- Accession Number
A local anesthetic that is chemically related to bupivacaine but pharmacologically related to lidocaine. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)
- Small Molecule
- Approved, Vet approved
- Average: 246.348
- Chemical Formula
For production of local or regional analgesia and anesthesia by local infiltration, peripheral nerve block techniques, and central neural techniques including epidural and caudal blocks.
- Associated Therapies
- Contraindications & Blackbox Warnings
Learn about our commercial Contraindications & Blackbox Warnings data.Learn More
Mepivicaine is an amide local anesthetic. Mepivicaine as a reasonably rapid onset and medium duration and is known by the proprietary names as Carbocaine and Polocaine. Mepivicaine is used in local infiltration and regional anesthesia. Systemic absorption of local anesthetics produces effects on the cardiovascular and central nervous systems. At blood concentrations achieved with normal therapeutic doses, changes in cardiac conduction, excitability, refractoriness, contractility, and peripheral vascular resistance are minimal.
- Mechanism of action
Local anesthetics block the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: pain, temperature, touch, proprioception, and skeletal muscle tone.
Target Actions Organism ASodium channel protein type 10 subunit alphainhibitor Humans
Absorbed locally. The rate of systemic absorption of local anesthetics is dependent upon the total dose and concentration of drug administered, the route of administration, the vascularity of the administration site, and the presence or absence of epinephrine in the anesthetic solution.
- Volume of distribution
- Not Available
- Protein binding
Mepivacaine is approximately 75% bound to plasma proteins. Generally, the lower the plasma concentration of drug, the higher the percentage of drug bound to plasma.
Rapidly metabolized, with only a small percentage of the anesthetic (5 percent to 10 percent) being excreted unchanged in the urine. The liver is the principal site of metabolism, with over 50% of the administered dose being excreted into the bile as metabolites.
- Route of elimination
It is rapidly metabolized, with only a small percentage of the anesthetic (5 percent to 10 percent) being excreted unchanged in the urine.The liver is the principal site of metabolism, with over 50% of the administered dose being excreted into the bile as metabolites.
The half-life of mepivacaine in adults is 1.9 to 3.2 hours and in neonates 8.7 to 9 hours.
- Not Available
- Adverse Effects
Learn about our commercial Adverse Effects data.Learn More
The mean seizure dosage of mepivacaine in rhesus monkeys was found to be 18.8 mg/kg with mean arterial plasma concentration of 24.4 µg/mL. The intravenous and subcutaneous LD 50 in mice is 23 mg/kg to 35 mg/kg and 280 mg/kg respectively.
- Affected organisms
- Humans and other mammals
Pathway Category Mepivacaine Action Pathway Drug action
- Pharmacogenomic Effects/ADRs
- Not Available
- Drug Interactions
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Abacavir Mepivacaine may decrease the excretion rate of Abacavir which could result in a higher serum level. Acarbose Acarbose may decrease the excretion rate of Mepivacaine which could result in a higher serum level. Acebutolol The serum concentration of Mepivacaine can be increased when it is combined with Acebutolol. Aceclofenac Aceclofenac may decrease the excretion rate of Mepivacaine which could result in a higher serum level. Acemetacin Acemetacin may decrease the excretion rate of Mepivacaine which could result in a higher serum level. Acetaminophen Acetaminophen may decrease the excretion rate of Mepivacaine which could result in a higher serum level. Acetazolamide Acetazolamide may increase the excretion rate of Mepivacaine which could result in a lower serum level and potentially a reduction in efficacy. Acetylsalicylic acid Acetylsalicylic acid may decrease the excretion rate of Mepivacaine which could result in a higher serum level. Aclidinium Mepivacaine may decrease the excretion rate of Aclidinium which could result in a higher serum level. Acrivastine Mepivacaine may decrease the excretion rate of Acrivastine which could result in a higher serum level.Additional Data Available
- Extended DescriptionExtended Description
Extended description of the mechanism of action and particular properties of each drug interaction.Learn more
A severity rating for each drug interaction, from minor to major.Learn more
- Evidence LevelEvidence Level
A rating for the strength of the evidence supporting each drug interaction.Learn more
An effect category for each drug interaction. Know how this interaction affects the subject drug.Learn more
- Food Interactions
- No interactions found.
