Bupivacaine (bue-PIV-a-kane), Meloxicam (mel-OX-i-kam)

Numbs an area of your body and relieves pain after soft tissue surgery (including surgery in the breast, groin, or stomach) or muscle or bone surgery (including surgery in the foot, knee, shoulder, or spine).

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• A nurse or other health provider will give you this medicine. It is usually given in the area where you had a surgery.

Drugs and Foods to Avoid:

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

• Do not use aspirin or any other NSAID medicine (including diflunisal, salsalate) unless your doctor says it is okay.
• Some medicines can affect how bupivacaine and meloxicam work. Tell your doctor if you are taking any of the following:
  • Acetaminophen, chloroquine, cyclosporine, digoxin, lithium, methotrexate, metoclopramide, pemetrexed, primaquine, quinine, sulfasalazine
  • Blood pressure medicine (including ACE inhibitors, ARBs, beta blockers)
  • Blood thinner (including warfarin)
  • Cancer medicine (including cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase)
  • Diuretics (water pill)
  • Medicine to treat depression (including SNRIs, SSRIs)
  • Medicine to treat an infection (including dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides)
  • Medicine to treat seizures (including phenobarbital, phenytoin, sodium valproate)
  • Nitrate or nitrite medicine (including nitric oxide, nitroglycerin, nitroprusside, nitrous oxide)
  • Other local anesthetics
  • Steroid medicine

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Do not use this medicine during the later part of a pregnancy unless your doctor tells you it is okay.
• Tell your doctor if you have kidney disease, liver disease, heart or blood vessel disease (including heart failure), heart rhythm problems (including heart block), high or low blood pressure, lung or breathing problems (including asthma), bleeding problems, blood or blood clotting problems (including methemoglobinemia), G6PD, or a history of heart attack, stroke, or stomach problems (including ulcers). Tell your doctor if you smoke or drink alcohol regularly.
• This medicine may cause the following problems:
  • Increased risk of blood clots, heart attack, stroke, or heart failure
  • Bleeding problems, including stomach or bowel bleeding or ulcer
  • Liver problems
  • High blood pressure
  • Kidney problems
  • Chondrolysis (a bone or joint problem)
  • Methemoglobinemia (blood disorder)
  • Serious skin reactions, including Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS)
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may cause a delay in ovulation in females and may decrease sperm count in males, which can affect the ability to have children. If you plan to have children, talk with your doctor before using this medicine.
• This medicine should cause numbness only to the area where it is injected. It is not meant to cause you to fall asleep or become unconscious.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

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, dizziness, drowsiness, ringing in your ears, blurred vision, muscle twitching
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate, difficult or painful urination
• Chest pain, trouble breathing, fast, pounding, slow, or uneven heartbeat
• Confusion, numbness or tingling in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fever, chills, cough, sore throat, body aches
• Lightheadedness, dizziness, or fainting
• Metallic taste in your mouth or other changes in taste
• Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking
• Pale, gray, or blue lips, nails, or skin, dark urine, headache, tiredness
• Rapid weight gain, swelling in your hands, ankles, or feet
• Severe stomach pain, vomiting blood or material that looks like coffee grounds, bloody or black, tarry stools
• Shoulder discomfort, pain, or stiffness
• Unusual bleeding, bruising, or weakness

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

• Constipation
• Pain, redness, or swelling where the needle was placed
• Unusual skin odor, slow wound healing

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