Drug reference

Mepivacaine

Local Anesthetic · Local Anaesthetic

Also known as Mepivacaine hydrochloride, Carbocaine, Isocaine

Local AnestheticLocal Anaesthetic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

May adversely affect the newborn infant if accidentally introduced into the scalp during caudal-paracervical anesthesia, causing bradypnea, apnea, bradycardia, and convulsions.

FDA category + note

Top interactions

PrilocaineSevereDatabaseDDInter

Mechanism

Mepivacaine acts at the cell membrane to prevent the generation and conduction of nerve impulses. It blocks conduction by decreasing or preventing the large transient increase in the permeability of excitable membranes to Na+ that normally is produced by a slight depolarization. This action is due to its direct interaction with voltage-gated Na+ channels.

Indications

Dental anaesthesiaRegional anaesthesiaNerve block anesthesia

Dosing

Adult: When used as a local anaesthetic, large doses can cause fetal bradycardia; if given during delivery can also cause neonatal respiratory depression, hypotonia, or bradycardia after paracervical or epidural block. l BREAST FEEDING Present in milk but amount too small to be harmful. l HEPATIC IMPAIRMENT Manufacturer advises caution (risk of increased exposure).…

Pharmacokinetics

Onset

Similar to lidocaine

Duration

Medium

Contraindications

Use with adrenaline is hazardous in patients with severe hypertension or unstable cardiac rhythm.
Use with adrenaline is not advisable in digits or appendages due to the risk of ischaemic necrosis.

Side effects

Serious

Severe local anaesthetic-induced cardiovascular toxicity
Cardiac arrest
Bradypnea (in newborn infant if accidentally introduced into scalp)
Apnea (in newborn infant if accidentally introduced into scalp)
Bradycardia (in newborn infant if accidentally introduced into scalp)
Convulsions (in newborn infant if accidentally introduced into scalp)

Pregnancy & lactation

Pregnancy

May adversely affect the newborn infant if accidentally introduced into the scalp during caudal-paracervical anesthesia, causing bradypnea, apnea, bradycardia, and convulsions.