Yes

Local Anesthetic

Local anesthesia by nerve block; infiltration in dental procedures; not for use in spinal anesthesia

C

Hypersensitivity to mepivacaine or any component or other amide anesthetics, allergy to sodium bisulfate

Use with caution in patients with cardiac disease, renal disease, and hyperthyroidism; convulsions due to systemic toxicity leading to cardiac arrest have been reported presumably due to intravascular injection

<1%: Bradycardia, myocardial depression, hypotension, cardiovascular collapse, edema, anxiety, restlessness, disorientation, confusion, seizures, drowsiness, unconsciousness, chills, urticaria, nausea, vomiting, transient stinging or burning at injection site, tremors, blurred vision, tinnitus, respiratory arrest, anaphylactoid reactions, shivering

Symptoms of overdose include dizziness, cyanosis, tremors, bronchial spasm

Treatment is primarily symptomatic and supportive. Termination of anesthesia by pneumatic tourniquet inflation should be attempted when the agent is administered by infiltration or regional injection. Seizures commonly respond to diazepam, while hypotension responds to I.V. fluids and Trendelenburg positioning. Bradyarrhythmias (when the heart rate is <60) can be treated with I.V., I.M., or S.C. atropine 15 mcg/kg. With the development of metabolic acidosis, I.V. sodium bicarbonate 0.5-2 mEq/kg and ventilatory assistance should be instituted.

Mepivacaine is an amino amide local anesthetic similar to lidocaine; like all local anesthetics, mepivacaine acts by preventing the generation and conduction of nerve impulses

Onset of action: Epidural: Within 7-15 minutes

Duration: 2-2.5 hours; similar onset and duration is seen following infiltration

Protein binding: 70% to 85%

Metabolism: Chiefly in the liver by N-demethylation, hydroxylation, and glucuronidation

Half-life: 1.9 hours

Elimination: Urinary excretion (95% as metabolites)

Children and Adults: Injectable local anesthetic: Varies with procedure, degree of anesthesia needed, vascularity of tissue, duration of anesthesia required, and physical condition of patient

Before injecting, withdraw syringe plunger to ensure injection is not into vein or artery

No information available to require special precautions

No effects or complications reported

You will experience decreased sensation to pain, heat, or cold in the area and/or decreased muscle strength (depending on area of application) until effects wear off; use necessary caution to reduce incidence of possible injury until full sensation returns. Report irritation, pain, burning at injection site; chest pain or palpitations; or difficulty breathing.

Pregnancy precautions: Inform prescriber if you are pregnant.

Before injecting, withdraw syringe plunger to ensure injection is not into vein or artery

Injection, as hydrochloride: 1% [10 mg/mL] (30 mL, 50 mL); 1.5% [15 mg/mL] (30 mL); 2% [20 mg/mL] (20 mL, 50 mL); 3% [30 mg/mL] (1.8 mL)

Dodson WE, Hillman RE, and Hillman LS, "Brain Tissue Levels in a Fatal Case of Neonatal Mepivacaine (Carbocaine®) Poisoning," J Pediatr, 1975, 86(4):624-7.

Torres MJ, Garcia JJ, del Cano Moratinos AM, et al, "Fixed Drug Eruption Induced by Mepivacaine," J Allergy Clin Immunol, 1995, 96(1):130-1.