{"product_id":"bupivacaine-0-5-injection-50-mg-per-10-ml-x-25-vials","title":"Bupivacaine 0.5% Injection 50 mg Per 10 ml x 25 Vials (RX)","description":"\u003ch1\u003eBupivacaine 0.5% Injection (50 mg per 10 mL)\u003c\/h1\u003e\n\u003cp\u003eBupivacaine is a potent amide-type local anesthetic used by clinicians for regional anesthesia. Each mL of a 0.5% solution contains 5 mg of bupivacaine (so a 10 mL vial has 50 mg). It blocks nerve impulse conduction by binding to open voltage-gated sodium channels in nerve membranes, stabilizing their inactive state and preventing depolarization. Bupivacaine has a relatively slow onset (often 10–20 minutes for operative anesthesia) but a \u003cstrong\u003elong duration\u003c\/strong\u003e of action (several hours of sensory and motor block) compared to shorter-acting agents.\u003c\/p\u003e\n\u003ch2\u003eUses\u003c\/h2\u003e\n\u003cp\u003eBupivacaine 0.5% injection (with or without added epinephrine) is used to produce \u003cstrong\u003eregional anesthesia or analgesia\u003c\/strong\u003e for various procedures. Indications include:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eSurgical anesthesia:\u003c\/strong\u003e infiltration or field block for surgery (especially when prolonged anesthesia is needed), and peripheral nerve blocks for procedures on limbs or torso.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eEpidural and caudal blocks:\u003c\/strong\u003e labor\/delivery pain relief and postoperative analgesia (e.g. epidural anesthesia during obstetrical or orthopedic procedures). (Only preservative-free drug should be used in epidural\/caudal space.)\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eDiagnostic\/therapeutic nerve blocks:\u003c\/strong\u003e e.g. sympathetic blocks, neck or ganglion blocks that require long-duration anesthetic effect.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eObstetrical anesthesia:\u003c\/strong\u003e Bupivacaine 0.5% (often diluted) is commonly used in epidural labor analgesia. It provides visceral and somatic block for Cesarean delivery or labor.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eNot indicated:\u003c\/strong\u003e This formulation should \u003cstrong\u003enever be given by spinal (intrathecal)\u003c\/strong\u003e injection (Intrathecal bupivacaine is given in special hyperbaric preparations at different concentrations.) It is used only by trained personnel, not for routine outpatient or self-administration.\u003c\/p\u003e\n\u003ch2\u003eDosage and Administration\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAdministration route:\u003c\/strong\u003e Bupivacaine 0.5% is given by injection, typically \u003cstrong\u003eslowly\u003c\/strong\u003e and in controlled increments. Aspirate before injecting to avoid intravascular administration. Monitor blood pressure and ECG during injection due to systemic effects. Always use the appropriate dose and formulation (e.g. preservative-free for neuraxial use).\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eTypical dosing:\u003c\/strong\u003e The dose depends on patient size, site, and block technique. Each mL contains 5 mg of drug. A single 10 mL vial (50 mg) is often used for minor blocks. For larger blocks or epidurals, volumes of 10–20 mL (50–100 mg) may be given. For example, epidural anesthesia often uses 10–20 mL of 0.5% (50–100 mg) for a moderate-to-complete motor block. Peripheral nerve blocks may use smaller volumes (e.g. 5–10 mL, 25–50 mg) to cover a nerve distribution. In obstetrics, continuous epidural or infusion techniques use more dilute solutions (e.g. 0.125–0.25% with opioids) rather than 0.5%.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eMaximum dose:\u003c\/strong\u003e Because of systemic toxicity risk, total dose limits must be observed. For an average adult, single-dose bupivacaine generally should \u003cstrong\u003enot exceed ~150–175 mg\u003c\/strong\u003e (about 30–35 mL of 0.5%). (This is roughly 2–2.5 mg\/kg for a 70-kg patient.) If epinephrine is added, slightly higher maximal doses (up to ~3 mg\/kg) are sometimes tolerated. Repeated injections (if needed) are usually given no more frequently than every 3–4 hours, with a 24-hour total not exceeding ~400 mg. In all cases, dose must be tailored to patient factors (age, weight, comorbidities) and monitored closely.