- Product Ingredients
Ingredient UNII CAS InChI Key Mepivacaine hydrochloride 4VFX2L7EM5 1722-62-9 RETIMRUQNCDCQB-UHFFFAOYSA-N
- International/Other Brands
- Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image 3% Polocaine Dental Liquid Infiltration Dentsply Pharmaceutical 2009-10-19 Not applicable Carbocaine Injection, solution 10 mg/1mL Epidural; Infiltration Hospira, Inc. 2006-03-23 Not applicable Carbocaine Injection, solution 20 mg/1mL Infiltration Hospira, Inc. 2006-09-27 Not applicable Carbocaine Injection, solution 20 mg/1mL Epidural; Infiltration Hospira, Inc. 2007-01-31 Not applicable Carbocaine Injection, solution 15 mg/1mL Epidural; Infiltration Hospira, Inc. 2006-04-28 Not applicable Carbocaine Injection, solution 10 mg/1mL Infiltration Hospira, Inc. 2007-10-10 Not applicable Carbocaine 1% Solution Epidural; Intracaudal Pfizer Canada Ulc 2001-06-01 Not applicable Carbocaine 1% Solution Infiltration Pfizer Canada Ulc 2001-07-15 Not applicable Carbocaine 2% Solution Epidural; Intracaudal Pfizer Canada Ulc 2001-07-15 Not applicable Carbocaine 3% Solution Infiltration Carestream Health Inc. 2005-11-21 2018-09-06
- Generic Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Carbocaine Injection, solution 30 mg/1mL Subcutaneous Caresteam Health, Inc. 2011-01-01 Not applicable Carbocaine Injection, solution 30 mg/1mL Subcutaneous Septodont, Inc. 2018-06-21 Not applicable IQ Dental Mepivacaine Injection, solution 30 mg/1mL Subcutaneous Iq Dental 2012-08-15 Not applicable Isocaine Injection, solution 30 mg/1mL Subcutaneous Novocol Inc. 2010-08-20 Not applicable Mepivacaine Injection, solution 30 mg/1mL Subcutaneous Patterson Dental Supply, Inc. 2011-01-01 Not applicable Mepivacaine Injection, solution 30 mg/1mL Subcutaneous Benco Dental 2011-01-01 Not applicable Mepivacaine Injection, solution 30 mg/1mL Subcutaneous Novocol Inc. 2013-07-31 Not applicable Mepivacaine Injection, solution 30 mg/1mL Subcutaneous Darby Dental Supply, LLC 2011-01-14 Not applicable Mepivacaine Injection, solution 30 mg/1mL Subcutaneous NDC, Inc. 2015-04-10 Not applicable Mepivacaine Hydrochloride Injection, solution 30 mg/1mL Dental; Infiltration Hospira, Inc. 2008-05-05 2012-06-01
- Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image 2% Polocaine Dental With Levonordefrin 1:20,000 Mepivacaine hydrochloride (20 mg) + Levonordefrin (0.05 mg) Solution Infiltration Dentsply Pharmaceutical 1990-12-31 2011-08-04 Carbocaine 2% With Neo-cobefrin Mepivacaine hydrochloride (20 mg) + Levonordefrin (0.05 mg) Solution Infiltration Kodak Canada Inc. 2005-04-22 2008-07-14 Carbocaine 2% With Neo-cobefrin Mepivacaine hydrochloride (20 mg) + Levonordefrin (0.05 mg) Solution Infiltration Carestream Health Inc. 2006-09-01 2018-09-06 Carbocaine 2% With Neo-cobefrin Mepivacaine hydrochloride (20 mg) + Levonordefrin (0.05 mg) Solution Infiltration Novocol Inc. 2019-07-30 Not applicable Carbocaine with Neo-Cobefrin Mepivacaine hydrochloride (20 mg/1mL) + Levonordefrin (0.05 mg/1mL) Injection, solution Subcutaneous Caresteam Health, Inc. 2011-01-01 Not applicable Carbocaine with Neo-Cobefrin Mepivacaine hydrochloride (30 mg/1mL) + Levonordefrin (0.05 mg/1mL) Injection, solution Subcutaneous Septodont, Inc. 2018-11-19 Not applicable Isocaine HCl Inj 2% Mepivacaine hydrochloride (20 mg) + Levonordefrin (0.05 mg) Solution Infiltration Novocol Inc. 1977-12-31 Not applicable Isocaine with Levonordefrin Mepivacaine hydrochloride (20 mg/1mL) + Levonordefrin (0.05 mg/1mL) Injection, solution Subcutaneous Novocol Pharmaceutical of Canada Inc. 2006-04-14 Not applicable Mepivacaine Hydrochloride and Levonordefrin Mepivacaine hydrochloride (20 mg/1mL) + Levonordefrin (0.05 mg/1mL) Injection, solution Subcutaneous Darby Dental Supply Llc 2011-01-14 Not applicable Mepivacaine Hydrochloride with Levonordefrin Mepivacaine hydrochloride (20 mg/1mL) + Levonordefrin (0.05 mg/1mL) Injection, solution Subcutaneous Henry Schein Inc. 2011-01-01 2016-05-24
- ATC Codes
- N01BB53 — Mepivacaine, combinationsN01BB03 — Mepivacaine
- Drug Categories
- Chemical TaxonomyProvided by Classyfire
- This compound belongs to the class of organic compounds known as piperidinecarboxamides. These are compounds containing a piperidine ring substituted with a carboxamide functional group.
