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Indications & Uses
Bupi (Bupivacaine Hydrochloride) is used to produce local or regional anaesthesia or analgesia for surgery, oral surgery procedures, diagnostic and therapeutic procedures, and obstetrical procedures. The routes of administration and the Bupi concentrations indicated for each are as follows. Local infiltration uses 0.25%. Peripheral nerve block uses 0.25% or 0.5%. Sympathetic block uses 0.25%. Lumbar epidural uses 0.25%, 0.5% or 0.75% (the 0.75% strength is for non-obstetrical use). Caudal uses 0.25% or 0.5%.
Pharmacology
Bupivacaine Hydrochloride is an amide-type local anaesthetic. It starts working fairly slowly, but the effect lasts long, about 8 hours, and it can give significant sensory anaesthesia and motor blockade.
Local anaesthetics work by stopping nerve fibres and nerve endings from generating and passing on impulses. Depolarization and ion-exchange are inhibited, and the effects are reversible.
Bupivacaine is about 95% bound to plasma proteins. In adults the half-life is 1.5 to 5.5 hours, and in neonates it is about 8 hours.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Each 30 ml contains 150 mg Bupivacaine Hydrochloride (anhydrous) USP. The dose of any local anaesthetic depends on the anaesthetic procedure, the area to be anaesthetized, the vascularity of the tissues and the number of neuronal segments to be blocked. At the recommended doses, Bupivacaine produces complete sensory block, but the effect on motor function differs among the three concentrations. The 0.25% strength, when used for caudal, epidural or peripheral nerve block, produces incomplete motor block. It should be used for operations where muscle relaxation is not important, or when another means of muscle relaxation is used at the same time. Its onset of action may be slower than with the 0.5% or 0.75% solutions. The 0.5% strength provides motor blockade for caudal, epidural or nerve block, but muscle relaxation may be inadequate for operations in which complete muscle relaxation is essential. The maximum dose must be worked out for each patient after looking at the size and physical status of the patient, and the usual rate of systemic absorption from the particular injection site. Most experience to date is with single doses of Bupivacaine up to 175 mg, and these doses may be repeated up to once every three hours. In clinical studies so far, total daily doses up to 400 mg have been reported. Until more experience is gained, this dose should not be exceeded in 24 hours. The following doses have generally proved satisfactory and are recommended as a guide for the average adult. They should be reduced for young, elderly or debilitated patients. Local infiltration, 0.25%: up to max (mg). Epidural, 0.5%: 50 to 100 mg. Epidural, 0.25%: 25 to 50 mg. Caudal, 0.5%: 75 to 150 mg. Caudal, 0.25%: 37.5 to 75 mg. Peripheral nerves, 0.5%: 25 mg to max. Peripheral nerves, 0.25%: 12.5 mg to max. Sympathetic, 0.25%: 50 to 125 mg.
Side Effects
Central Nervous System and Neurological effects of Bupivacaine Hydrochloride include restlessness, excitement, nervousness, dizziness, tinnitus, blurred vision, miosis, nausea and vomiting. Some people also get numbness of the tongue and perioral region, chills, tremors, muscle twitching and convulsions. Cardiovascular System Reactions come from myocardial depression and peripheral vasodilatation, which can lead to hypotension and bradycardia. Ventricular arrhythmia and cardiac arrest can also occur. Hypersensitivity reactions are urticaria, pruritus, erythema, angioneurotic edema, tachycardia, sneezing, nausea, vomiting, dizziness, syncope, excessive sweating and elevated temperature. Anaphylactoid reactions are also possible.
Cautions & Contraindications
Warnings & Precautions
Only clinicians who are well trained in diagnosing and managing dose-related toxicity, and any other acute emergencies that could arise from the block being used, should give local anaesthetics like Bupivacaine Hydrochloride. Even then, they should first make sure oxygen, other resuscitative drugs, cardiopulmonary resuscitation equipment and the staff needed to manage toxic reactions and related emergencies are immediately available. Give it cautiously to the elderly, the debilitated and children, and to patients with epilepsy, impaired cardiac conduction, shock, liver damage and myasthenia gravis. Use the lowest dose of local anaesthetic that gives effective anaesthesia, so that high plasma levels and serious adverse effects are avoided. Don't inject a large volume of the solution quickly. Where feasible, give it in fractional (incremental) doses. After each injection, monitor the cardiovascular and respiratory vital signs (including the adequacy of ventilation) and the patient's state of consciousness, carefully and constantly. If a local anaesthetic is absorbed too rapidly, it can cause systemic adverse effects. For this reason, don't inject it into inflamed or infected tissues, and don't apply it to damaged mucosa.
Contraindications
Bupivacaine Hydrochloride must not be used in people who are hypersensitive to bupivacaine, to other amide type local anaesthetics, or to any other component of these preparations. It must also not be used for intravenous regional anaesthesia, or for obstetrical paracervical block anaesthesia.
Pregnancy & Breastfeeding
Bupivacaine injection should be given during pregnancy only when the expected benefit is greater than the possible risk to the fetus. Take care when it is given to a breastfeeding mother.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Use in Children: Bupivacaine Hydrochloride is not recommended for children under 12 years of age, because more experience is needed in this age group before it can be advised.
Storage
Store Bupivacaine Hydrochloride in a cool, dry place and keep it away from light. Keep it out of the reach of children.
Drug Interactions
Common questions about Bupi 0.5%
What is Bupi 0.5% Injection?
Bupi 0.5% Injection is a medicine that contains Bupivacaine Hydrochloride. It is made by Popular Pharmaceuticals PLC. It belongs to the Regional anesthesia group of medicines.
What is Bupi used for?
Bupi (Bupivacaine Hydrochloride) is used to produce local or regional anaesthesia or analgesia for surgery, oral surgery procedures, diagnostic and therapeutic procedures, and obstetrical procedures. The routes of administration and the Bupi concentrations indicated for each are as follows.
What are the side effects of Bupi?
Central Nervous System and Neurological effects of Bupivacaine Hydrochloride include restlessness, excitement, nervousness, dizziness, tinnitus, blurred vision, miosis, nausea and vomiting. Some people also get numbness of the tongue and perioral region, chills, tremors, muscle twitching and convulsions.
Can I take Bupi during pregnancy or while breastfeeding?
Bupivacaine injection should be given during pregnancy only when the expected benefit is greater than the possible risk to the fetus. Take care when it is given to a breastfeeding mother. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Bupi?
Store Bupivacaine Hydrochloride in a cool, dry place and keep it away from light. Keep it out of the reach of children.
Can I take other medicines with Bupi?
Some medicines can interact with Bupivacaine Hydrochloride, for example: Lidocaine, Amiodarone Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Bupi?
Bupi is a prescription (Rx) medicine. Take it as your doctor advises.