Local or regional anesthesia for infiltration and nerve block (see full labeling).


See full labeling for recommended dosages based on procedures. Epidural anesthesia: administer test dose first; monitor for CNS or cardiovascular toxicity. For all procedures: Max total dose: 4.5mg/kg not to exceed 300mg; epidural or caudal anesthesia should not be administered at intervals <90 minutes. Paracervical block: max 200mg total per 90 minute period. Elderly, debilitated, acutely ill (eg, cardiac or liver disease): reduce dose.


3yrs: usual max dose: 1.5–2mg/lb. See full labeling for dosages specific to procedures.


To be administered under the supervision of experienced clinicians. Have intubation, artificial respiration, oxygen therapy and reversal agents available. Risk of methemoglobinemia (esp. in G6PD deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants <6 months of age, concurrent exposure to oxidizing agents or metabolites); monitor. Intra-articular infusions: not recommended. Avoid intravascular inj. Avoid methylparaben with spinal or epidural anesthesia. Monitor cardiovascular and respiratory vital signs. Severe shock. Heart block. Neurological disease. Spinal deformities. Septicemia. Severe hypertension. Hepatic disease. Impaired cardiovascular function. Malignant hyperthermia. Head and neck administration. Labor & delivery: see full labeling. Pregnancy (Cat.B). Nursing mothers.

Pharmacologic Class:

Local anesthetic.


Increased risk of methemoglobinemia when concurrently exposed to nitrates/nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants, others. Additive effects with other products containing local anesthetics.

Adverse Reactions:

CNS effects (eg, lightheadedness, confusion), cardiovascular effects (eg, bradycardia, hypotension, cardiovascular collpase), hypersensitivity reactions, headache, backache, nausea, increased creatinine phosphokinase.

How Supplied:

Multi-dose vial (10mL, 20mL, 50mL)—25; MPF plastic ampules (10mL, 20mL)—5; MPF single-dose vial (2mL, 5mL, 50mL)—25; MPF single-dose vial (30mL)—5, 25