Identification

Name
Levobupivacaine
Accession Number
DB01002  (APRD00110)
Type
Small Molecule
Groups
Approved, Investigational
Description

Levobupivacaine is an amino-amide local anaesthetic drug belonging to the family of n-alkylsubstituted pipecoloxylidide. It is the S-enantiomer of bupivacaine. Levobupivacaine hydrochloride is commonly marketed by AstraZeneca under the trade name Chirocaine. Compared to bupivacaine, levobupivacaine is associated with less vasodilation and has a longer duration of action. It is approximately 13 per cent less potent (by molarity) than racemic bupivacaine.Levobupivacaine is indicated for local anaesthesia including infiltration, nerve block, ophthalmic, epidural and intrathecal anaesthesia in adults; and infiltration analgesia in children. Adverse drug reactions (ADRs) are rare when it is administered correctly. Most ADRs relate to administration technique (resulting in systemic exposure) or pharmacological effects of anesthesia, however allergic reactions can rarely occur. [Wikipedia]

Structure
Thumb
Synonyms
  • (-)-Bupivacaine
  • (S)-1-Butyl-2',6'-pipecoloxylidide
  • (S)-Bupivacaine
  • L-(-)-1-Butyl-2',6'-pipecoloxylidide
  • L-(-)-Bupivacaine
  • Levobupivacaine
Product Ingredients
IngredientUNIICASInChI Key
Levobupivacaine hydrochlorideJ998RDZ51I27262-48-2SIEYLFHKZGLBNX-NTISSMGPSA-N
International/Other Brands
Chirocaine (Abbott Laboratories)
Categories
UNII
A5H73K9U3W
CAS number
27262-47-1
Weight
Average: 288.4277
Monoisotopic: 288.220163528
Chemical Formula
C18H28N2O
InChI Key
LEBVLXFERQHONN-INIZCTEOSA-N
InChI
InChI=1S/C18H28N2O/c1-4-5-12-20-13-7-6-11-16(20)18(21)19-17-14(2)9-8-10-15(17)3/h8-10,16H,4-7,11-13H2,1-3H3,(H,19,21)/t16-/m0/s1
IUPAC Name
(2S)-1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide
SMILES
CCCCN1CCCC[[email protected]]1C(=O)NC1=C(C)C=CC=C1C

Pharmacology

Indication

For the production of local or regional anesthesia for surgery and obstetrics, and for post-operative pain management

Structured Indications
Not Available
Pharmacodynamics

Levobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures.

Mechanism of action

Local anesthetics such as Levobupivacaine 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. Specifically, the drug binds to the intracellular portion of sodium channels and blocks sodium influx into nerve cells, which prevents depolarization.

TargetActionsOrganism
ASodium channel protein type 10 subunit alpha
inhibitor
Human
Absorption

The plasma concentration of levobupivacaine following therapeutic administration depends on dose and also on route of administration, because absorption from the site of administration is affected by the vascularity of the tissue. Peak levels in blood were reached approximately 30 minutes after epidural administration, and doses up to 150 mg resulted in mean Cmax levels of up to 1.2 µg/mL.

Volume of distribution

66.91 ±18.23 L [after intravenous administration of 40 mg in healthy volunteers]

Protein binding

>97%

Metabolism

Levobupivacaine is extensively metabolized with no unchanged levobupivacaine detected in urine or feces. In vitro studies using [14 C] levobupivacaine showed that CYP3A4 isoform and CYP1A2 isoform mediate the metabolism of levobupivacaine to desbutyl levobupivacaine and 3-hydroxy levobupivacaine, respectively. In vivo, the 3-hydroxy levobupivacaine appears to undergo further transformation to glucuronide and sulfate conjugates. Metabolic inversion of levobupivacaine to R(+)-bupivacaine was not evident both in vitro and in vivo.

Route of elimination

Following intravenous administration, recovery of the radiolabelled dose of levobupivacaine was essentially quantitative with a mean total of about 95% being recovered in urine and feces in 48 hours. Of this 95%, about 71% was in urine while 24% was in feces.

Half life

3.3 hours

Clearance

39.06 ±13.29 L/h [after intravenous administration of 40 mg in healthy volunteers]

Toxicity

LD50: 5.1mg/kg in rabbit, intravenous; 18mg/kg in rabbit, oral; 207mg/kg in rabbit, parenteral; 63mg/kg in rat, subcutaneous (Archives Internationales de Pharmacodynamie et de Therapie. Vol. 200, Pg. 359, 1972.) Levobupivacaine appears to cause less myocardial depression than both bupivacaine and ropivacaine, despite being in higher concentrations.

