Bupivacaine Hydrochloride and Hydrocortisone Iodoquinol Cream

• Generic Name: bupivacaine
• Dosage Forms: n.a.
• Other Brand Names: Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF, Sensorcaine-MPF Spinal, Bupivacaine Fisiopharma, Bupivacaine Spinal, Marcaine, Marcaine Preservative Free, P-Care M, ReadySharp Bupivacaine

Local or regional anesthesia or analgesia in surgical, obstetrical, dental, diagnostic, and therapeutic procedures.

Available as conventional bupivacaine hydrochloride preparations with or without epinephrine or as a liposomal injection containing bupivacaine in an aqueous suspension of multivesicular liposomes (Exparel).

Conventional preparations are used for local infiltration and nerve block techniques including peripheral, sympathetic, epidural (including caudal), retrobulbar, and dental block. Do not use 0.75% concentration for obstetrical anesthesia. (See Boxed Warning.) A hyperbaric solution containing 0.75% bupivacaine hydrochloride in 8.25% dextrose is used for spinal anesthesia.

Liposomal bupivacaine (Exparel) is used for local infiltration or interscalene brachial plexus nerve block to provide postsurgical analgesia; safety and efficacy not established for other nerve blocks. Because of possible differences in physiochemical and functional properties, do not use liposomal bupivacaine interchangeably with other bupivacaine-containing preparations.

Local anesthetics should be used as a component of multimodal analgesia (i.e., simultaneous use of a combination of analgesic drugs and techniques that target different mechanisms) in the management of postoperative pain.

Studies comparing relative efficacy of liposomal bupivacaine and conventional bupivacaine hydrochloride for postsurgical analgesia have shown variable results.

Do not use for obstetric paracervical block.

• Generic Name: hydrocortisone / iodoquinol topical
• Dosage Forms: cream
• Other Brand Names: Dermazene, Vytone

Principally used in combination with hydrocortisone for the topical treatment of subacute and chronic dermatoses.

National Research Council and FDA state that iodoquinol/hydrocortisone combinations are “possibly” effective for topical treatment of eczema (e.g., impetiginized eczema, nummular eczema, infantile eczema, nuchal eczema) and dermatitis (e.g., contact, atopic, endogenous chronic infectious, stasis, localized or disseminated neurodermatitis). Also may be effective for treatment of bacterial dermatoses, mycotic dermatoses [e.g., tinea (capitis, cruris, corporis, pedis), pyoderma, chronic eczematoid otitis externa, acne urticata, lichen simplex chronicus, anogenital pruritus (vulvae, scroti, ani), folliculitis, moniliasis, and intertrigo. .

Has been used topically in a suitable dermatologic vehicle alone or in combination with coal tar in the treatment of bacterial and fungal infections of the skin.

Has been used in the treatment of diaper rash (diaper dermatitis); however, use in children currently is not recommended. (See Pediatric Use under Cautions.)

Has been used as a shampoo (no longer commercially available in the US) for control of seborrheic dermatitis of the scalp; however, relapse usually occurs when the drug is discontinued.