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSpecial techniques:\u003c\/strong\u003e Before performing labor epidurals or major blocks, clinicians often administer a \u003cstrong\u003etest dose\u003c\/strong\u003e (e.g. 3 mL of 0.5% solution with epinephrine) to check for inadvertent intrathecal or intravascular placement. (This formulation without epinephrine would not contain epinephrine, but the principle of slow injection and monitoring still applies.)\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2\u003eSide Effects and Safety\u003c\/h2\u003e\n\u003cp\u003eBecause bupivacaine is a \u003cstrong\u003epotent anesthetic\u003c\/strong\u003e, side effects stem from both its local action and potential systemic absorption:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eCNS effects (LAST – Local Anesthetic Systemic Toxicity):\u003c\/strong\u003e Early warning signs of toxicity include central nervous system symptoms: circumoral numbness, tinnitus, blurred vision, dizziness, lightheadedness, tingling, or tremors. If plasma levels get high (e.g. from rapid IV injection or excessive dose), seizures (tonic-clonic convulsions) can occur. Importantly, bupivacaine can cause \u003cem\u003eimmediate cardiotoxicity\u003c\/em\u003e without warning by CNS signs.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eCardiovascular effects:\u003c\/strong\u003e Bupivacaine is notably cardiotoxic at higher concentrations. Overdose or intravascular injection may cause severe cardiac arrhythmias. Reported signs include \u003cstrong\u003ebradycardia\u003c\/strong\u003e, conduction blocks (AV block), ventricular arrhythmias, and even cardiac arrest. In obstetric cases, there are rare reports of cardiovascular collapse during epidural use. Hypotension and reflex tachycardia can occur as a sympathetic block effect, especially with larger volume epidurals. (If epinephrine is present, careful with underlying heart conditions.)\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAllergic reactions:\u003c\/strong\u003e True IgE-mediated allergy to bupivacaine is extremely rare. Bupivacaine contains no ester groups and has low cross-reactivity; most “allergy” is actually to preservatives\/sulfites (in epinephrine vials). Standard contraindications include any history of hypersensitivity to amide local anesthetics or to any formulation component. If a rash, swelling, or anaphylactic reaction occurs after injection, treatment must be stopped and appropriate care given.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eNeurotoxicity:\u003c\/strong\u003e High spinal or epidural blocks can cause prolonged neurological effects. Care must be taken not to inject intrathecally (spinal) unless using the proper formulation. Post-LP syndrome or nerve injury can occur if technique is improper. Repeated intra-articular infusions of local anesthetics (e.g. pain pumps in shoulder joints) have been linked to cartilage damage (chondrolysis), although a single injection is generally safe.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eOthers:\u003c\/strong\u003e Bupivacaine can induce methemoglobinemia (rarely), so watch for cyanosis\/dark blood if given high doses intravenously or to infants. Large epidural blocks can cause respiratory depression if very high neuraxial block occurs (e.g. diaphragmatic weakness). Nausea, vomiting, urinary retention, and fever have been reported with epidural use.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eMonitoring:\u003c\/strong\u003e Because of these risks, bupivacaine injections are given only by experienced providers with resuscitation equipment at hand. Vital signs (blood pressure, heart rate, ECG, oxygen saturation) are monitored. If any symptoms of toxicity arise, injection is stopped. Intravenous lipid emulsion (lipid rescue) is a treatment for severe LAST (cardiac arrest) in case it occurs.\u003c\/p\u003e\n\u003ch2\u003ePrecautions and Contraindications\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eContraindicated uses:\u003c\/strong\u003e Do \u003cem\u003enot\u003c\/em\u003e use bupivacaine 0.5% for \u003cstrong\u003eobstetric paracervical block\u003c\/strong\u003e (this technique can cause fetal bradycardia and death). Bupivacaine is also contraindicated for intravenous regional anesthesia (Bier block). Other absolute contra: known allergy to bupivacaine or related amide anesthetics. Avoid formulations containing preservatives (e.g. multi-dose vials) for epidural or spinal use.