Affected organisms
  • Humans and other mammals
Pathways
PathwayCategory
Levobupivacaine Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
7-NitroindazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with 7-Nitroindazole.Experimental
AbirateroneThe serum concentration of Levobupivacaine can be increased when it is combined with Abiraterone.Approved
AcebutololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Acebutolol.Approved
AcepromazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Acepromazine.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Aceprometazine.Approved
AdipiplonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Adipiplon.Investigational
AgomelatineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Agomelatine.Approved, Investigational
AlaproclateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alaproclate.Experimental
AldesleukinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Aldesleukin.Approved
AlfaxaloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alfaxalone.Vet Approved
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levobupivacaine.Approved, Illicit
AliskirenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Aliskiren.Approved, Investigational
AllopregnanoloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Allopregnanolone.Investigational
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alphacetylmethadol.Experimental, Illicit
AlphaprodineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alphaprodine.Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Levobupivacaine.Approved, Illicit, Investigational
AmifostineThe risk or severity of adverse effects can be increased when Amifostine is combined with Levobupivacaine.Approved, Investigational
AmilorideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amiloride.Approved
AmiodaroneThe serum concentration of Levobupivacaine can be increased when it is combined with Amiodarone.Approved, Investigational
AmisulprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amisulpride.Approved, Investigational
AmitriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amitriptyline.Approved
AmlodipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amlodipine.Approved
AmobarbitalThe risk or severity of adverse effects can be increased when Amobarbital is combined with Levobupivacaine.Approved, Illicit
AmoxapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amoxapine.Approved
AmperozideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amperozide.Experimental
Amphotericin BThe risk or severity of adverse effects can be increased when Amphotericin B is combined with Levobupivacaine.Approved, Investigational
Amyl NitriteThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Amyl Nitrite.Approved
ApomorphineThe risk or severity of adverse effects can be increased when Apomorphine is combined with Levobupivacaine.Approved, Investigational
ApraclonidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Apraclonidine.Approved
AprepitantThe serum concentration of Levobupivacaine can be increased when it is combined with Aprepitant.Approved, Investigational
AripiprazoleAripiprazole may increase the hypotensive activities of Levobupivacaine.Approved, Investigational
ArotinololThe risk or severity of adverse effects can be increased when Arotinolol is combined with Levobupivacaine.Approved, Investigational
Arsenic trioxideThe risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Levobupivacaine.Approved, Investigational
ArticaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Articaine.Approved
AsenapineThe risk or severity of adverse effects can be increased when Asenapine is combined with Levobupivacaine.Approved
AtazanavirThe serum concentration of Levobupivacaine can be increased when it is combined with Atazanavir.Approved, Investigational
AtenololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Atenolol.Approved
AtomoxetineThe metabolism of Levobupivacaine can be decreased when combined with Atomoxetine.Approved
AzaperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Azaperone.Investigational, Vet Approved
AzelastineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Azelastine.Approved
Azilsartan medoxomilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Azilsartan medoxomil.Approved
AzithromycinThe metabolism of Levobupivacaine can be decreased when combined with Azithromycin.Approved
BaclofenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Baclofen.Approved
BarbexacloneBarbexaclone may increase the hypotensive activities of Levobupivacaine.Experimental
BarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Barbital.Illicit
BarnidipineThe risk or severity of adverse effects can be increased when Barnidipine is combined with Levobupivacaine.Approved
BenazeprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benazepril.Approved, Investigational
BendroflumethiazideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bendroflumethiazide.Approved
BenperidolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benperidol.Investigational
BenzocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benzocaine.Approved
Benzyl alcoholThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Benzyl alcohol.Approved
BepridilThe risk or severity of adverse effects can be increased when Bepridil is combined with Levobupivacaine.Approved, Withdrawn
BetaxololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Betaxolol.Approved
BisoprololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bisoprolol.Approved
BoceprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Boceprevir.Approved, Withdrawn
BortezomibThe metabolism of Levobupivacaine can be decreased when combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Levobupivacaine can be decreased when it is combined with Bosentan.Approved, Investigational
BretyliumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bretylium.Approved
BrexpiprazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brexpiprazole.Approved
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved
BromazepamThe risk or severity of adverse effects can be increased when Bromazepam is combined with Levobupivacaine.Approved, Illicit
BromisovalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bromisoval.Experimental
BromocriptineThe risk or severity of adverse effects can be increased when Bromocriptine is combined with Levobupivacaine.Approved, Investigational
BromperidolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bromperidol.Investigational
BrompheniramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brompheniramine.Approved
BrotizolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Brotizolam.Approved, Investigational, Withdrawn
BumetanideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Bumetanide.Approved
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Levobupivacaine.Approved, Investigational
BuprenorphineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.Approved, Illicit, Investigational, Vet Approved
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Levobupivacaine.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Levobupivacaine.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butacaine.Vet Approved
ButalbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butalbital.Approved, Illicit
ButambenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butamben.Approved
ButethalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Butethal.Approved, Illicit
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Levobupivacaine.Approved, Illicit, Vet Approved
CaffeineThe metabolism of Levobupivacaine can be decreased when combined with Caffeine.Approved
CanagliflozinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Canagliflozin.Approved
Candesartan cilexetilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Candesartan.Approved
CanertinibThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Canertinib.Investigational
CaptoprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Captopril.Approved
CarbamazepineThe metabolism of Levobupivacaine can be increased when combined with Carbamazepine.Approved, Investigational
CarbetocinThe risk or severity of adverse effects can be increased when Carbetocin is combined with Levobupivacaine.Approved
CarbinoxamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carbinoxamine.Approved
CarfentanilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carfentanil.Illicit, Investigational, Vet Approved
CarisoprodolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carisoprodol.Approved
CarteololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carteolol.Approved
CarvedilolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Carvedilol.Approved, Investigational
CeritinibThe serum concentration of Levobupivacaine can be increased when it is combined with Ceritinib.Approved
CetirizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cetirizine.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chloral hydrate.Approved, Illicit, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Levobupivacaine.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlormezanone.Approved, Investigational, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chloroprocaine.Approved
ChlorothiazideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorothiazide.Approved, Vet Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorphenamine.Approved
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Levobupivacaine.Approved, Vet Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorprothixene.Approved, Investigational, Withdrawn
ChlorthalidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorthalidone.Approved
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Chlorzoxazone.Approved
CilazaprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cilazapril.Approved
CilnidipineThe risk or severity of adverse effects can be increased when Cilnidipine is combined with Levobupivacaine.Approved, Investigational
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Levobupivacaine.Approved, Vet Approved
CitalopramThe metabolism of Levobupivacaine can be decreased when combined with Citalopram.Approved
ClarithromycinThe serum concentration of Levobupivacaine can be increased when it is combined with Clarithromycin.Approved
ClemastineThe metabolism of Levobupivacaine can be decreased when combined with Clemastine.Approved
ClevidipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clevidipine.Approved
ClidiniumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clidinium.Approved
ClobazamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clobazam.Approved, Illicit
ClofarabineThe risk or severity of adverse effects can be increased when Clofarabine is combined with Levobupivacaine.Approved, Investigational
clomethiazoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with clomethiazole.Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clomipramine.Approved, Vet Approved
ClonazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clonazepam.Approved, Illicit
ClonidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clonidine.Approved
ClopenthixolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clopenthixol.Experimental
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Levobupivacaine.Approved, Illicit
ClothiapineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Clothiapine.Experimental
ClotrimazoleThe metabolism of Levobupivacaine can be decreased when combined with Clotrimazole.Approved, Vet Approved
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Levobupivacaine.Approved
CobicistatThe serum concentration of Levobupivacaine can be increased when it is combined with Cobicistat.Approved
CocaineThe risk or severity of adverse effects can be increased when Cocaine is combined with Levobupivacaine.Approved, Illicit
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Levobupivacaine.Approved, Illicit
ConivaptanThe serum concentration of Levobupivacaine can be increased when it is combined with Conivaptan.Approved, Investigational
CrizotinibThe metabolism of Levobupivacaine can be decreased when combined with Crizotinib.Approved
CyclizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cyclizine.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Levobupivacaine.Approved
CyclosporineThe metabolism of Levobupivacaine can be decreased when combined with Cyclosporine.Approved, Investigational, Vet Approved
CyproheptadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Cyproheptadine.Approved
Cyproterone acetateThe serum concentration of Levobupivacaine can be decreased when it is combined with Cyproterone acetate.Approved, Investigational
DabrafenibThe serum concentration of Levobupivacaine can be decreased when it is combined with Dabrafenib.Approved
DantroleneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dantrolene.Approved
DapagliflozinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dapagliflozin.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Levobupivacaine.Approved
DapoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dapoxetine.Investigational
DarunavirThe serum concentration of Levobupivacaine can be increased when it is combined with Darunavir.Approved
DasatinibThe serum concentration of Levobupivacaine can be increased when it is combined with Dasatinib.Approved, Investigational
DeferasiroxThe serum concentration of Levobupivacaine can be decreased when it is combined with Deferasirox.Approved, Investigational
DelavirdineThe metabolism of Levobupivacaine can be decreased when combined with Delavirdine.Approved
DeramciclaneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Deramciclane.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Levobupivacaine.Approved
DesipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desipramine.Approved
DesloratadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desloratadine.Approved, Investigational
DesvenlafaxineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desvenlafaxine.Approved
DetomidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Detomidine.Vet Approved
DexbrompheniramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dexbrompheniramine.Approved
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Levobupivacaine.Approved, Vet Approved
DextromoramideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dextromoramide.Experimental, Illicit
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Levobupivacaine.Approved, Illicit, Investigational, Withdrawn
DezocineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dezocine.Approved, Investigational
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Levobupivacaine.Approved, Illicit, Vet Approved
DiclofenamideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Diclofenamide.Approved
Diethyl etherThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Diethyl ether.Experimental
DifenoxinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Difenoxin.Approved, Illicit
DihydrocodeineThe risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Levobupivacaine.Approved, Illicit
DihydroergotamineThe metabolism of Levobupivacaine can be decreased when combined with Dihydroergotamine.Approved
DihydroetorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dihydroetorphine.Experimental, Illicit
DihydromorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dihydromorphine.Experimental, Illicit
DiltiazemThe metabolism of Levobupivacaine can be decreased when combined with Diltiazem.Approved
DimenhydrinateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dimenhydrinate.Approved
DinutuximabThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dinutuximab.Approved
DiphenhydramineThe risk or severity of adverse effects can be increased when Diphenhydramine is combined with Levobupivacaine.Approved
DiphenoxylateThe risk or severity of adverse effects can be increased when Diphenoxylate is combined with Levobupivacaine.Approved, Illicit
DipyridamoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dipyridamole.Approved
DixyrazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dixyrazine.Experimental
DoramectinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doramectin.Vet Approved
DosulepinThe metabolism of Levobupivacaine can be decreased when combined with Dosulepin.Approved
DoxazosinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doxazosin.Approved
DoxepinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Doxepin.Approved
DoxycyclineThe metabolism of Levobupivacaine can be decreased when combined with Doxycycline.Approved, Investigational, Vet Approved
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Vet Approved
DPDPEThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with DPDPE.Investigational
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Illicit
DronedaroneThe metabolism of Levobupivacaine can be decreased when combined with Dronedarone.Approved
DroperidolDroperidol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Vet Approved
DrotebanolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Drotebanol.Experimental, Illicit
DuloxetineLevobupivacaine may increase the orthostatic hypotensive activities of Duloxetine.Approved
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Levobupivacaine.Approved
EcgonineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ecgonine.Experimental, Illicit
EcopipamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ecopipam.Investigational
EfavirenzThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Efavirenz.Approved, Investigational
EfonidipineThe risk or severity of adverse effects can be increased when Efonidipine is combined with Levobupivacaine.Approved
EltanoloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Eltanolone.Investigational
EmpagliflozinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Empagliflozin.Approved
EnalaprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Enalapril.Approved, Vet Approved
EnalaprilatThe risk or severity of adverse effects can be increased when Enalaprilat is combined with Levobupivacaine.Approved
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Levobupivacaine.Approved, Investigational, Vet Approved
EntacaponeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Entacapone.Approved, Investigational
EnzalutamideThe serum concentration of Levobupivacaine can be decreased when it is combined with Enzalutamide.Approved
EplerenoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Eplerenone.Approved
EpoprostenolThe risk or severity of adverse effects can be increased when Epoprostenol is combined with Levobupivacaine.Approved
EprosartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Eprosartan.Approved
ErythromycinThe metabolism of Levobupivacaine can be decreased when combined with Erythromycin.Approved, Vet Approved
EscitalopramThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Escitalopram.Approved, Investigational
EsmololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Esmolol.Approved
EstazolamThe risk or severity of adverse effects can be increased when Estazolam is combined with Levobupivacaine.Approved, Illicit
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Levobupivacaine.Approved
Etacrynic acidThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etacrynic acid.Approved
EthanolLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Ethanol.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Levobupivacaine.Approved, Illicit, Withdrawn
EthosuximideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethosuximide.Approved
EthotoinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethotoin.Approved
Ethyl carbamateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethyl carbamate.Withdrawn
Ethyl chlorideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethyl chloride.Experimental, Investigational
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethyl loflazepate.Approved, Illicit
EthylmorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ethylmorphine.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etidocaine.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etifoxine.Investigational, Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etizolam.Approved
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Levobupivacaine.Approved
EtoperidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etoperidone.Withdrawn
EtorphineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Etorphine.Illicit, Vet Approved
EzogabineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ezogabine.Approved
FelbamateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Felbamate.Approved
FelodipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Felodipine.Approved, Investigational
FencamfamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fencamfamine.Approved, Illicit, Withdrawn
FenoldopamThe risk or severity of adverse effects can be increased when Fenoldopam is combined with Levobupivacaine.Approved
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Levobupivacaine.Approved, Illicit, Investigational, Vet Approved
FexofenadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fexofenadine.Approved
FimasartanThe risk or severity of adverse effects can be increased when Fimasartan is combined with Levobupivacaine.Approved, Investigational
FlibanserinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flibanserin.Approved
FluanisoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluanisone.Experimental
FluconazoleThe metabolism of Levobupivacaine can be decreased when combined with Fluconazole.Approved
FludiazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fludiazepam.Approved, Illicit
FlunarizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flunarizine.Approved
FlunitrazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Flunitrazepam.Approved, Illicit
FluoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluoxetine.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Flupentixol is combined with Levobupivacaine.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Levobupivacaine.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Levobupivacaine.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluspirilene.Approved, Investigational
Fluticasone propionateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fluticasone propionate.Approved
FluvoxamineThe metabolism of Levobupivacaine can be decreased when combined with Fluvoxamine.Approved, Investigational
FosamprenavirThe metabolism of Levobupivacaine can be decreased when combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Levobupivacaine can be increased when it is combined with Fosaprepitant.Approved
FosinoprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fosinopril.Approved
FosphenytoinThe metabolism of Levobupivacaine can be increased when combined with Fosphenytoin.Approved
FospropofolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Fospropofol.Approved, Illicit, Investigational
FurosemideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Furosemide.Approved, Vet Approved
Fusidic AcidThe serum concentration of Levobupivacaine can be increased when it is combined with Fusidic Acid.Approved
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Levobupivacaine.Approved, Investigational
Gabapentin EnacarbilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Gabapentin Enacarbil.Approved
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levobupivacaine.Approved, Illicit, Investigational
GepironeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Gepirone.Investigational
GlutethimideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Glutethimide.Approved, Illicit
GuanfacineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Guanfacine.Approved, Investigational
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Levobupivacaine.Approved, Illicit, Withdrawn
HaloperidolThe risk or severity of adverse effects can be increased when Haloperidol is combined with Levobupivacaine.Approved
HalothaneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Halothane.Approved, Vet Approved
HeroinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Heroin.Approved, Illicit, Investigational
HexobarbitalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Hexobarbital.Approved
HyaluronidaseThe risk or severity of adverse effects can be increased when Hyaluronidase is combined with Levobupivacaine.Approved, Investigational
HydralazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Hydralazine.Approved
HydrochlorothiazideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.Approved, Illicit
HydroflumethiazideThe risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Levobupivacaine.Approved, Investigational
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Levobupivacaine.Approved, Illicit
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved
IloperidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Iloperidone.Approved
IloprostThe risk or severity of adverse effects can be increased when Iloprost is combined with Levobupivacaine.Approved, Investigational
ImatinibThe metabolism of Levobupivacaine can be decreased when combined with Imatinib.Approved
ImidaprilThe risk or severity of adverse effects can be increased when Imidapril is combined with Levobupivacaine.Investigational
ImipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Imipramine.Approved
IndalpineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Indalpine.Investigational, Withdrawn
IndapamideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Indapamide.Approved
IndinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Indinavir.Approved
IndiplonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Indiplon.Investigational
IndoraminThe risk or severity of adverse effects can be increased when Indoramin is combined with Levobupivacaine.Withdrawn
IrbesartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Irbesartan.Approved, Investigational
IsavuconazoniumThe metabolism of Levobupivacaine can be decreased when combined with Isavuconazonium.Approved, Investigational
IsocarboxazidThe risk or severity of adverse effects can be increased when Isocarboxazid is combined with Levobupivacaine.Approved
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Levobupivacaine.Approved, Vet Approved
Isosorbide DinitrateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Isosorbide Dinitrate.Approved
Isosorbide MononitrateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Isosorbide Mononitrate.Approved
IsoxsuprineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Isoxsuprine.Approved, Withdrawn
IsradipineThe metabolism of Levobupivacaine can be decreased when combined with Isradipine.Approved
ItraconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Levobupivacaine can be increased when it is combined with Ivacaftor.Approved
KetamineThe risk or severity of adverse effects can be increased when Ketamine is combined with Levobupivacaine.Approved, Vet Approved
KetazolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ketazolam.Approved
KetobemidoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ketobemidone.Approved, Investigational
KetoconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Ketoconazole.Approved, Investigational
LabetalolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Labetalol.Approved
LacidipineThe risk or severity of adverse effects can be increased when Lacidipine is combined with Levobupivacaine.Approved, Investigational
LamotrigineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lamotrigine.Approved, Investigational
LercanidipineThe risk or severity of adverse effects can be increased when Lercanidipine is combined with Levobupivacaine.Approved, Investigational
LevetiracetamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levetiracetam.Approved, Investigational
LevobunololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levobunolol.Approved
LevocabastineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levocabastine.Approved
LevocetirizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levocetirizine.Approved
LevodopaLevobupivacaine may increase the orthostatic hypotensive activities of Levodopa.Approved
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levomethadyl Acetate.Approved, Investigational
LevomilnacipranThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levomilnacipran.Approved
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Levobupivacaine.Approved
LevosimendanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levosimendan.Approved, Investigational
LidocaineThe metabolism of Levobupivacaine can be decreased when combined with Lidocaine.Approved, Vet Approved
LisinoprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lisinopril.Approved, Investigational
LithiumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lithium.Approved
LobeglitazoneThe metabolism of Levobupivacaine can be decreased when combined with Lobeglitazone.Approved, Investigational
LofentanilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lofentanil.Illicit
LofexidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lofexidine.Approved, Investigational
LopinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Lopinavir.Approved
LoprazolamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Loprazolam.Experimental
LoratadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Loratadine.Approved
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Levobupivacaine.Approved
LormetazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Lormetazepam.Approved
LosartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Losartan.Approved
LovastatinThe metabolism of Levobupivacaine can be decreased when combined with Lovastatin.Approved, Investigational
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Levobupivacaine.Approved
LuliconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Luliconazole.Approved
LumacaftorThe metabolism of Levobupivacaine can be increased when combined with Lumacaftor.Approved
LurasidoneThe risk or severity of adverse effects can be increased when Lurasidone is combined with Levobupivacaine.Approved
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Vet Approved
MannitolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Mannitol.Approved, Investigational
MaprotilineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Maprotiline.Approved
MebicarThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Mebicar.Experimental
MecamylamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Mecamylamine.Approved
MeclizineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Meclizine.Approved
MedazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Medazepam.Experimental
MedetomidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Medetomidine.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Melatonin.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Melperone.Approved, Investigational
MepivacaineThe risk or severity of adverse effects can be increased when Mepivacaine is combined with Levobupivacaine.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Levobupivacaine.Approved, Illicit
MeptazinolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Meptazinol.Experimental
MesoridazineThe risk or severity of adverse effects can be increased when Mesoridazine is combined with Levobupivacaine.Approved, Investigational
MetaxaloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Metaxalone.Approved
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Levobupivacaine.Approved
Methadyl AcetateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methadyl Acetate.Approved, Illicit
MethapyrileneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methapyrilene.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methaqualone.Illicit, Withdrawn
MethazolamideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methazolamide.Approved
MethocarbamolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methocarbamol.Approved, Vet Approved
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Levobupivacaine.Approved
MethotrimeprazineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.Approved
MethoxyfluraneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methoxyflurane.Approved, Investigational, Vet Approved
MethsuximideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methsuximide.Approved
MethyclothiazideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methyclothiazide.Approved
MethyldopaThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methyldopa.Approved
MethylecgonineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Methylecgonine.Experimental
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Methylphenobarbital is combined with Levobupivacaine.Approved
MetipranololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Metipranolol.Approved
MetolazoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Metolazone.Approved
MetoprololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Metoprolol.Approved, Investigational
MetyrosineLevobupivacaine may increase the sedative activities of Metyrosine.Approved
MexiletineThe metabolism of Levobupivacaine can be decreased when combined with Mexiletine.Approved
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Levobupivacaine.Approved, Illicit
MidostaurinThe metabolism of Levobupivacaine can be decreased when combined with Midostaurin.Approved
MifepristoneThe serum concentration of Levobupivacaine can be increased when it is combined with Mifepristone.Approved, Investigational
MilnacipranThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Milnacipran.Approved
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Investigational
MinoxidilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Minoxidil.Approved
MirtazapineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.Approved
MitotaneThe serum concentration of Levobupivacaine can be decreased when it is combined with Mitotane.Approved
MoexiprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Moexipril.Approved
MolindoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Molindone.Approved
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Levobupivacaine.Approved, Investigational
MoxonidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Moxonidine.Approved, Investigational
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved, Investigational
NadololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nadolol.Approved
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Levobupivacaine.Approved
NebivololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nebivolol.Approved, Investigational
NefazodoneThe serum concentration of Levobupivacaine can be increased when it is combined with Nefazodone.Approved, Withdrawn
NelfinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Nelfinavir.Approved
NesiritideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nesiritide.Approved, Investigational
NetupitantThe serum concentration of Levobupivacaine can be increased when it is combined with Netupitant.Approved
NevirapineThe metabolism of Levobupivacaine can be increased when combined with Nevirapine.Approved
NicardipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nicardipine.Approved
NicorandilNicorandil may increase the hypotensive activities of Levobupivacaine.Approved, Investigational
NifedipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nifedipine.Approved
NilotinibThe metabolism of Levobupivacaine can be decreased when combined with Nilotinib.Approved, Investigational
NilvadipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nilvadipine.Approved, Investigational
NimodipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nimodipine.Approved
NisoldipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nisoldipine.Approved
NitrazepamThe risk or severity of adverse effects can be increased when Nitrazepam is combined with Levobupivacaine.Approved
NitrendipineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitrendipine.Approved, Investigational
Nitric OxideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitric Oxide.Approved
NitroglycerinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitroglycerin.Approved, Investigational
NitroprussideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nitroprusside.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Nitrous oxide is combined with Levobupivacaine.Approved, Vet Approved
NorfluraneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Norflurane.Investigational
NormethadoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Normethadone.Approved, Illicit
NortriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nortriptyline.Approved
ObinutuzumabThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Obinutuzumab.Approved
OlanzapineThe risk or severity of adverse effects can be increased when Olanzapine is combined with Levobupivacaine.Approved, Investigational
OlaparibThe metabolism of Levobupivacaine can be decreased when combined with Olaparib.Approved
OlmesartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Olmesartan.Approved, Investigational
OlopatadineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Olopatadine.Approved
OndansetronThe risk or severity of adverse effects can be increased when Ondansetron is combined with Levobupivacaine.Approved
OpiumThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Opium.Approved, Illicit
OrphenadrineLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.Approved
OsanetantThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Osanetant.Investigational
OsimertinibThe serum concentration of Levobupivacaine can be increased when it is combined with Osimertinib.Approved
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Levobupivacaine.Approved
OxethazaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Oxethazaine.Approved, Investigational
OxprenololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Oxprenolol.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Oxybuprocaine is combined with Levobupivacaine.Approved
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Levobupivacaine.Approved, Illicit, Investigational
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Levobupivacaine.Approved, Investigational, Vet Approved
PaclitaxelThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Paclitaxel.Approved, Vet Approved
PalbociclibThe serum concentration of Levobupivacaine can be increased when it is combined with Palbociclib.Approved
PaliperidoneThe risk or severity of adverse effects can be increased when Paliperidone is combined with Levobupivacaine.Approved
PapaverineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Papaverine.Approved
ParaldehydeLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.Approved, Investigational
ParoxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Paroxetine.Approved, Investigational
Peginterferon alfa-2bThe serum concentration of Levobupivacaine can be increased when it is combined with Peginterferon alfa-2b.Approved
PenbutololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Penbutolol.Approved, Investigational
PenfluridolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Penfluridol.Experimental
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Levobupivacaine.Approved, Vet Approved
PentobarbitalThe metabolism of Levobupivacaine can be increased when combined with Pentobarbital.Approved, Vet Approved
PerampanelPerampanel may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved
PerazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Perazine.Investigational
PerindoprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Perindopril.Approved
PerospironeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Perospirone.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Levobupivacaine.Approved
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Levobupivacaine.Approved
PhenazocineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenazocine.Experimental
PhenelzineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenelzine.Approved
PhenibutThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenibut.Experimental
PhenobarbitalThe metabolism of Levobupivacaine can be increased when combined with Phenobarbital.Approved
PhenoperidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenoperidine.Experimental
PhenoxybenzamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenoxybenzamine.Approved
PhenoxyethanolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phenoxyethanol.Approved
PhentolamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Phentolamine.Approved
PhenytoinThe metabolism of Levobupivacaine can be increased when combined with Phenytoin.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Pimozide is combined with Levobupivacaine.Approved
PindololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pindolol.Approved
PipamperoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pipamperone.Approved, Investigational
PipotiazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pipotiazine.Approved, Investigational
PiritramideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Piritramide.Investigational
PizotifenThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pizotifen.Approved
PomalidomideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pomalidomide.Approved
PosaconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Posaconazole.Approved, Investigational, Vet Approved
PramipexoleLevobupivacaine may increase the sedative activities of Pramipexole.Approved, Investigational
PramocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Pramocaine.Approved
PrazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Prazepam.Approved, Illicit
PrazosinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Prazosin.Approved
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Levobupivacaine.Approved, Illicit, Investigational
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Levobupivacaine.Approved
PrimidoneThe metabolism of Levobupivacaine can be increased when combined with Primidone.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Levobupivacaine.Approved, Investigational, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Levobupivacaine.Approved, Vet Approved
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Levobupivacaine.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Promethazine.Approved
PropanididThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Propanidid.Experimental
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Levobupivacaine.Approved, Vet Approved
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Levobupivacaine.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Propoxycaine.Approved
PropranololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Propranolol.Approved, Investigational
ProtriptylineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Protriptyline.Approved
ProxibarbalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Proxibarbal.Experimental
PSD502The risk or severity of adverse effects can be increased when Levobupivacaine is combined with PSD502.Investigational
QuazepamThe risk or severity of adverse effects can be increased when Quazepam is combined with Levobupivacaine.Approved, Illicit
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Levobupivacaine.Approved
QuinaprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Quinapril.Approved, Investigational
QuinisocaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Quinisocaine.Experimental
RacloprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Raclopride.Investigational
RamelteonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ramelteon.Approved, Investigational
RamiprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ramipril.Approved
RanolazineThe metabolism of Levobupivacaine can be decreased when combined with Ranolazine.Approved, Investigational
RasagilineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Rasagiline.Approved
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Levobupivacaine.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Levobupivacaine.Approved, Withdrawn
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Levobupivacaine.Approved, Investigational
RifabutinThe metabolism of Levobupivacaine can be increased when combined with Rifabutin.Approved
RifampicinThe metabolism of Levobupivacaine can be increased when combined with Rifampicin.Approved
RifapentineThe metabolism of Levobupivacaine can be increased when combined with Rifapentine.Approved
RiociguatThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Riociguat.Approved
RisperidoneLevobupivacaine may increase the hypotensive activities of Risperidone.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ritanserin.Investigational
RitonavirThe serum concentration of Levobupivacaine can be increased when it is combined with Ritonavir.Approved, Investigational
RomifidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Romifidine.Vet Approved
RopiniroleLevobupivacaine may increase the sedative activities of Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Levobupivacaine.Approved
RotigotineLevobupivacaine may increase the sedative activities of Rotigotine.Approved
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Levobupivacaine.Approved
SacubitrilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sacubitril.Approved
SaquinavirThe serum concentration of Levobupivacaine can be increased when it is combined with Saquinavir.Approved, Investigational
ScopolamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Scopolamine.Approved
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Levobupivacaine.Approved, Vet Approved
SelegilineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Selegiline.Approved, Investigational, Vet Approved
SepranoloneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sepranolone.Investigational
SertindoleThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sertindole.Approved, Investigational, Withdrawn
SertralineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sertraline.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Levobupivacaine.Approved, Vet Approved
SildenafilThe metabolism of Levobupivacaine can be decreased when combined with Sildenafil.Approved, Investigational
SiltuximabThe serum concentration of Levobupivacaine can be decreased when it is combined with Siltuximab.Approved
SimeprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Simeprevir.Approved
Sodium NitriteThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sodium Nitrite.Approved
Sodium oxybateSodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved
SotalolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sotalol.Approved
SpironolactoneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Spironolactone.Approved
St. John's WortThe serum concentration of Levobupivacaine can be decreased when it is combined with St. John's Wort.Investigational, Nutraceutical
StiripentolThe serum concentration of Levobupivacaine can be increased when it is combined with Stiripentol.Approved
StreptokinaseThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Streptokinase.Approved, Investigational
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Levobupivacaine.Approved, Investigational
SulfisoxazoleThe metabolism of Levobupivacaine can be decreased when combined with Sulfisoxazole.Approved, Vet Approved
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Levobupivacaine.Approved, Investigational
SultoprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sultopride.Experimental
SuvorexantLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.Approved
TamsulosinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tamsulosin.Approved, Investigational
TandospironeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tandospirone.Investigational
TapentadolTapentadol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.Approved
TasimelteonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tasimelteon.Approved
Technetium Tc-99m tilmanoceptLevobupivacaine may decrease effectiveness of Technetium Tc-99m tilmanocept as a diagnostic agent.Approved, Investigational
TelaprevirThe serum concentration of Levobupivacaine can be increased when it is combined with Telaprevir.Approved, Withdrawn
TelithromycinThe serum concentration of Levobupivacaine can be increased when it is combined with Telithromycin.Approved
TelmisartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Telmisartan.Approved, Investigational
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Levobupivacaine.Approved
Tenofovir disoproxilThe metabolism of Levobupivacaine can be decreased when combined with Tenofovir disoproxil.Approved, Investigational
TerazosinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Terazosin.Approved
TeriflunomideThe serum concentration of Levobupivacaine can be decreased when it is combined with Teriflunomide.Approved
TetrabenazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetrabenazine.Approved
TetracaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetracaine.Approved, Vet Approved
TetrahydropalmatineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetrahydropalmatine.Investigational
TetrodotoxinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tetrodotoxin.Investigational
ThalidomideLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.Approved, Investigational, Withdrawn
TheophyllineThe metabolism of Levobupivacaine can be decreased when combined with Theophylline.Approved
ThiamylalThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Thiamylal.Approved, Vet Approved
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Levobupivacaine.Approved, Vet Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Levobupivacaine.Approved, Withdrawn
ThiothixeneThe risk or severity of adverse effects can be increased when Thiothixene is combined with Levobupivacaine.Approved
TiagabineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tiagabine.Approved
TiaprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tiapride.Approved, Investigational
TiclopidineThe metabolism of Levobupivacaine can be decreased when combined with Ticlopidine.Approved
TiletamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tiletamine.Vet Approved
TilidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tilidine.Experimental
TimololThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Timolol.Approved
TizanidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tizanidine.Approved
TocilizumabThe serum concentration of Levobupivacaine can be decreased when it is combined with Tocilizumab.Approved
TolazolineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tolazoline.Approved, Vet Approved
TolcaponeThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tolcapone.Approved, Withdrawn
TopiramateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Topiramate.Approved
TorasemideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Torasemide.Approved
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Levobupivacaine.Approved, Investigational
TrandolaprilThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trandolapril.Approved
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trans-2-Phenylcyclopropylamine.Experimental
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Levobupivacaine.Approved
TrazodoneThe risk or severity of adverse effects can be increased when Trazodone is combined with Levobupivacaine.Approved, Investigational
TretinoinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tretinoin.Approved, Investigational, Nutraceutical
TriamtereneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Triamterene.Approved
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Levobupivacaine.Approved
Tricaine methanesulfonateThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Tricaine methanesulfonate.Vet Approved
TrichloroethyleneThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trichloroethylene.Experimental
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Levobupivacaine.Approved
TrifluperidolThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trifluperidol.Experimental
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Levobupivacaine.Approved, Vet Approved
TrimipramineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trimipramine.Approved
TriprolidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Triprolidine.Approved
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Levobupivacaine.Approved, Investigational
ValsartanThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Valsartan.Approved, Investigational
VemurafenibThe serum concentration of Levobupivacaine can be increased when it is combined with Vemurafenib.Approved
VenlafaxineThe metabolism of Levobupivacaine can be decreased when combined with Venlafaxine.Approved
VeraliprideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Veralipride.Experimental
VerapamilThe metabolism of Levobupivacaine can be decreased when combined with Verapamil.Approved
VigabatrinThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vigabatrin.Approved
Vinyl etherThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vinyl ether.Experimental
VoriconazoleThe serum concentration of Levobupivacaine can be increased when it is combined with Voriconazole.Approved, Investigational
VortioxetineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Vortioxetine.Approved
XenonThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Xenon.Experimental
XylazineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Xylazine.Vet Approved
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Levobupivacaine.Approved, Illicit, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ziconotide.Approved
ZimelidineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zimelidine.Withdrawn
ZiprasidoneThe metabolism of Levobupivacaine can be decreased when combined with Ziprasidone.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zolazepam.Vet Approved
ZolpidemLevobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.Approved
ZonisamideThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zonisamide.Approved, Investigational
ZopicloneThe risk or severity of adverse effects can be increased when Zopiclone is combined with Levobupivacaine.Approved
ZotepineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zotepine.Approved, Investigational
ZucapsaicinThe metabolism of Levobupivacaine can be decreased when combined with Zucapsaicin.Approved
ZuclopenthixolThe risk or severity of adverse effects can be increased when Zuclopenthixol is combined with Levobupivacaine.Approved, Investigational
Food Interactions
Not Available

