Nesacaine

Nesacaine

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Questions & Answers

Side Effects & Adverse Reactions

LOCAL ANESTHETICS SHOULD ONLY BE EMPLOYED BY CLINICIANS WHO ARE WELL VERSED IN DIAGNOSIS AND
MANAGEMENT OF DOSE RELATED TOXICITY AND OTHER ACUTE EMERGENCIES WHICH MIGHT ARISE FROM
THE BLOCK TO BE EMPLOYED, AND THEN ONLY AFTER ENSURING THE IMMEDIATE AVAILABILITY OF OXYGEN,
OTHER RESUSCITATIVE DRUGS, CARDIOPULMONARY RESUSCITATIVE EQUIPMENT, AND THE PERSONNEL
RESOURCES NEEDED FOR PROPER MANAGEMENT OF TOXIC REACTIONS AND RELATED EMERGENCIES (see also
ADVERSE REACTIONS and PRECAUTIONS). DELAY IN PROPER MANAGEMENT OF DOSE RELATED TOXICITY,
UNDERVENTILATION FROM ANY CAUSE AND/OR ALTERED SENSITIVITY MAY LEAD TO THE DEVELOPMENT
OF ACIDOSIS, CARDIAC ARREST AND, POSSIBLY, DEATH. NESACAINE (chloroprocaine HCl Injection, USP) contains
methylparaben and should not be used for lumbar or caudal epidural anesthesia because safety of this antimicrobial preservative has
not been established with regard to intrathecal injection, either intentional or unintentional. NESACAINE-MPF Injection contains no
preservative; discard unused injection remaining in vial after initial use.
Intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures is an unapproved use, and there have
been post-marketing reports of chondrolysis in patients receiving such infusions. The majority of reported cases of chondrolysis have
involved the shoulder joint; cases of gleno-humeral chondrolysis have been described in pediatric and adult patients following intraarticular
infusions of local anesthetics with and without epinephrine for periods of 48 to 72 hours. There is insufficient information to
determine whether shorter infusion periods are not associated with these findings. The time of onset of symptoms, such as joint pain,
stiffness and loss of motion can be variable, but may begin as early as the 2nd month after surgery. Currently, there is no effective
treatment for chondrolysis; patients who experienced chondrolysis have required additional diagnostic and therapeutic procedures and
some required arthroplasty or shoulder replacement.
Vasopressors should not be used in the presence of ergot-type oxytocic drugs, since a severe persistent hypertension may occur.
To avoid intravascular injection, aspiration should be performed before the anesthetic solution is injected. The needle must be
repositioned until no blood return can be elicited. However, the absence of blood in the syringe does not guarantee that intravascular
injection has been avoided.
Mixtures of local anesthetics are sometimes employed to compensate for the slower onset of one drug and the shorter duration of
action of the second drug. Experiments in primates suggest that toxicity is probably additive when mixtures of local anesthetics
are employed, but some experiments in rodents suggest synergism. Caution regarding toxic equivalence should be exercised when
mixtures of local anesthetics are employed.

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

Nesacaine 1% and 2% Injections, in multidose vials with methylparaben as preservative, are indicated for the production of local
anesthesia by infiltration and peripheral nerve block. They are not to be used for lumbar or caudal epidural anesthesia.
Nesacaine-MPF 2% and 3% Injections, in single dose vials without preservative and without EDTA, are indicated for the production
of local anesthesia by infiltration, peripheral and central nerve block, including lumbar and caudal epidural blocks.
Nesacaine and Nesacaine-MPF Injections are not to be used for subarachnoid administration.

History

There is currently no drug history available for this drug.

Other Information

NESACAINE - chloroprocaine hydrochloride injection, solution
NESACAINE MPF - chloroprocaine hydrochloride injection, solution
APP Pharmaceuticals, LLC
For Infiltration and Nerve Block
DESCRIPTION
Nesacaine and Nesacaine-MPF Injections are sterile non pyrogenic local anesthetics. The active ingredient in Nesacaine and
Nesacaine-MPF Injections is chloroprocaine HCl (benzoic acid, 4-amino-2-chloro-2-(diethylamino) ethyl ester, monohydrochloride),
which is represented by the following structural formula:

Formula1.jpg


Table 1: Composition of Available Injections

Product Indentification
Chloroprocaine HCl
Sodium Chloride
Disodium EDTA dihydrate
Methylparaben
Nesacaine 1%
10
6.7
0.111
1
Nesacaine 2%
20
4.7
0.111
1
Nesacaine-MPF 2%
20
4.7
-
-
Nesacaine-MPF 3%
30
3.3
-
-





The solutions are adjusted to pH 2.7–4.0 by means of sodium hydroxide and/or hydrochloric acid. Filled under nitrogen.
Nesacaine and Nesacaine-MPF Injections should not be resterilized by autoclaving.

Nesacaine Manufacturers


  • General Injectables & Vaccines, Inc
    Nesacaine (Chloroprocaine Hydrochloride) Injection, Solution [General Injectables & Vaccines, Inc]
  • General Injectables & Vaccines, Inc
    Nesacaine (Chloroprocaine Hydrochloride) Injection, Solution [General Injectables & Vaccines, Inc]
  • Fresenius Kabi Usa, Llc
    Nesacaine (Chloroprocaine Hydrochloride) Injection, Solution Nesacaine Mpf (Chloroprocaine Hydrochloride) Injection, Solution [Fresenius Kabi Usa, Llc]

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