Drug reference

Ropivacaine

Local Anesthetic · Local anaesthetic

Also known as Ropivacaine hydrochloride

Local AnestheticLocal anaesthetic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

Crosses the placenta but not known to be

FDA category + note

Top interactions

PrilocaineSevereDatabaseDDInter

Mechanism

Ropivacaine is a long-acting amide-type local anesthetic that is formulated as the pure S-enantiomer, which provides equivalent nerve-blocking potency to bupivacaine but with a significantly wider margin of safety for cardiac toxicity. It blocks voltage-gated sodium channels in a use-dependent manner, but its S-configuration results in faster dissociation from cardiac sodium channels, reducing the risk of fatal bupivacaine-type cardiac arrest. It also produces greater separation between sensory and motor blockade at lower concentrations, making it preferred for epidural analgesia.

Indications

Epidural anesthesiaRegional anesthesiaPostoperative pain relief (continuous epidural)Labour pain (continuous epidural)Nerve blocks

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).…