Marcaine

Before taking this medicine

Marcaine must not be used if you are allergic to bupivacaine, other amide-type local anesthetics, or any of its ingredients. It must not be used for an obstetrical paracervical block (an injection around the cervix during childbirth), because this has caused a slow fetal heart rate and fetal death, or for intravenous regional anesthesia (Bier block), because cardiac arrest and death have been reported. Extra caution and monitoring are needed in older, debilitated or acutely ill patients, and in people with kidney impairment or moderate to severe liver impairment. People aged 65 or over, particularly those with high blood pressure, may be more likely to develop low blood pressure during anesthesia. Use in children younger than 12 years is not recommended. Tell your clinician if you have G6PD deficiency, a history of methemoglobinemia, heart or lung problems, or take medicines that can cause methemoglobinemia. These factors increase susceptibility to this serious blood condition, which can cause bluish skin discoloration and requires immediate treatment. During pregnancy, bupivacaine crosses the placenta and may cause toxicity in the mother and baby. Cardiac arrest, sometimes fatal or difficult to resuscitate, has been reported during epidural anesthesia in obstetric patients. Bupivacaine passes into breast milk; use while breastfeeding should be limited to situations where it is clearly needed, as effects on breastfed children and milk production have not been studied. Marcaine requires careful monitoring of breathing, heart function and alertness because systemic toxicity or accidental injection into a blood vessel or spinal fluid can cause seizures, cardiac arrest or respiratory arrest. Infusion directly into a joint is not an approved use and has been associated with destruction of joint cartilage.