Bupivacaine Dosage
Generic name: bupivacaine
Brand names: Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF, Sensorcaine-MPF Spinal, Xaracoll
Drug class: Local injectable anesthetics
Adult Dosing
Dosage forms: INJ (0.25%): 2.5 mg per mL; INJ (0.5%): 5 mg per mL; INJ (0.75%): 7.5 mg per mL; INJ (0.75% hyperbaric): 7.5 mg per mL
Special Note
- [formulation clarification]
- Info: not interchangeable w/ bupivacaine liposomal; do not substitute on a mg to mg basis; some concentrations methylparaben-free (MPF)
Local anesthesia
- [infiltration]
- Dose: up to 175 mg (0.25% conc.) via infiltration x1; Max: 400 mg/24h; Info: may repeat dose q3h prn; onset 2-10min, peak 30-45min, duration 3-6h
Regional anesthesia
- Peripheral nerve blockDose: 25-175 mg (0.5% conc.) perineurally x1; Max: 400 mg/24h; Alt: 12.5-175 mg (0.25% conc.) perineurally x1; Info: may repeat dose q3h prn; onset 2-10min, peak 30-45min, duration 3-6hRetrobulbar blockDose:15-30 mg (0.75% conc.) retrobulbar injection x1; Max: 400 mg/24h; Info: may repeat dose q3h prn; onset 2-10min, peak 30-45min, duration 3-6hSympathetic nerve blockDose: 50-125 mg (0.25% conc.) perineurally x1; Max: 400 mg/24h; Info: may repeat dose q3h prn; onset 2-10min, peak 30-45min, duration 3-6h
- Caudal blockDose: 75-150 mg (0.5% conc. MPF) intracaudally x1; Max: 400 mg/24h; Alt: 37.5-75 mg (0.25% conc. MPF) intracaudally x1; Info: may repeat dose q3h prn; onset 2-10min, peak 30-45min, duration 3-6h
- Lumbar blockDose: 50-100 mg (0.5% conc. MPF) epidurally x1; Max: 400 mg/24h; Alt: 25-50 mg (0.25% conc. MPF) epidurally x1; 75-150 mg (0.75% conc. MPF) epidurally x1; Info: may repeat dose q3h prn (0.25% or 0.5% conc. only); do not use 0.75% conc. for obstetrics; onset 2-10min, peak 30-45min, duration 3-6h
Spinal anesthesia
lower abdominal procedures
Dose: 12 mg (0.75% hyperbaric) intrathecally x1; Info: onset <1min, peak 15min, duration 3-6h
- lower extremity or perineural procedures
- Dose: 7.5 mg (0.75% hyperbaric) intrathecally x1; Info: onset <1min, peak 15min, duration 3-6h
- obstetrical procedures, vaginal delivery
- Dose: 6 mg (0.75% hyperbaric) intrathecally x1; Info: onset <1min, peak 15min, duration 3-6h
- Obstetrical procedures, cesarean section
- Dose: 7.5-10.5 mg (0.75% hyperbaric) intrathecally x1; Info: onset <1min, peak 15min, duration 3-6h
Renal dosing
- renal impairment: not defined, caution advised
- HD/PD: not defined
Hepatic dosing
- mild impairment: not defined, caution advised; moderate-severe impairment: consider decr. dose
SRC: NLM .