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


See full labeling for recommended doses based on procedures. When larger volumes are required, only solutions containing epinephrine should be used except where vasopressors are contraindicated. Caudal and lumbar epidural block: administer test dose; epinephrine may serve as a warning of unintentional intravascular inj. For all procedures: max dose: 7mg/kg, not to exceed 500mg. Elderly, debilitated, cardiac and/or liver disease: reduce dose.


Max dose determined by age and weight. See full labeling for specific dosages based on 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. Peripheral or hypertensive vascular disease. Hepatic disease. Impaired cardiovascular function. Malignant hyperthermia. Head and neck administration. Discontinue if severe anaphylactic reactions occur. Labor & delivery: see full labeling. Pregnancy (Cat.B). Nursing mothers.

Pharmacologic Class:

Local anesthetic + vasoconstrictor.


Concurrent during or after potent general anesthetic agents may cause cardiac arrhythmias; use caution. Concurrent vasopressor and ergot-type oxytocic drugs may cause severe, persistent hypertension or cerebrovascular accidents. Severe prolonged hypertension with MAOIs or tricyclic antidepressants. Phenothiazines and butyrophenones antagonize pressor effect of epinephrine; avoid. 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), allergic reactions, headache, backache, nausea, increased creatinine phosphokinase.

How Supplied:

Multi-dose vials (10mL, 20mL, 50mL)—25; MPF single-dose vials (10mL)—25; MPF single-dose vials (20mL, 30mL)—5, 25