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eHepatic impairment:\u003c\/strong\u003e Bupivacaine is \u003cstrong\u003emetabolized in the liver\u003c\/strong\u003e, so patients with severe liver disease clear it more slowly. Dose reduction and careful monitoring are recommended in hepatic impairment. Excessive levels can build up with repeated dosing in such patients.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eRenal impairment:\u003c\/strong\u003e Bupivacaine and its metabolites are excreted by the kidneys. In renal failure, accumulation can occur over time; use caution and assess dosing for renal insufficiency.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eCardiovascular disease:\u003c\/strong\u003e Patients with conduction blocks, bradycardia, or severe cardiac dysfunction should receive bupivacaine only with extreme caution. Concurrent use of other cardiodepressant drugs (beta-blockers, certain calcium channel blockers, antiarrhythmics) may magnify bupivacaine’s effects. Also, because dose administration can cause hypotension, ensure patient volume is adequate before large epidural blocks.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003ePregnancy\/lactation:\u003c\/strong\u003e Bupivacaine crosses the placenta, so maternal administration can affect the fetus (fetal heart rate should be monitored in obstetric use). While widely used for labor analgesia, it should only be used when benefit outweighs risk. Bupivacaine is excreted into breast milk in small amounts; caution is advised if nursing (though a one-time block is unlikely to harm the infant significantly).\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eOther drugs:\u003c\/strong\u003e Avoid mixing with other local anesthetics in the same syringe. Some drug interactions: potent CYP3A4 inhibitors (e.g. cimetidine) can raise plasma bupivacaine levels, whereas inducers (e.g. phenytoin, rifampin) can lower levels. If epinephrine is added, drugs affecting coagulation or the fetus should be considered.\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2\u003eSummary\u003c\/h2\u003e\n\u003cp\u003eBupivacaine 0.5% (5 mg\/mL) injection is a prescription local anesthetic given by healthcare professionals for \u003cstrong\u003elong-duration regional anesthesia\u003c\/strong\u003e. It provides several hours of numbness and muscle relaxation, making it useful for surgeries, labor epidurals, and nerve blocks. The typical adult dose is individually determined (often up to 10–20 mL for epidural blocks), with absolute maximums around 150–175 mg per single dose. Careful administration is crucial: do not inject intravenously or intrathecally. Common side effects include numbness and muscle weakness in the blocked area; serious risk comes from systemic absorption – manifesting as neurological (e.g. seizures) and cardiovascular (arrhythmias, hypotension) toxicity. Strict monitoring of vital signs and readiness to manage complications (e.g. airway, blood pressure support, intralipid) are standard practice.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eImportant:\u003c\/strong\u003e Bupivacaine injection is \u003cem\u003enot\u003c\/em\u003e for patient self-use and should be used exactly as directed by an anesthesiologist or physician. Always follow the clinician’s instructions and equipment protocols when this drug is used. If any adverse symptoms (e.g. numbness beyond expected, difficulty breathing or heartbeat changes) occur during or after its use, notify medical staff immediately.\u003c\/p\u003e","brand":"Eugia US","offers":[{"title":"Default Title","offer_id":53723137704304,"sku":"55150-0169-10P","price":79.95,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0996\/0350\/files\/Bupivacaine-0.5_-Injection-50-mg-Per-10-ml.jpg?v=1778165038","url":"https:\/\/www.mountainside-medical.com\/products\/bupivacaine-0-5-injection-50-mg-per-10-ml-x-25-vials","provider":"Mountainside Medical","version":"1.0","type":"link"}