When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to bupivacaine, epinephrine, sulfites, or certain other types of local anesthetic.

How to Use This Medicine:
Injectable

• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how this medicine works. Tell your doctor if you are taking any of the following:
  
  • An MAO inhibitor
  • Ergot medicine or other medicines for headaches or migraines
  • Medicine to treat nausea and vomiting, pain, nervousness, or anxiety
  • Phenothiazine medicine, such as promethazine, chlorpromazine
  • Tricyclic antidepressant medicine

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart disease, liver disease, high blood pressure, low blood pressure, atherosclerosis (hardening of the arteries), other circulation problems, diabetes, asthma, thyroid problems, or a history of stroke.
• Numbness may last for several hours after using this medicine. 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.
• To avoid injury after dental work, do not chew solid foods until normal feeling has returned to the area. Do not test the feeling in your mouth by biting or poking at your tissues.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, depression, restlessness, drowsiness, ringing in your ears, blurred vision
• Chest pain, fast, pounding, slow, or uneven heartbeat, trouble breathing
• Lightheadedness, fainting
• Nausea, vomiting, chills, metallic taste in your mouth
• Seizures, shivering, shaking, or tremors

If you notice these less serious side effects, talk with your doctor:

• Headache, back pain
• Swelling near the injection site

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088