Mepivacaine

Registered South African indications:

• Local anaesthesia

Contraindications

• Known hypersensitivity to the amide type of local anaesthetic or excipients
• Children below 4 years of age (ca. 20 kg body weight)
• Porphyria
• Severe disorders of the atrioventricular conduction not compensated by pacemaker
• Epilepsy not controlled by appropriate treatment

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Cardiovascular disease
• Hyperthyroidism
• Acutely ill patients
• Debilitated patients
• Intravenous administration

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

Local anaesthesia - oral region

• SC: Max: Up to 400mg/dose; Max: 1g/24hrs

Dosage depends on the site to be anaesthetised, the area and vascularity thereof, condition of patient, duration of anaesthesia required and the technique used

Contraindicated in children below 4 years

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Porphyria Information

• Contraindicated

Central Nervous System Disorders

• Yawning
• Restlessness
• Excitement
• Nervousness
• Dizziness
• Tinnitus
• Nystagmus
• Muscle twitching 
• Tremors
• Seizures 
• Drowsiness
• Coma
• Anxiety
• Chills
• Confusion
• Increased body temperature
• Paralysis
• Persistent anaesthesia

Cardiovascular Disorders

• Myocardial depression 
• Peripheral vasodilation 
• Hypotension 
• Bradycardia
• Arrhythmias 
• Cardiac arrest 
• Cardiac insufficiency
• Cardiovascular depression
• Cardiovascular stimulation
• Heart block
• Hypertension
• Low cardiac output
• Syncope
• Tachycardia

Respiratory Disorders

• Respiratory failure
• Apnoea
• Respiratory depression
• Sneezing

Gastrointestinal Disorders

• Nausea and vomiting
• Fecal incontinence
• Oral paresthesia

Genitourinary Disorders

• Urinary incontinence
• Urinary retention

Musculoskeletal Disorders

• Chondrolysis 
• Tremor
• Weakness

Skin and Subcutaneous Tissue Disorders

• Diaphoresis
• Erythema
• Pruritus
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Methaemoglobinaemia
• Anaphylactoid reaction
• Angioedema
• Hypersensitivity reaction

Sensory Disorders

• Blurred vision
• Miosis
• Tinnitis

Bupivacaine 

None routine

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.

Injection (per 1.8ml) 54mg

• Carbocaine 3% Dental (Adcock) originator
• Scandonest 3% Plain (The Dental Warehouse)