine 7.6 Potent Inhalation Anesthetics Serious dose-related cardiac arrhythmias may occur if preparations containing a vasoconstrictor such as epinephrine (e.g., MARCAINE WITH EPINEPHRINE) are used in patients during or following the administration of potent inhalation anesthetics [see Warnings and Precautions (5.13) ] .

Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine 7.6 Potent Inhalation Anesthetics Serious dose-related cardiac arrhythmias may occur if preparations containing a vasoconstrictor such as epinephrine (e.g., MARCAINE WITH EPINEPHRINE) are used in patients during or following the administration of potent inhalation anesthetics [see Warnings and Precautions (5.13) ] .

May produce severe, prolonged hypertension. Concurrent use should generally be avoided; if necessary, careful hemodynamic monitoring is essential.

May cause severe hypertension and bradycardia. Concurrent use should generally be avoided; if necessary, careful monitoring of blood pressure and heart rate is essential.

Serious dose-related cardiac arrhythmias may occur if MARCAINE WITH EPINEPHRINE is used during or following potent inhalation anesthetic administration.

Serious dose-related cardiac arrhythmias may occur when epinephrine-containing preparations are used during or following trichloroethylene administration.

Concurrent administration may cause severe, persistent hypertension or cerebrovascular accidents.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

May reduce or reverse the pressor effect of epinephrine. Concurrent use should generally be avoided; if necessary, careful patient monitoring is essential.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

May reduce or reverse the pressor effect of epinephrine. Concurrent use should generally be avoided; if necessary, careful patient monitoring is essential.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Sedatives combined with local anesthetic agents may have additive CNS depressant effects. Reduced doses of sedatives are recommended.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when concurrently exposed.

Vivacaine® (bupivacaine hydrochloride and epinephrine injection, USP) should be used cautiously in persons with known drug allergies or sensitivities, particularly to the amide-type local anesthetics.