CARBOCAINE Dosage and Administration

(mepivacaine Hydrochloride Injection, USP)

DOSAGE AND ADMINISTRATION

The dose of any local anesthetic administered varies with the anesthetic procedure, the area to be anesthetized, the vascularity of the tissues, the number of neuronal segments to be blocked, the depth of anesthesia and degree of muscle relaxation required, the duration of anesthesia desired, individual tolerance and the physical condition of the patient. The smallest dose and concentration required to produce the desired result should be administered. Dosages of CARBOCAINE should be reduced for elderly and debilitated patients and patients with cardiac and/or liver disease. The rapid injection of a large volume of local anesthetic solution should be avoided and fractional doses should be used when feasible.

For specific techniques and procedures, refer to standard textbooks.

There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. CARBOCAINE is not approved for this use (See WARNINGS and DOSAGE AND ADMINISTRATION).

The recommended single adult dose (or the total of a series of doses given in one procedure) of CARBOCAINE for unsedated, healthy, normal-sized individuals should not usually exceed 400 mg. The recommended dosage is based on requirements for the average adult and should be reduced for elderly or debilitated patients.

While maximum doses of 7 mg/kg (550 mg) have been administered without adverse effect, these are not recommended, except in exceptional circumstances and under no circumstances should the administration be repeated at intervals of less than 1 1/2 hours. The total dose for any 24-hour period should not exceed 1,000 mg because of a slow accumulation of the anesthetic or its derivatives or slower than normal metabolic degradation or detoxification with repeat administration (See CLINICAL PHARMACOLOGY and PRECAUTIONS).

Pediatric patients tolerate the local anesthetic as well as adults. However, the pediatric dose should be carefully measured as a percentage of the total adult dose based on weight, and should not exceed 5 mg/kg to 6 mg/kg (2.5 mg/lb to 3 mg/lb) in pediatric patients, especially those weighing less than 30 lb. In pediatric patients under 3 years of age or weighing less than 30 lb concentrations less than 2% (e.g., 0.5% to 1.5%) should be employed.

Unused portions of solutions not containing preservatives, i.e., those supplied in single-dose vials, should be discarded following initial use.

This product should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Solutions which are discolored or which contain particulate matter should not be administered.

Recommended Concentrations and Doses of Carbocaine

Total Dose

Procedure

Concentration

mL

mg

Comments

Cervical, brachial,

intercostal, pudendal

nerve block

1%
 

2%

5-40
 

5-20

50-400
 

100-400

Pudendal block: one half of total dose injected each side.

Transvaginal block

(paracervical plus pudendal)

1%

up to 30

(both sides)

up to 300

(both sides)

One half of total dose injected each side.

See PRECAUTIONS.

Paracervical block

1%

up to 20

(both sides)

up to 200

(both sides)

One half of total dose injected each side. This is maximum recommended dose per 90-minute period in obstetrical and non-obstetrical patients. Inject slowly, 5 minutes between sides.

See PRECAUTIONS.

Caudal and epidural block

1%

1.5%

2%

15-30

10-25

10-20

150-300

150-375

200-400

Use only single-dose vials which do not contain a preservative.

Infiltration

1%

up to 40

up to 400

An equivalent amount of a 0.5% solution (prepared by diluting the 1% solution with Sodium Chloride Injection, USP) may be used for large areas.

Therapeutic block

(pain management)

1%

2%

1-5

1-5

10-50

20-100

Unused portions of solutions not containing preservatives should be discarded.

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Dosage and Administration

DOSAGE AND ADMINISTRATION

The dose of any local anesthetic administered varies with the anesthetic procedure, the area to be anesthetized, the vascularity of the tissues, the number of neuronal segments to be blocked, the depth of anesthesia and degree of muscle relaxation required, the duration of anesthesia desired, individual tolerance and the physical condition of the patient. The smallest dose and concentration required to produce the desired result should be administered. Dosages of CARBOCAINE should be reduced for elderly and debilitated patients and patients with cardiac and/or liver disease. The rapid injection of a large volume of local anesthetic solution should be avoided and fractional doses should be used when feasible.

For specific techniques and procedures, refer to standard textbooks.

There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. CARBOCAINE is not approved for this use (See WARNINGS and DOSAGE AND ADMINISTRATION).

The recommended single adult dose (or the total of a series of doses given in one procedure) of CARBOCAINE for unsedated, healthy, normal-sized individuals should not usually exceed 400 mg. The recommended dosage is based on requirements for the average adult and should be reduced for elderly or debilitated patients.

While maximum doses of 7 mg/kg (550 mg) have been administered without adverse effect, these are not recommended, except in exceptional circumstances and under no circumstances should the administration be repeated at intervals of less than 1 1/2 hours. The total dose for any 24-hour period should not exceed 1,000 mg because of a slow accumulation of the anesthetic or its derivatives or slower than normal metabolic degradation or detoxification with repeat administration (See CLINICAL PHARMACOLOGY and PRECAUTIONS).

Pediatric patients tolerate the local anesthetic as well as adults. However, the pediatric dose should be carefully measured as a percentage of the total adult dose based on weight, and should not exceed 5 mg/kg to 6 mg/kg (2.5 mg/lb to 3 mg/lb) in pediatric patients, especially those weighing less than 30 lb. In pediatric patients under 3 years of age or weighing less than 30 lb concentrations less than 2% (e.g., 0.5% to 1.5%) should be employed.

Unused portions of solutions not containing preservatives, i.e., those supplied in single-dose vials, should be discarded following initial use.

This product should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Solutions which are discolored or which contain particulate matter should not be administered.

Recommended Concentrations and Doses of Carbocaine

Total Dose

Procedure

Concentration

mL

mg

Comments

Cervical, brachial,

intercostal, pudendal

nerve block

1%
 

2%

5-40
 

5-20

50-400
 

100-400

Pudendal block: one half of total dose injected each side.

Transvaginal block

(paracervical plus pudendal)

1%

up to 30

(both sides)

up to 300

(both sides)

One half of total dose injected each side.

See PRECAUTIONS.

Paracervical block

1%

up to 20

(both sides)

up to 200

(both sides)

One half of total dose injected each side. This is maximum recommended dose per 90-minute period in obstetrical and non-obstetrical patients. Inject slowly, 5 minutes between sides.

See PRECAUTIONS.

Caudal and epidural block

1%

1.5%

2%

15-30

10-25

10-20

150-300

150-375

200-400

Use only single-dose vials which do not contain a preservative.

Infiltration

1%

up to 40

up to 400

An equivalent amount of a 0.5% solution (prepared by diluting the 1% solution with Sodium Chloride Injection, USP) may be used for large areas.

Therapeutic block

(pain management)

1%

2%

1-5

1-5

10-50

20-100

Unused portions of solutions not containing preservatives should be discarded.

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