Bupivacaine/epinephrine (By injection)

Bupivacaine HCl with EPINEPHrine Novaplus, Marcaine Epi, Marcaine with EPINEPHrine, Sensorcaine With EPINEPHrine, Sensorcaine-MPF with EPINEPHrine

Injectable

• A nurse or other trained health professional will give you this medicine in a medical facility. It is sometimes given through a catheter placed into your lower back for an epidural or a spinal block. You may also receive the injection into your rib cage, chest, or other body areas. This medicine may also be injected directly into your gums for dental work.

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how bupivacaine/epinephrine works. Tell your doctor if you are using any of the following:
  • Acetaminophen, chloroquine, metoclopramide, primaquine, quinine, sulfasalazine
  • Blood pressure medicine
  • Cancer medicine (including cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase)
  • Ergot medicine or other medicines for headaches or migraines
  • Medicine to treat depression (including an MAO inhibitor, tricyclic antidepressant)
  • Medicine to treat seizures (including phenobarbital, phenytoin, sodium valproate)
  • Nitrate or nitrite medicine (including nitric oxide, nitroglycerin, nitroprusside, nitrous oxide)
  • Phenothiazine medicine (including chlorpromazine, promethazine)

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, high blood pressure, low blood pressure, lung or breathing problems, a blood disorder, G6PD, atherosclerosis (hardening of the arteries), other circulation problems, diabetes, asthma, thyroid problems, or a history of stroke. Tell your doctor if you have a sulfite allergy.
• This medicine may cause methemoglobinemia (blood disorder).
• You may experience temporary loss of sensation and movement, usually in the lower half of your body, if you receive this medicine into your lower back (epidural). It may be easier to hurt yourself while your treated body area is still numb. Be careful to avoid injury until you have regained all the feeling and are no longer numb.
• To avoid injury after dental work, do not chew solid foods until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking the treated area (up to 7 hours).
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, depression, restlessness, drowsiness, ringing in your ears, blurred vision
• Chest pain, fast, pounding, slow, or uneven heartbeat, trouble breathing
• Lightheadedness, dizziness, or fainting
• Nausea, vomiting, chills, metallic taste in your mouth
• Pale, gray, or blue lips, nails, or skin, dark urine, headache, unusual tiredness or weakness
• Seizures, shivering, shaking, or tremors

If you notice these less serious side effects, talk with your doctor:

• Back pain
• Pain, redness, or swelling where the needle was placed

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088