Nesacaine (Injection)

Chloroprocaine injection is used to make a specific area numb or to stop pain during certain medical procedures.

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

It is very important that your doctor check 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 any of 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 any of these symptoms while using 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 also 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 or 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, you and your doctor must consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know if you have any other 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 toxic, it should be used very carefully in children younger than 6 months old. Do not exceed the recommended doses, and the patient should be closely monitored during treatment.

Geriatric

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

Breast Feeding

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

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if interactions could happen. In such cases, your doctor may change the dose or take other precautions. When receiving this medicine, it's especially important for your healthcare professional to know if you are taking any of the following medicines. The following interactions are noteworthy but not exhaustive.

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

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

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at the same time as eating food or specific types of food due to potential interactions. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

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

• Blood vessel disease
• Heart disease
• Hypertension (high blood pressure)
• Liver disease—Use with caution. Side effects may be more likely.

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

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

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they might require medical attention.

Check with your doctor or nurse right away if any of the following 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 require medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your healthcare professional may also be able to tell you how to prevent or lessen some of these side effects. Check with your healthcare professional if any of the following side effects continue or 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.