Mepivacaine/ Adrenaline
Indications
Registered South African indications:
- Local anaesthesia for dental procedures
Cautions
Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients
Mepivacaine hydrochloride
Contraindications
- Hypersensitivity to the active ingredient or any of the excipients in this combination product
Cautions
- Pregnancy
- Breastfeeding
- Renal impairment
- Hepatic impairment
- Elderly
- Cardiovascular disease
- Hyperthyroidism
- Acutely ill patients
- Debilitated patients
- Intravenous administration
Adrenaline
Contraindications
- Hypersensitivity to the active ingredient or any of the excipients in this combination product
- Hypersensitivity to sulfites
- Use in fingers, toes, ears, nose or genitalia (adrenaline 1:1000)
Cautions
- Pregnancy
- Breastfeeding
- Severe renal impairment
- Elderly
- Hyperthyroidism
- Psychoneurosis
- Phaeochromocytoma
- Narrow angle glaucoma
- Diabetes mellitus
- Hypokalaemia
- Hypercalcaemia
- Prostatic hypertrophy
- Cerebrovascular disease
- Organic brain damage
- Arteriosclerosis
- Autonomic dysreflexia
- Shock (other than anaphylactic shock)
- Cardiac dilatation
- Organic heart disease
- Arrhythmias
- Coronary insufficiency
- Bronchial asthma and emphysema in patients who have developed degenerative heart disease
- Parkinson's Disease
- Second stage of labour
- Intravenous injection
- Prolonged use
Additional contraindications for this combination product
- Arterial hypertension
- Cardiovascular disease and coadministration with monoamine oxidase inhibitors
- Coadministrration with tricyclic antidepressants
- Coronary disease
- Vulvular affection
Adult dosage
Forms avail. in SA and covered in this monograph: inj
Local anaesthesia for dental procedures
Mepivacaine hydrochloride/ Adrenaline
36/0.018 (mg/1.8ml)
- Local infiltration: 1.8ml; Max: 5.4ml
Do not inject repeatedly at the same site
Paediatric dosage
Paed. forms avail. in SA and covered in this monograph: inj
Local anaesthesia for dental procedures
Mepivacaine hydrochloride/ Adrenaline
36/0.018 (mg/1.8ml)
- Younger than 3 years: Not established for use
- Between 3-6 years: Local infiltration: 1.1-1.2ml
- Between 6-14 years: Local infiltration: 1.6ml; Max: 3.3ml
- Older than 14 years: See adult dosage
Do not inject repeatedly at the same site
Special populations
Recommendations for this combination product as per highest risk category when comparing individual active ingredients
Pregnancy
Breastfeeding
Renal Impairment
Hepatic Impairment
Elderly
Adverse reactions
Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients
Mepivacaine hydrochloride
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
Adrenaline
Central Nervous System Disorders
- Psychotic states
- Anxiety
- Fear
- Confusion
- Irritability
- Insomnia
- Restlessness
- Headache
- Dizziness
- Rigidity
- Yremors
- Subarachnoid haemorrhage
- Hemiplegia
Cardiovascular Disorders
- Palpitation
- Tachycardia
- Ventricular arrhythmias
- Myocardial ischaemia
- Myocardial infarction
- Cardiomyopathy
- Hypertension
- Coldness of extremities
- Bowel necrosis
Respiratory Disorders
- Dyspnoea
- Pulmonary oedema
Gastrointestinal Disorders
- Dry mouth
- Reduced appetite
- Nausea
- Vomiting
- Hypersalivation
Genitourinary Disorders
- Difficulty in micturition
- Urinary retention
Endocrine and Metabolic Disorders
- Hypokalaemia
- Metabolic acidosis
- Inhibition of insulin secretion
- Hyperglycaemia
- Gluconeogenesis
- Glycolysis
- Lipolysis
- Ketogenesis
Skin and Subcutaneous Tissue Disorders
- Hyperhidrosis
- Tissue necrosis
Immune, Blood and Lymphatic System Disorders
- Anaphylaxis
Others
- Weakness
- Pallor
Interactions
Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients
Mepivacaine hydrochloride
- Bupivacaine
Adrenaline
- Sympathomimetic agents
- Alpha agonists
- Alpha blockers
- Beta blockers
- General anaesthetics
- Antihypertensive agents
- Antidepressant agents
- Phenothiazines
- Cardiac glycosides
- Antihistamines
- Antiparkinsons agents
- Thyroid hormones
- Corticosteroids
- Diuretics
- Aminophylline
- Theophylline
- Antidiabetic agents
Monitoring
- Vital signs
- Pupil size
- Urine output
Mechanism of action
Mepivacaine hydrochloride
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.
Adrenaline
Adrenaline is a sympathomimetic amine which is a potent stimulant of alpha- and beta- adrenergic receptors. It has strong vasoconstrictor action through alpha- adrenergic stimulation, which counteracts the vasodilatation and increases vascular permeability leading to loss of intravascular fluid and subsequent hypotension in anaphylactic shock. Adrenaline stimulates bronchial beta-adrenergic receptors, causing bronchial smooth muscle relaxation.
Dosage forms
- Injection
Formulation
COMBINATION PREPARATIONS
Mepivacaine hydrochloride/ Adrenaline
Injection (per 1.8ml) 36mg/0.018mg
- Scandonest 2% Special (The Dental Warehouse)
References
1. PI: Scandonest 2% special solution for injection, The Dental Warehouse (Pty) Ltd:Date of registration: 8 Oct 1991 [https://drive.google.com/drive/u/0/folders/1WkarlMueriPgxzmmhG09APEcXQI8lLRX] See individual monographs: -https://admin.emguidance.com/medicine-edit/f5bc7c26-0872-4ec6-9ab8-f95a1c2c0ad6 -https://admin.emguidance.com/medicine-edit/ac0139db-74ae-4cd0-b029-ee173caf62cd **No SPC available **no uptodate **no drugs.com
Brands & products
1 product · cached snapshot- Scandonest 2 % Special
INJInjection· 1 product
from R451.07| Product | Strength | Pack | Applicant | Min price |
|---|---|---|---|---|
| Scandonest 2% Special | 36 mg/1.8ml;mg/1.8ml | 1.8 | Henry Schein Dental Warehouse (Pty) Ltd | R451.07 |
Medical aid coverage
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