- Organic compounds
- Super Class
- Organoheterocyclic compounds
- Sub Class
- Piperidinecarboxylic acids and derivatives
- Direct Parent
- Alternative Parents
- m-Xylenes / Trialkylamines / Propargyl-type 1,3-dipolar organic compounds / Carboximidic acids / Azacyclic compounds / Organopnictogen compounds / Organooxygen compounds / Hydrocarbon derivatives
- 2-piperidinecarboxamide / Amine / Aromatic heteromonocyclic compound / Azacycle / Benzenoid / Carboximidic acid / Carboximidic acid derivative / Hydrocarbon derivative / M-xylene / Monocyclic benzene moiety
- Molecular Framework
- Aromatic heteromonocyclic compounds
- External Descriptors
- piperidinecarboxamide (CHEBI:6759)
- CAS number
- InChI Key
- IUPAC Name
- Synthesis Reference
- General References
- Not Available
- Human Metabolome Database
- KEGG Drug
- KEGG Compound
- PubChem Compound
- PubChem Substance
- Therapeutic Targets Database
- RxList Drug Page
- Drugs.com Drug Page
- AHFS Codes
- 72:00.00 — Local Anesthetics
- FDA label
- Download (180 KB)
- Download (73.2 KB)
- Clinical Trials
Phase Status Purpose Conditions Count 4 Completed Basic Science Cancer of Bladder 1 4 Completed Supportive Care Ankle Fusion / Intraoperative Hypertension / Total Ankle Arthroplasty / Tourniquet Hypertension 1 4 Completed Supportive Care Pain 1 4 Completed Treatment Ambulatory Surgical Procedures / Arthroplasty, Replacement, Knee / Early Ambulation / Pain Management / Spinal Anaesthesia 1 4 Completed Treatment Anaesthesia therapy / General Surgery / Pain / Varicosities of the great saphenous vein 1 4 Completed Treatment Arthroplasties, Hip Replacement 1 4 Completed Treatment Dysrhythmia, Cardiac 1 4 Completed Treatment Knee Arthritis 1 4 Completed Treatment Orthopedic Surgical Procedures / Postoperative pain 1 4 Completed Treatment Osteoarthritis, Hip 1
- Solvay pharmaceuticals
- Eastman kodak co
- Hospira inc
- Novocol pharmaceutical inc
- Graham chemical co
- International medication system
- Watson laboratories inc
- App pharmaceuticals llc
- Dentsply pharmaceutical
- Deproco inc
- American Dental Cooperative Inc.
- APP Pharmaceuticals
- Ato Zizine Sarl
- Benco Dental Co.
- Cardent International Inc.
- Carestream Health Inc.
- Carlisle Laboratories Inc.
- Darby Dental Supply Co. Inc.
- DENTSPLY International
- Eastman Kodak Co. Dental Products
- H Meer Dental Supply Co.
- Henry Schein Inc.
- Hospira Inc.
- Kent Dental
- Les Laboratoires Medis S A
- Novocol Pharmaceutical Canada
- Patterson Dental Supply Inc.
- Safco Dental Supply Co.
- Septodont Inc.
- Spectrum Pharmaceuticals
- Veratex Corp.
