Drug information of mepivacaine

mepivacaine

Drug group:

Mepivacaine is an anesthetic (numbing medicine) that blocks the nerve impulses that send pain signals to your brain

mepivacaine

Mechanism of effect

Local anesthetics block the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: pain, temperature, touch, proprioception, and skeletal muscle tone.

Pharmacodynamic

Mepivicaine is an amide local anesthetic. Mepivicaine as a reasonably rapid onset and medium duration and is known by the proprietary names as Carbocaine and Polocaine. Mepivicaine is used in local infiltration and regional anesthesia. Systemic absorption of local anesthetics produces effects on the cardiovascular and central nervous systems. At blood concentrations achieved with normal therapeutic doses, changes in cardiac conduction, excitability, refractoriness, contractility, and peripheral vascular resistance are minimal.

Pharmacokinetics

Absorption: absorbed locally. The rate of systemic absorption of local anesthetics is dependent upon the total dose and concentration of drug administered, the route of administration, the vascularity of the administration site, and the presence or absence of epinephrine in the anesthetic solution.

Protein binding: Mepivacaine is approximately 75% bound to plasma proteins. Generally, the lower the plasma concentration of drug, the higher the percentage of drug bound to plasma.

Metabolism: Rapidly metabolized, with only a small percentage of the anesthetic (5 percent to 10 percent) being excreted unchanged in the urine. The liver is the principal site of metabolism, with over 50% of the administered dose being excreted into the bile as metabolites.

Elimination:
It is rapidly metabolized, with only a small percentage of the anesthetic (5 percent to 10 percent) being excreted unchanged in the urine.The liver is the principal site of metabolism, with over 50% of the administered dose being excreted into the bile as metabolites.

Drug indications

Mepivacaine is used as a local (in only one area) anesthetic for an epidural or spinal block. It is also used as an anesthetic for dental procedures.

Side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives, itching, skin redness; nausea, vomiting, sweating, feeling hot; fast heartbeats; sneezing, difficult breathing; dizziness, fainting; swelling of your face, lips, tongue, or throat.
Tell your caregiver right away if you have:
  • numbness and tingling in your mouth or lips, metallic taste in your mouth;
  • ringing in your ears, blurred vision, slurred speech, headache;
  • confusion, depression, severe drowsiness, feeling like you might pass out;
  • slow heart rate, weak pulse, weak or shallow breathing;
  • fever, neck stiffness, increased sensitivity to light;
  • tremors or muscle twitching, feeling anxious or restless;
  • ongoing numbness, weakness, or loss of movement in your legs or feet;
  • loss of bladder or bowel control;
  • loss of feeling in your lower stomach, groin, or genitals;
  • painful or difficult urination; or
  • fast heart rate, rapid breathing, feeling hot.
Common side effects may include:
  • anxiety, feeling restless or excited;
  • depression, dizziness;
  • tremors; or
  • blurred vision, ringing in your ears.

Interactions

Dorzolamide and timolol , Bretylium

Alerts

You should not receive mepivacaine if you have ever had an allergic reaction to any type of numbing medicine.

To make sure mepivacaine is safe for you, tell your doctor if you have:

  • liver or kidney disease;
  • low or high blood pressure;
  • heart disease or a history of stroke;
  • heart rhythm disorder;
  • coronary artery disease;
  • epilepsyor other seizure disorder;
  • a drug allergy; or
  • if you regularly use any medicines (especially to treat migraine headache, depression, or mental illness).

FDA pregnancy category C. It is not known whether mepivacaine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using mepivacaine.

It is not known whether mepivacaine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Pregnancy level

C

FDA pregnancy category C.

Breast feeding warning

It is not known whether mepivacaine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

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