Licensed for intrathecal use
Products licensed for intrathecal use are the first line option and should be used wherever suitable.
Aspen (Marcain®)
Strength
Panpharma
Strength
Not licensed for intrathecal use, limited information available
Products with partial information that are not licensed for intrathecal administration can still sometimes be used. Refer to the advice in our article and complete a risk assessment to enable you to interpret the details below and choose an appropriate product.
Accord
Strength
2.5mg/mL (0.25%) in 5mL ampoule
2.5mg/mL (0.25%) in 10mL ampoule
2.5mg/mL (0.25%) in 20mL ampoule
Excipients
Sodium chloride, sodium hydroxide, water for injection
Osmolarity
No information
pH
No information
Endotoxin content
≤ 0.23 EU/mL
Strength
5mg/mL (0.5%) in 2mL ampoule
5mg/mL (0.5%) in 4mL ampoule
5mg/mL (0.5%) in 5mL ampoule
5mg/mL (0.5%) in 10mL ampoule
5mg/mL (0.5%) in 20mL ampoule
5mg/mL (0.5%) in 20mL vial
Excipients
Sodium chloride, sodium hydroxide, water for injection
Osmolarity
No information
pH
No information
Endotoxin content
≤ 0.47 EU/mL
Aspen (Marcain Polyamp Steripack®)
Strength
2.5mg/mL (0.25%) in 10mL ampoule
2.5mg/mL (0.25%) in 20mL ampoule
Excipients
Sodium chloride (tonicity contributor), sodium hydroxide/hydrochloric acid (pH adjustment to 4.0-6.5), water for injection
Osmolarity
No information
pH
4.0 – 6.5
Endotoxin content
≤ 0.23 EU/mL
Strength
5mg/mL (0.5%) in 10mL ampoule
5mg/mL (0.5%) in 20mL ampoule
Excipients
Sodium chloride (tonicity contributor), sodium hydroxide/hydrochloric acid (pH adjustment to 4.0-6.5)
Osmolarity
No information
pH
4.0 – 6.5
Endotoxin content
≤ 0.46 EU/mL
Baxter
Strength
2.5mg/mL (0.25%) in 10mL vial
2.5mg/mL (0.25%) in 20mL vial
5mg/mL (0.5%) in 10mL vial
5mg/mL (0.5%) in 20mL vial
Excipients
Sodium chloride, 0.4% sodium hydroxide (for pH adjustment), 0.85% hydrochloric acid (for pH adjustment), water for injection
Osmolarity
290 mOsmol/L
pH
4.0 – 6.5
Endotoxin content
No information
Mercury Pharmaceuticals
Strength
1mg/mL (0.1%) in 100mL infusion bags
1mg/mL (0.1%) in 250mL infusion bags
1.25mg/mL (0.125%) in 100mL infusion bags
1.25mg/mL (0.125%) in 250mL infusion bags
Excipients
Sodium chloride, sodium hydroxide, water for injection
Osmolarity
No information
pH
4.0 – 6.5
Endotoxin content
≤ 0.5 EU/mL
Strength
2.5mg/mL (0.25%) in 10mL ampoule
2.5mg/mL (0.25%) in 20mL ampoule
5mg/mL (0.5%) in 10mL ampoule (glass)
5mg/mL (0.5%) in 10mL ampoule (plastic)
5mg/mL (0.5%) in 20mL ampoule (glass)
5mg/mL (0.5%) in 20mL ampoule (plastic)
Excipients
Sodium chloride, sodium hydroxide, water for injection
Osmolarity
No information
pH
No information
Endotoxin content
≤ 2.5 EU/mL
MilPharm
Strength
2.5mg/mL (0.25%) in 10mL ampoule
5mg/mL (0.5%) in 10mL ampoule
Excipients
Sodium chloride, sodium hydroxide (pH adjustment), hydrochloric acid (pH adjustment), water for injection
Osmolarity
270 – 330 mOsmol/kg
pH
4.0 – 6.5
Endotoxin content
No information
Noriderm
Strength
2.5mg/mL (0.25%) in 5mL ampoule
2.5mg/mL (0.25%) in 10mL ampoule
2.5mg/mL (0.25%) in 20mL ampoule
5mg/mL (0.5%) in 5mL ampoule
5mg/mL (0.5%) in 10mL ampoule
5mg/mL (0.5%) in 20mL ampoule
Excipients
Sodium chloride, sodium hydroxide (pH adjustment), hydrochloric acid (pH adjustment), water for injection
Osmolarity
270 – 320 mOsmol/kg
pH
4.0 – 6.5
Endotoxin content
No information
Pacira (Exparel®)
Bupivacaine liposomal (Exparel®) prolonged-release dispersion for injection
Strength
133mg in 10mL vial
266mg in 20mL vial
Excipients
Dierucoylphosphatidylcholine (DEPC), Dipalmitoylphosphatidylglycerol (DPPG), cholesterol for parenteral use, tricaprylin, sodium chloride, phosphoric acid, water for injection
Osmolarity
260 – 330 mOsmol/L
pH
5.8 – 7.8
Endotoxin content
No information
Unlicensed ‘Special’, specified for intrathecal use
Unlicensed medicines that are manufactured in MHRA-licensed Specials Manufacturing Units, at the request of an authorised healthcare professional specifically for intrathecal use.
St Mary’s Pharmaceutical Unit, Cardiff
Strength
Bupivacaine hydrochloride 3% in 10mL vials
Unlicensed ‘Special’, specified for epidural use
Unlicensed medicines that are manufactured in MHRA-licensed Specials Manufacturing Units, at the request of an authorised healthcare professional specifically for epidural use.
Plain
Huddersfield Royal Infirmary Pharmacy Manufacturing Unit
Strength
Bupivacaine 0.25% in 960mL bottles
Bupivacaine 0.5% in 500mL bottles
Adrenaline containing
Stepping Hill Hospital – Stockport Pharmaceuticals
Strength
Bupivacaine hydrochloride 0.5% and Adrenaline 1:200,000 in 10mL ampoules
Note that this product contains sodium metabisulphate
Torbay PMU
Strength
Bupivacaine hydrochloride 0.5% and Adrenaline 1:200,000 in 10mL ampoules
Note that this product contains sodium metabisulphate
Fentanyl containing
Queen Alexandra Hospital, Portsmouth
Strength
Bupivacaine 0.1% and Fentanyl 2 micrograms/mL in 50mL syringes
Torbay PMU
Strength
Bupivacaine 0.1% and Fentanyl 2 micrograms/mL in 10mL ampoules