References

Synthesis Reference

Hooshang Shahriari Zavareh, Graham Anthony Charles Frampton, "Process for preparing levobupivacaine and analogues thereof." U.S. Patent US5777124, issued February, 1985.

US5777124
General References
  1. Burlacu CL, Buggy DJ: Update on local anesthetics: focus on levobupivacaine. Ther Clin Risk Manag. 2008 Apr;4(2):381-92. [PubMed:18728849]
  2. Leone S, Di Cianni S, Casati A, Fanelli G: Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed. 2008 Aug;79(2):92-105. [PubMed:18788503]
External Links
Human Metabolome Database
HMDB15137
KEGG Compound
C07887
PubChem Compound
92253
PubChem Substance
46505295
ChemSpider
83289
BindingDB
50350791
ChEBI
6149
ChEMBL
CHEMBL1201193
Therapeutic Targets Database
DAP001233
PharmGKB
PA164754741
RxList
RxList Drug Page
Wikipedia
Levobupivacaine
ATC Codes
N01BB10 — Levobupivacaine
FDA label
Download (2.72 MB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
2Active Not RecruitingTreatmentLabour1
2CompletedPreventionAdverse Effects / Toxicity1
2CompletedPreventionEffects of; Anesthesia, in Labor and Delivery1
2CompletedSupportive CareInguinal Hernias / Undescended Testis1
2CompletedTreatmentAnaesthesia therapy1
2Not Yet RecruitingTreatmentEpisiotomy1
2RecruitingTreatmentPostoperative Cognitive Dysfunction1
2, 3CompletedPreventionRecovery After Cleft Palate Surgery1
2, 3RecruitingTreatmentIntractable Abdominal Pain Secondary to Inoperable Malignancy1
2, 3Unknown StatusSupportive CareStillborn Caesarean Section1
3CompletedPreventionNormal Pregnancies1
3CompletedTreatmentAnalgesia, Postoperative1
3CompletedTreatmentElective Caesarean Section Surgeries1
3CompletedTreatmentPain1
3CompletedTreatmentPostoperative pain1
3RecruitingTreatmentLumbar epidural anesthesia therapy1
3TerminatedNot AvailableSurgical Pathology of the Leg or the Foot1
3TerminatedPreventionPain2
3WithdrawnTreatmentOrthopedic Disorder of Spine1
4Active Not RecruitingSupportive CarePostoperative pain1
4Active Not RecruitingTreatmentArterial Hypotension / Bradycardia / Tumors, Breast1
4Active Not RecruitingTreatmentInguinal Hernias / Spinal Anaesthesia1
4Active Not RecruitingTreatmentLaparoscopic Cholecystectomy / Postoperative pain1
4CompletedNot AvailableAnaesthesia / Caudal epidural block therapy / Orthopaedic Disorders1
4CompletedNot AvailableGeneral Surgery / Hallux Valgus1
4CompletedNot AvailablePain1
4CompletedBasic SciencePostoperative pain1
4CompletedPreventionArterial Hypotension1
4CompletedPreventionPerioperative/Postoperative Complications1
4CompletedSupportive CareCognitive Function Abnormal / Intraoperative Monitoring / Vitreoretinal Surgery1
4CompletedSupportive CarePostoperative pain / Prophylaxis against postoperative nausea and vomiting1
4CompletedSupportive CarePreeclampsia1
4CompletedTreatmentAnalgesia / Pain / Systemic Inflammatory Stress Response1
4CompletedTreatmentBenign Prostatic Hyperplasia (BPH)1
4CompletedTreatmentCholecystolithiasis / Postoperative pain1
4CompletedTreatmentComplication of Anesthesia1
4CompletedTreatmentCoronary Artery Bypass Graft / Lumbar epidural anesthesia therapy1
4CompletedTreatmentEpisiotomy / Post-partum Perineal Pain / Vaginal Tear1
4CompletedTreatmentHeart Surgery Via Sternotomy / Post-operative Analgesia1
4CompletedTreatmentHypertensive1
4CompletedTreatmentLower Limb Surgery1
4CompletedTreatmentNeoplasms, Brain1
4CompletedTreatmentOther Peripheral Nerve Disease1
4CompletedTreatmentPain3
4CompletedTreatmentGallstone formation / Pain1
4CompletedTreatmentPatients Undergoing Lower Limb Surgery1
4CompletedTreatmentPostoperative pain / Postoperative Pain Following Cesarean Section1
4CompletedTreatmentPostoperative pain2
4CompletedTreatmentRegional Anesthesia1
4CompletedTreatmentThis Study Was Focused on Selective Spinal Anesthesia for Lower Extremity Surgery in Order to Achieve Early Mobilization and to Shorten Hospital Stay1
4CompletedTreatmentSynovitis of osteoarthritis1
4RecruitingPreventionAnaesthesia therapy / Hip Fractures1
4RecruitingSupportive CarePhrenic Nerve Palsy1
4RecruitingTreatmentLocal Anesthesia1
4RecruitingTreatmentNeuromuscular Block1
4SuspendedTreatmentArthroplasty, Replacement, Knee / Pain1
4SuspendedTreatmentPain1
4TerminatedTreatmentPostoperative pain / Reaction; Anesthesia1
4Unknown StatusNot AvailableFracture of Neck of Femur1
4Unknown StatusTreatmentAnalgesia, Patient-Controlled / Arthroplasty, Replacement, Knee1
4Unknown StatusTreatmentKnee Replacement Surgery1
4Unknown StatusTreatmentPatients to Benefit a Planned Femoropopliteal Bypass Through PAOD (Peripheral Arterial Occlusive Disease) Stage II or III1
4Unknown StatusTreatmentSpinal Anaesthesia1
4Unknown StatusTreatmentTotal Hip Arthroplasty (THA)1
4WithdrawnTreatmentCaesarean Sections1
Not AvailableActive Not RecruitingTreatmentPostoperative pain1
Not AvailableCompletedNot AvailableOsteoarthritis of the Knees1
Not AvailableCompletedNot AvailablePostoperative pain1
Not AvailableCompletedDiagnosticAnaesthesia therapy1
Not AvailableCompletedSupportive CareFemoroacetabular Impingement1
Not AvailableCompletedSupportive CarePain Insensitivity, Congenital1
Not AvailableCompletedTreatmentAdverse Reaction to Spinal Anesthetic1
Not AvailableCompletedTreatmentPost-Operative Pain / Postoperative Complications / Prophylaxis against postoperative nausea and vomiting1
Not AvailableCompletedTreatmentReconstruction Breast Surgery1
Not AvailableCompletedTreatmentSynovitis of osteoarthritis1
Not AvailableEnrolling by InvitationSupportive CareCancer, Breast / Radical Mastectomy Surgery1
Not AvailableEnrolling by InvitationTreatmentArthropathy1
Not AvailableNot Yet RecruitingPreventionPostoperative pain / Ureter Stone1
Not AvailableRecruitingPreventionArterial Hypotension1
Not AvailableRecruitingTreatmentLabour Pain1
Not AvailableUnknown StatusHealth Services ResearchPregnancy1
Not AvailableWithdrawnTreatmentPostoperative pain1

