Formulary
Mepivacaine hydrochloride: Indications, Dosing, Side Effects and Interactions
Mepivacaine hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Mepivacaine hydrochloride: Indications, Dosing, Side Effects and Interactions
Mepivacaine hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Infiltration anaesthesia and nerve block in dentistry for mepivacaine hydrochloride**
- **Child 3-17 years** (): Consult expert dental sources.
Cautions
Cardiovascular disease; children (consider dose reduction); debilitated patients (consider dose reduction); elderly (consider dose reduction) (in adults); 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; severe atrio-ventricular conduction disorders not controlled by a pacemaker Contra-indications, further information Injection site Manufacturer advises the local anaesthetic effect may be reduced when injected into an inflamed or infected area, due to altered local pH. Increased absorption into the blood also increases the possibility of systemic side-effects.
Side effects
Common or very common Arrhythmias; dizziness; hypertension; hypotension; nausea; paraesthesia; vomiting Uncommon Neurotoxicity Rare or very rare Arachnoiditis; cardiac arrest; diplopia; nerve disorders; respiratory depression Side-effects, further information Toxic effects after administration of local anaesthetics are a result of excessively high plasma concentrations; severe toxicity usually results from inadvertent intravascular injection or too rapid injection. The systemic toxicity of local anaesthetics mainly involves the central nervous and cardiovascular systems. The onset of toxicity can be unpredictable and delayed. Monitor as per local protocol for at least 30 minutes after administration.
Pregnancy
Use with caution in early pregnancy.
Breast feeding
Use with caution.
Hepatic impairment
Manufacturer advises caution; increased risk of toxic plasma concentrations in severe impairment.
Renal impairment
Use with caution; increased risk of side-effects.
Medicinal forms
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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