- Dosage Forms
Form Route Strength Solution Epidural; Intracaudal Liquid Epidural; Intracaudal Liquid Intraspinal Solution Subcutaneous Injection, solution Dental; Infiltration 30 mg/1mL Solution Infiltration Injection Dental 30 mg/1mL Injection Infiltration 10 mg/1mL Injection Infiltration 15 mg/1mL Injection Infiltration 20 mg/1mL Injection Subcutaneous Injection, solution Infiltration 10 mg/1mL Injection, solution Infiltration 20 mg/1mL Injection Dental Injection, solution Epidural; Infiltration 10 mg/1mL Injection, solution Epidural; Infiltration 15 mg/1mL Injection, solution Epidural; Infiltration 20 mg/1mL Liquid Infiltration Solution Infiltration Liquid Infiltration Injection, solution Subcutaneous Injection, solution Subcutaneous 30 mg/1mL
Unit description Cost Unit Mepivacaine hcl powder 318.33USD g Mepivacaine hcl 3% cartridge 0.46USD ml Carbocaine 1% vial 0.26USD ml Polocaine 1% vial 0.25USD ml Polocaine 2% vial 0.24USD ml Carbocaine 2% vial 0.19USD mlDrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
- Not Available
- Experimental Properties
Property Value Source melting point (°C) 150.5 °C PhysProp water solubility 7000 mg/L (at 23 °C) YALKOWSKY,SH & DANNENFELSER,RM (1992) logP 1.95 HANSCH,C ET AL. (1995) logS -1.55 ADME Research, USCD pKa 7.7 SANGSTER (1994)
- Predicted Properties
Property Value Source Water Solubility 0.621 mg/mL ALOGPS logP 2.16 ALOGPS logP 3.19 ChemAxon logS -2.6 ALOGPS pKa (Strongest Acidic) 13.62 ChemAxon pKa (Strongest Basic) 7.25 ChemAxon Physiological Charge 1 ChemAxon Hydrogen Acceptor Count 2 ChemAxon Hydrogen Donor Count 1 ChemAxon Polar Surface Area 32.34 Å2 ChemAxon Rotatable Bond Count 2 ChemAxon Refractivity 76.32 m3·mol-1 ChemAxon Polarizability 28.61 Å3 ChemAxon Number of Rings 2 ChemAxon Bioavailability 1 ChemAxon Rule of Five Yes ChemAxon Ghose Filter Yes ChemAxon Veber's Rule Yes ChemAxon MDDR-like Rule No ChemAxon
- Predicted ADMET Features
Property Value Probability Human Intestinal Absorption + 0.9568 Blood Brain Barrier + 0.9749 Caco-2 permeable + 0.6836 P-glycoprotein substrate Substrate 0.7866 P-glycoprotein inhibitor I Inhibitor 0.6872 P-glycoprotein inhibitor II Non-inhibitor 0.8665 Renal organic cation transporter Non-inhibitor 0.5878 CYP450 2C9 substrate Non-substrate 0.7853 CYP450 2D6 substrate Substrate 0.7423 CYP450 3A4 substrate Substrate 0.7726 CYP450 1A2 substrate Non-inhibitor 0.7996 CYP450 2C9 inhibitor Non-inhibitor 0.933 CYP450 2D6 inhibitor Inhibitor 0.6146 CYP450 2C19 inhibitor Non-inhibitor 0.9387 CYP450 3A4 inhibitor Non-inhibitor 0.5395 CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.7497 Ames test Non AMES toxic 0.8252 Carcinogenicity Non-carcinogens 0.9333 Biodegradation Not ready biodegradable 0.939 Rat acute toxicity 1.7237 LD50, mol/kg Not applicable hERG inhibition (predictor I) Weak inhibitor 0.908 hERG inhibition (predictor II) Inhibitor 0.6936
- Mass Spec (NIST)
- Download (7.1 KB)
- Pharmacological action
- General Function
- Voltage-gated sodium channel activity
- Specific Function
- Tetrodotoxin-resistant channel that mediates the voltage-dependent sodium ion permeability of excitable membranes. Assuming opened or closed conformations in response to the voltage difference acro...
- Gene Name
- Uniprot ID
- Uniprot Name
- Sodium channel protein type 10 subunit alpha
- Molecular Weight
- 220623.605 Da
- Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
- Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
- Leffler A, Reckzeh J, Nau C: Block of sensory neuronal Na+ channels by the secreolytic ambroxol is associated with an interaction with local anesthetic binding sites. Eur J Pharmacol. 2010 Mar 25;630(1-3):19-28. doi: 10.1016/j.ejphar.2009.12.027. Epub 2010 Jan 4. [PubMed:20044988]
Drug created on June 13, 2005 07:24 / Updated on August 10, 2020 08:11