Levobupivacaine
- Atc Codes:N01BB10
- CAS Codes:27262-48-2
- PHARMGKB ID:27262-48-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Chirocaine; Belgium: Chirocaine; Bulgaria: Chirocaine; Czech Republic: Chirocaine; Finland: Chirocaine; France: Chirocaine; Germany: Chirocaine; Greece: Chirocaine; Ireland: Chirocaine; Italy: Chirocaine; Latvia: Chirocaine; Netherlands: Chirocaine; Poland: Chirocaine; Portugal: Chirocaine; Romania: Chirocaine; Slovakia: Chirocaine; Slovenia: Chirocaine; Spain: Chirocane; Sweden: Chirocaine; UK: Chirocaine.
Latin America
Brazil: Novabupi.
Asia
Japan: Popscaine.
Drug combinations
Chemistry
Levobupivacaine Hydrochloride: C~18~H~28~N~2~O HCl. Mw: 324.89. (1)(S)-1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide monohydrochloride; (2)(S)-1-Butyl-2′,6′-pipecoloxylidide monohydrochloride. CAS-27262-48-2 (1998).
Pharmacologic Category
Local Anesthetics. (ATC-Code: N01BB10).
Mechanism of action
Levobupivacaine is S-enantiomer of bupivacaine. Blocks both initiation and transmission of nerve impulses by decreasing permeability of neuronal membrane to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction.
Therapeutic use
Production of local or regional anesthesia for surgery and obstetrics, and for postoperative pain management.
Pregnancy and lactiation implications
Crosses placenta rapidly and may cause maternal, fetal, and neonatal toxicity. Use caution during lactation.
Unlabeled use
Contraindications
Hypersensitivity to levobupivacaine, any component of the formulation, bupivacaine, or any local anesthetic of amide type.
Warnings and precautions
CNS toxicity (restlessness, anxiety, tinnitus, dizziness, blurred vision, tremors, depression, or drowsiness) might occur. Sudden respiratory arrest, especially when administered near head or neck possible. Convulsions due to systemic toxicity leading to cardiac arrest reported (following unintentional intravascular injection or administration near head or neck). Use with caution in hypotension, hypovolemia, heart block, or cardiac impairment, also in hepatic impairment, and in patients receiving other local anesthetics or structurally related agents. Higher concentration formulations are more likely to produce cardiac toxicity (use with caution). 0.75% concentration not recommended for obstetrical anesthesia. Intravascular injections should be avoided. Not for use in intravenous regional anesthesia (Bier block) or to produce obstetrical paracervical block anesthesia.