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Bupivacaine/epinephrine (Injection)

Bupivacaine (bue-PIV-a-kane), Epinephrine (ep-i-NEF-rin)

This medicine is a local anesthetic that causes numbness (loss of feeling) in the mouth. Given before and during dental work to help prevent pain.

Brand Name(s):

Marcaine Epi, Marcaine HCl/Epinephrine, Marcaine w/ Epinephrine, Marcaine with Epinephrine, Sensorcaine With Epinephrine, Sensorcaine-MPF With Epinephrine

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not receive this medicine if you have had an allergic reaction to bupivacaine, epinephrine, sulfites, or certain other types of local anesthetic (numbing medicine).

How to Use This Medicine:


  • A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Tell your doctor if you are using a MAO inhibitor (MAOI) medicine such as Eldepryl®, Marplan®, Nardil®, or Parnate®.
  • Tell your doctor if you are using medicine to treat nausea and vomiting, pain, nervousness, or anxiety. Let your doctor know if you are using medicine such as haloperidol (Haldol®) to treat psychiatric (mental) problems. Make sure your doctor knows if you are also using ergot medicine or other medicines for headaches or migraines, such as Cafergot® or Ergomar®. Tell your doctor if you are using medicine to treat depression such as amitriptyline (Elavil®), nortriptyline (Pamelor®), or imipramine (Tofranil®). Make sure your doctor knows about any other medicine you have used recently.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breast feeding, or if you have diabetes, asthma, or thyroid problems. Tell your doctor if you have a history of stroke.
  • Make sure your doctor knows if you have heart disease, high blood pressure, low blood pressure, atherosclerosis (hardening of the arteries), or other circulation problems. Tell your doctor if you have liver disease, or any other health problems or drug allergies you may have.
  • Numbness may last for several hours after using this medicine. There is an increased risk of injury to your tongue, lips, and the inside of your cheeks until this medicine wears off. To avoid injury, do not chew solid foods until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking at your tissues.
  • If your child is to receive this medicine, make sure your doctor knows if your child is under the age of 12 years old.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Dizziness, drowsiness, confusion (trouble thinking), seizures (convulsions), or fainting.
  • Nausea or vomiting.
  • Restlessness, anxiety.
  • Ringing in the ears.
  • Skin rash.
  • Sudden or severe headache, or problems with vision, speech, or walking.
  • Tremors, shaking, or chills.
  • Uneven, pounding, fast, or slow heartbeats.

If you notice these less serious side effects, talk with your doctor:

  • Swelling near the injection site.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/4/2014

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