Mepivacaine hydrochloride (Carbocaine, Polocaine, Arestocaine, Isocaine)

The benefit of Mepivacaine is that there is no apparent cross allergenicity with other amide LA’s or with ester LA’s.

Dental use for infiltration and block: 3% solution without vasoconstrictor; 2% solution with vasoconstrictor (1:20,000 levonordefrin [Neo-Cobefrin]). The vasoconstrictor is 5x more concentrated than the typical epinephrine dose (1:20,000 vs. 1:100,000) but levonordefrin has about 1/5 the potency of epinephrine, so it evens out.

MRD for normal, healthy adults 2% carbocaine (Mepivacaine) with 1:20,000 neocobefrin (Levonordefrin)

The Mepivacaine with vasoconstrictor is found in 2% concentration, so has 20 mg/ml. The MRD is 3.0 mg/lb (6.6 mg/kg). It is recommended that 5 carps is “usually adequate” although 400 mg is the maximum dosage permissible (regardless of body weight).

The manufacturer has recently discontinued 2% Mepivacaine with levonordefrin.

Category: Pharmacology Notes