A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Carbocaine Indications, Dosage, Storage, Stability - Mepivacaine
Carbocaine Indications, Dosage, Storage, Stability - Mepivacaine
INDICATIONS
AND USES
POLOCAINE (Mepivacaine HCl Injection, USP), is indicated for production of
local or regional analgesia and anesthesia by local infiltration, peripheral
nerve block techniques, and central neural techniques including epidural and
caudal blocks.
The routes of administration and indicated concentrations for mepivacaine are:
|
local infiltration
|
0.5% (via dilution) or 1%
|
|
peripheral nerve blocks
|
1% and 2%
|
|
epidural block
|
1%, 1.5%, 2%
|
|
caudal block
|
1%, 1.5%, 2%
|
See DOSAGE AND ADMINISTRATION
for additional information. Standard textbooks
should be consulted to determine the accepted procedures and techniques for
the administration of mepivacaine.
DOSAGE AND ADMINISTRATION
The dose of any local anesthetic administered varies with the anesthetic procedure,
the area to be anesthetized, the vascularity of the tissues, the number of neuronal
segments to be blocked, the depth of anesthesia and degree of muscle relaxation
required, the duration of anesthesia desired, individual tolerance and the physical
condition of the patient. The smallest dose and concentration required to produce
the desired result should be administered. Dosages of mepivacaine hydrochloride
should be reduced for elderly and debilitated patients and patients with cardiac
and/or liver disease. The rapid injection of a large volume of local anesthetic
solution should be avoided and fractional doses should be used when feasible.
For specific techniques and procedures, refer to standard textbooks.
The recommended single adult dose (or the total of a series of
doses given in one procedure) of mepivacaine hydrochloride for unsedated, healthy,
normal-sized individuals should not usually exceed 400 mg. The recommended dosage
is based on requirements for the average adult and should be reduced for elderly
or debilitated patients.
While maximum doses of 7 mg/kg (550 mg) have been administered without adverse
effect, these are not recommended, except in exceptional circumstances and under
no circumstances should the administration be repeated at intervals of less
than 1 ½ hours. The total dose for any 24-hour period should not exceed 1,000
mg because of a slow accumulation of the anesthetic or its derivatives or slower
than normal metabolic degradation or detoxification with repeat administration.
(See CLINICAL PHARMACOLOGY and PRECAUTIONS).
Pediatric patients tolerate the local anesthetic as well as adults.
However, the pediatric dose should be carefully measured as a
percentage of the total adult dose based on weight, and should
not exceed 5 mg/kg to 6 mg/kg (2.5 mg/lb to 3 mg/lb) in pediatric patients,
especially those weighing less than 30 lbs. In pediatric patients under
3 years of age or weighing less than 30 lbs concentrations less than
2% (eg, 0.5% to 1.5%) should be employed.
Unused portions of solutions not containing preservatives, ie, those supplied
in single-dose vials, should be discarded following initial use. This product
should be inspected visually for particulate matter and discoloration prior
to administration whenever solution and container permit. Solutions which are
discolored or which contain particulate matter should not be administered.
Recommended Concentrations and Doses of Mepivacaine
Hydrochloride
|
Procedure
|
Concentration |
Total Dose |
Comments
|
| mL |
mg |
|
Cervical, branchial,
intercostal,
pudendal nerve block
|
1%
2% |
5-40
5-20 |
50-400
100-400 |
Pudendal block: one half of total dose injected each side.
|
|
Transvaginal block
(paracervical
plus pudendal)
|
1% |
up to 30
(both sides) |
up to 300
(both sides) |
One half of total dose injected each side. See PRECAUTIONS
.
|
|
Paracervical block
|
1% |
up to 20
(both sides) |
up to 200
(both sides) |
One half of total dose injected each side. This is maxium
recommended dose per 90-minute period in obstetrical and non-obstetrical
patients. Inject slowly, 5 minutes between sides. See PRECAUTIONS.
|
|
Caudal and
Epidural block
|
1%
1.5%
2% |
15-30
10-25
10-20 |
150-300
150-375
200-400 |
* Use only single-dose vials which do not contain a preservative.
|
|
Infiltration
|
1% |
up to 40 |
up to 400 |
An equivalent amount of a 0.5% solution (prepared by diluting
the 1% solution with Sodium Chloride Injection, USP) may be used for
large areas.
|
|
Therapeutic block
(pain management)
|
1%
2% |
1-5
1-5 |
10-50
20-100 |
|
|
Unused portions of solutions not containing preservatives
should be discarded
|
|
* Dosage forms listed as POLOCAINE-MPF (Mepivacaine HCl
Injection, USP) are single-dose solutions which do not contain a preservative.
|
HOW SUPPLIED
Single-dose vials and multiple-dose vials of POLOCAINE may be sterilized by
autoclaving at 15 pound pressure, 121°C (250°F) for 15 minutes. Solutions of
POLOCAINE may be reautoclaved when necessary. Do not administer solutions which
are discolored or which contain particulate matter.
THESE SOLUTIONS ARE NOT INTENDED FOR SPINAL ANESTHESIA OR DENTAL USE.
POLOCAINE-MPF (Mepivacaine HCl Injection, USP) without preservatives is available
as follows:
1% Single-dose vials of 30 mL (NDC 0186-0412-01)
1.5% Single-dose vials of 30 mL (NDC 0186-0418-01)
2% Single-dose vials of 20 mL (NDC 0186-0422-01)
POLOCAINE (Mepivacaine HCl Injection, USP) with preservatives is available
as follows:
1% Multiple-dose vials of 50 mL (NDC 0186-0410-01)
2% Multiple-dose vials of 50 mL (NDC 0186-0420-01)
Store at controlled room temperature 15-30°C (59-86°F); brief exposure up to
40°C (104°F) does not adversely affect the product.
All trademarks are the property of the AstraZeneca group
© AstraZeneca 2000
AstraZeneca LP, Wilmington, DE 19850
top
