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BUPivacaine

BUPivacaine

Restricted Medications Epidural

Drug Name	Form	Strength	Non-Formulary	Restricted	TX Sub	Notes
Marcaine	SOLUTION, INJECTABLE	0.25%; 0.5%; 0.75%
Marcaine	SOLUTION, INTRATHECAL	0.75%-D8.25% preservative-free

Display Local Anesthetics Class : 720000

Medication comments:

Per policy, these medications require cardiac and/or special monitoring. (KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
generic (Brand) / Notes	CCU, OR, PACU, CCL, ED	PCU	2N (Tele)	1N (Tele), 3N (Tele)	Med/Surg (1N w/o Tele, 3N w/o Tele, 4N, 5N)	BirthPlace	SNF	ICS	OPS
BUPivacaine (Marcaine) Epidural Key: management only	Y	Y	Y	Y	Y	Y	Y	Y	N

During shortage, OR staff can prepare these products at bedside:
EPINEPHrine 1:1000 (1 mg/mL) Volume needed	Local Anesthetic Product and Volume needed	Final Product	Expiration
0.05 mL	BUPivacaine 0.25% 10 mL vial	BUPivacaine 0.25% with EPINEPHrine 1:200,000	Immediate use 60 minutes
0.15 mL	BUPivacaine 0.25% 30 mL vial	BUPivacaine 0.25% with EPINEPHrine 1:200,000
0.05 mL	BUPivacaine 0.5% 10 mL vial	BUPivacaine 0.5% with EPINEPHrine 1:200,000
0.15 mL	BUPivacaine 0.5% 30 mL vial	BUPivacaine 0.5% with EPINEPHrine 1:200,000

Last updated: Jun. 4, 2025

Black Box Warnings Intravascular Injection Risk (0.75% strength caution); Risk of Cardiac Arrest with Use in Obstetrical Anesthesia
Look-Alike/Sound-Alike BUPivacaine confused with ROPivacaine

UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.