Posimir

Not interchangeable with other forms of bupivacaine. To be administered in a setting where trained personnel and equipment are immediately available. Avoid epidural, intrathecal, intravascular, intra-articular, regional nerve blocks, pre-incisional or pre-procedural locoregional anesthetic techniques that require deep and complete sensory block in the area of administration. Risk of joint cartilage necrosis after unapproved intra-articular injection. Risk of systemic toxicities (including CNS or cardiorespiratory depression, coma) with unintended intravascular injection. Monitor cardiovascular and respiratory vital signs, and patient's state of consciousness after administration. Risk of methemoglobinemia (esp. in G6PD deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants <6 months of age, concurrent exposure to oxidizing agents or metabolites); monitor closely and discontinue any oxidizing agents. Cardiovascular dysfunction (eg, hypotension, heart block); consider dose reduction and monitor closely for BP, HR, and ECG changes. Debilitated, elderly, acutely ill, renal or moderate to severe hepatic impairment: monitor for toxicity. Labor & delivery. Pregnancy. Nursing mothers.