Marcovar® 0.25% (Bupivacaine hydrochloride)

Marcovar is a local anesthetic commonly used to block sensation in a specific area of the body during surgical procedures, or labor.

Sterile isotonic solution
Avoid intravenous administration.
For hospital use only.

Adults:
Local Anesthesia (Infiltration):
0.25% infiltrated locally; maximum: 175 mg.
Note: Aspiration should be performed prior to each injection.
Caudal Block (Preservative Free):
15 to 30 mL of 0.25% or 0.5%
Epidural Block (Other than Caudal Block; Preservative Free):
Administer in 3 to 5 mL increments, allowing sufficient time to detect toxic manifestations of inadvertent IV or intrathecal administration: 10 to 20 mL of 0.25% or 0.5%
Surgical Procedures Requiring a High Degree of Muscle Relaxation and Prolonged Effects Only:
Note: Not to be used in obstetrical cases: 10 to 20 mL of 0.75%
Peripheral Nerve Block:
5 mL of 0.25% or 0.5%; maximum: 400 mg/day
Sympathetic Nerve Block:
20 to 50 mL of 0.25%
Retrobulbar Anesthesia:
2 to 4 mL of 0.75%
Spinal Anesthesia (Preservative Free Solution of 0.75% Bupivacaine in 8.25% Dextrose):
Lower extremity and perineal procedures: 1 mL
Lower abdominal procedures: 1.6 mL
Labor and normal vaginal delivery: 0.8 mL
Cesarean delivery: 1 to 1.4 mL

Visible bruising (91.1%)

Postprocedural contusion (14-71.2%)

Nausea (20-55.8%)

Surgical site bleeding (8.7-48.9%)

Dizziness (15-40.3%)

Somnolence (8.3-40%)

Constipation (30.4%)

Vomiting (4.4-29%)

Bradycardia (22.9%)

Headache (11.1-27.2%)

Pruritus generalized (2.2-21.6%)

Paresthesia (7.5-18.4%)

Dysgeusia (13-17.6%)

Hypoesthesia (17.3%)

Anemia (4.5-16.7%)

Tinnitus (13.2%)

C-reactive protein increased (11.7%)

Pyrexia (6-11.7%)

Procedural pain (<11.4%)

Dysuria (10.1%)

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination.
Fexinidazole: Bradycardia-Causing Agents may enhance the arrhythmogenic effect of Fexinidazole. Risk X: Avoid combination.
Ponesimod: Either increases the effects of the other by pharmacodynamic synergism. Avoid or use alternate drugs. Consult a cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.

Store below 30°C and protect from light and freezing.
Keep out of the reach and sight of children.