Formulary
Levobupivacaine: Indications, Dosing, Side Effects and Interactions
Levobupivacaine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Levobupivacaine: Indications, Dosing, Side Effects and Interactions
Levobupivacaine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Surgical anaesthesia, Acute pain for levobupivacaine**
- **Child** (By regional administration): Doses adjusted according to child's physical status and nature of procedure, seek expert advice (consult product literature or local protocols).
Cautions
Cardiovascular disease; complete heart block; debilitated patients (consider dose reduction); elderly (consider dose reduction); epilepsy; hypovolaemia; impaired cardiac conduction; impaired respiratory function; myasthenia gravis; shock
Contraindications
Avoid injection into infected tissues; avoid injection into inflamed tissues; intravenous regional anaesthesia (Bier's block); preparations containing preservatives should not be used for caudal, epidural, or spinal block Contra-indications, further information Injection site Manufacturer advises local anaesthetics should not be injected into inflamed or infected tissues. Increased absorption into the blood increases the possibility of systemic side-effects, and the local anaesthetic effect may also be reduced by altered local pH.
Side effects
Common or very common Anaemia; back pain; dizziness; fever; headache; hypotension; nausea; procedural pain; vomiting Frequency not known Angioedema; apnoea; arrhythmias; asthenia; atrioventricular block; bladder disorder; cardiac arrest; drowsiness; eye disorders; faecal incontinence; flushing; loss of consciousness; muscle twitching; muscle weakness; nerve disorders; neurological injury; oral hypoaesthesia; paralysis; priapism; respiratory disorders; seizure; sensation abnormal; skin reactions; sneezing; sweat changes; syncope; vision blurred Side-effects, further information The systemic toxicity of local anaesthetics mainly involves the central nervous and cardiovascular systems. Systemic toxicity can occur due to inadvertent intravascular injection. The onset of toxicity can be unpredictable and delayed. Monitor as per local protocol for at least 30 minutes after administration.
Pregnancy
Large doses during delivery can cause neonatal respiratory depression, hypotonia, and bradycardia after epidural block. Avoid if possible in the first trimester-toxicity in animal studies. May cause fetal distress syndrome. Do not use for paracervical block in obstetrics. Do not use 7.5 mg/mL strength in obstetrics.
Breast feeding
Amount too small to be harmful.
Hepatic impairment
Manufacturer advises caution in impairment or patients with reduced hepatic blood flow (no information available).
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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