Chloroprocaine (Injection)

Chloroprocaine (Injection) is used to make a specific area numb or to stop pain for patients undergoing certain medical procedures.

This medicine is to be given only by your doctor or under their direct supervision.

It is very important that your doctor checks your or your child's progress closely while receiving this medicine to see if it is working properly. Blood tests may be needed to check for any unwanted effects.

This medicine may cause a rare but serious blood problem called methemoglobinemia. The risk may be higher in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to happen in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails; confusion; headache; lightheadedness; fast heartbeat; or unusual tiredness or weakness.

Tell your doctor or nurse right away if you have the following symptoms with this medicine: anxiety; blurred vision; depression; drowsiness; lightheadedness; nausea or vomiting; numbness and tingling of the mouth or lips; restlessness; ringing in the ears; speech problems; or tremors.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat after receiving this medicine.

This medicine may also increase your risk of having serious heart and blood vessel problems such as a heart attack, heart rhythm changes, or low blood pressure. Check with your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, pounding, slow heartbeat, troubled breathing, or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits it will provide. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Because this medicine can be harmful, it should be used very carefully in children younger than 6 months of age. Recommended doses must not be exceeded, and the patient should be closely watched during treatment.

Geriatric

Studies done so far have not shown any specific problems in elderly patients that would limit the use of chloroprocaine injection. However, older adults are more likely to have kidney issues, which may require caution and a dose adjustment for patients receiving chloroprocaine injection.

Breast Feeding

There are no sufficient studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

While some medicines should not be used together at all, in other cases, two different medicines may be used together even if an interaction could happen. In these situations, your doctor may want to adjust the dose, or other precautions may be needed. When you are receiving this medicine, it is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended but may be needed in some cases. If both medicines are prescribed together, your doctor might change the dose or frequency of one or both medicines.

• Bupivacaine
• Bupivacaine Liposome
• Hyaluronidase
• St John's Wort

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used close to mealtime or with specific types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• Blood vessel disease or
• Heart disease or
• Hypertension (high blood pressure) or
• Liver disease—Use with caution. The risk of side effects may be higher.

• Brain or nerve disease or
• Heart block or
• Severe hypotension (low blood pressure) or
• Sepsis or
• Spine problems—Use with caution.

• Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
• Heart problems or
• Lung or breathing problems or
• Methemoglobinemia (blood disorder), whether hereditary or idiopathic (unknown cause)—Use with caution. May increase the risk of having methemoglobinemia.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may happen, if they do, you may need medical attention.

Check with your doctor or nurse right away if any of these side effects occur:

Incidence not known

• Anxiety
• blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles," or tingling feelings
• chest pain or discomfort
• cold, clammy, pale skin
• confusion
• continuing ringing or buzzing or other unexplained noise in the ears
• cough
• decrease in the frequency and amount of urine
• difficulty in passing urine (dribbling)
• difficulty swallowing
• discouragement
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• excitement
• false or unusual sense of well-being
• fast or irregular heartbeat
• feeling sad or empty
• general feeling of illness
• hearing loss
• hives, itching, skin rash
• irritability
• lack of appetite
• loss of interest or pleasure
• nausea
• painful urination
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• restlessness
• seizures
• severe headache
• shivering
• slow heart rate
• slowing of labor
• stiff neck or back
• sweating
• tightness in the chest
• trouble concentrating
• trouble sleeping
• unusual tiredness or weakness
• vomiting
• weakness of the muscles in your face

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of these side effects continue, are bothersome, or if you have any questions about them:

Incidence not known

• Abnormal ejaculation
• decreased sexual performance or desire
• feeling of heat
• loss of bladder and bowel control
• loss of genital sensation and sexual function
• no sensation in the legs
• numbness
• unable to move the legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nesacaine
• Nesacaine-MPF

Available Dosage Forms:

• Solution

Therapeutic Class: Anesthetic, Local

Chemical Class: Amino Ester

A nurse or other trained health professional will give you this medicine in a medical facility. You may receive the injection into your rib cage, chest, or other body areas. Only Nesacaine®-MPF is given through a catheter placed into your lower back for an epidural or a spinal block.

This medicine should cause numbness only to the area where it is injected. You may experience temporary loss of sensation or movement in the injected area. This type of numbing procedure is called local anesthesia. It is not meant to cause you to fall asleep or become unconscious.

You may experience temporary loss of sensation and movement, usually in the lower half of your body, if you receive Nesacaine®-MPF into your lower back (epidural). It may be easier to hurt yourself while your treated body area is still numb. Be careful to avoid injury until you have regained all the feeling and are no longer numb.

If you are receiving Nesacaine®-MPF as an epidural to ease labor pains, it may take longer than normal for you to push your baby out. It is also possible that the baby may have unwanted effects after birth (including sleepiness, slow responses). Talk to your doctor if you have questions about how this medicine might affect your baby.