Levonordefrin/ Mepivacaine

Registered South African indications:

• Local anaesthesia for conservative and surgical oral interventions

Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Known hypersensitivity to amide-type of local anaesthetic
• Should not be given to patients receiving tricylic antidepressants or within several days of their discontinuation, since concurrent administration may induce hazardous cardiac arrhythmias
• Narrow-angle glaucoma

Cautions

• Pregnancy 
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Arteriosclerotic heart disease
• Cerebral vascular insufficiency
• Heart block
• Hypertension
• Ischemic heart disease
• Diabetes mellitus
• Hyperthyroidism
• Acutely ill patients
• Debilitated patients
• Children
• Asthma
• Intravascular injection
• Inflammation or sepsis at injection site

Forms avail. in SA and covered in this monograph: inj

Local anaesthesia for conservative and surgical oral interventions 

Levonordefrin/ Mepivacaine
0.09/36 (mg/1.8ml)

• Local infiltration: Dose varies and depends on the area to be anaesthetised, vascularity of the tissues, number of neuronal segments to be blocked, individual tolerances, and the technique of anaesthesia; Max: 1g/24hrs

Dose should not exceed 400 mg mepivacaine (7mg/kg) at any one time

See adult dosage

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution; no information available

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; dose adjustment recommended

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Disorientation
• Dizziness
• Drowsiness
• Excitement
• Loss of consciousness
• Nervousness
• Seizure

Musculoskeletal Disorders

• Tremor

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reaction

Sensory Disorders

• Blurred vision

• Benzylpenicilloyl polylysine
• Beta blockers
• Bupivacaine 
• Cocaine
• Ergot derivatives
• Hyaluronidase
• Iobenguane I 123
• Monoamine oxidase inhibitors
• Serotonin/norepinephrine reuptake inhibitors
• Tricyclic antidepressants

None routine

Mepivacaine
Mepivacaine is a local anaesthetic of the amide type. It has a rapid onset and intermediate duration of action. Local anesthetics bind selectively to the intracellular surface of sodium channels to block influx of sodium into the axon. As a result, depolarization necessary for action potential propagation and subsequent nerve function is prevented. 

Levonordefrin
Levonordefrin is a vasoconstrictor with actions similar to those of adrenaline.

COMBINATION PREPARATIONS

Levonordefrin/ Mepivacaine

Injection (per 1.8ml) 0.09mg/36mg

• Carbocaine L 2% (Adcock)