Pharmacoeconomics

Manufacturers
  • Purdue pharma lp
Packagers
Dosage forms
Not Available
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5708011No1994-10-132014-10-13Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
logP3.6Not Available
pKa8.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0977 mg/mLALOGPS
logP3.31ALOGPS
logP4.52ChemAxon
logS-3.5ALOGPS
pKa (Strongest Acidic)13.62ChemAxon
pKa (Strongest Basic)8ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area32.34 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity90.19 m3·mol-1ChemAxon
Polarizability34.45 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9814
Blood Brain Barrier+0.936
Caco-2 permeable+0.6669
P-glycoprotein substrateSubstrate0.8435
P-glycoprotein inhibitor IInhibitor0.8582
P-glycoprotein inhibitor IINon-inhibitor0.7836
Renal organic cation transporterNon-inhibitor0.6471
CYP450 2C9 substrateNon-substrate0.7957
CYP450 2D6 substrateSubstrate0.8346
CYP450 3A4 substrateSubstrate0.7045
CYP450 1A2 substrateInhibitor0.6863
CYP450 2C9 inhibitorNon-inhibitor0.9099
CYP450 2D6 inhibitorInhibitor0.8932
CYP450 2C19 inhibitorNon-inhibitor0.9026
CYP450 3A4 inhibitorInhibitor0.6205
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.6066
Ames testNon AMES toxic0.8462
CarcinogenicityNon-carcinogens0.8859
BiodegradationNot ready biodegradable0.9729
Rat acute toxicity2.2574 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.8283
hERG inhibition (predictor II)Inhibitor0.7851
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
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.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Piperidines
Sub Class
Piperidinecarboxylic acids and derivatives
Direct Parent
Piperidinecarboxamides
Alternative Parents
m-Xylenes / Trialkylamines / Propargyl-type 1,3-dipolar organic compounds / Carboximidic acids / Azacyclic compounds / Organopnictogen compounds / Organooxygen compounds / Hydrocarbon derivatives
Substituents
2-piperidinecarboxamide / Piperidinecarboxamide / M-xylene / Xylene / Monocyclic benzene moiety / Benzenoid / Tertiary aliphatic amine / Tertiary amine / Carboximidic acid / Carboximidic acid derivative
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide (CHEBI:6149)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
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
SCN10A
Uniprot ID
Q9Y5Y9
Uniprot Name
Sodium channel protein type 10 subunit alpha
Molecular Weight
220623.605 Da
References
  1. 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]
  2. 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]
  3. Ueta K, Sugimoto M, Suzuki T, Uchida I, Mashimo T: In vitro antagonism of recombinant ligand-gated ion-channel receptors by stereospecific enantiomers of bupivacaine. Reg Anesth Pain Med. 2006 Jan-Feb;31(1):19-25. [PubMed:16418020]
  4. Vladimirov M, Nau C, Mok WM, Strichartz G: Potency of bupivacaine stereoisomers tested in vitro and in vivo: biochemical, electrophysiological, and neurobehavioral studies. Anesthesiology. 2000 Sep;93(3):744-55. [PubMed:10969308]
  5. Brau ME, Branitzki P, Olschewski A, Vogel W, Hempelmann G: Block of neuronal tetrodotoxin-resistant Na+ currents by stereoisomers of piperidine local anesthetics. Anesth Analg. 2000 Dec;91(6):1499-505. [PubMed:11094008]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP1A2
Uniprot ID
P05177
Uniprot Name
Cytochrome P450 1A2
Molecular Weight
58293.76 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]

Drug created on June 13, 2005 07:24 / Updated on November 07, 2017 01:45