Medicine Information

Bupi-Heavy

Name: Bupi-Heavy
Brand: Bupi-Heavy
Rating: 4.5 (117 reviews)

Injection (Solution for Spinal Anaesthesia)0.5% w/v (5 mg/ml) with 8% GlucoseLocal AnestheticsATC: N01BB01

Generic Name

Bupivacaine Hydrochloride (Heavy) 0.5% w/v Injection

Manufacturer

Various manufacturers (e.g., AstraZeneca, BEXIMCO Pharma, Incepta Pharmaceuticals)

Country

Globally manufactured

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
bupi heavy 05 8 injection	৳ 30.11	N/A

Description

Overview of the medicine

Bupi-Heavy 0.5% w/v Injection is a sterile, hyperbaric solution containing bupivacaine hydrochloride for spinal anaesthesia. It is used to produce sensory and motor block in specific surgical procedures.

Uses & Indications

Spinal anaesthesia for surgical procedures (e.g., urological, lower limb, abdominal, gynaecological)

Surgical procedures requiring prolonged sensory and motor block below the diaphragm

Dosage

Adults

Typical doses for spinal anaesthesia range from 5 mg to 20 mg (1-4 ml of 0.5% solution), adjusted based on patient factors, height, spread, and duration required. Max single dose 20mg.

Elderly

Reduced doses are often recommended due to potential altered pharmacokinetics and increased sensitivity. Start at the lower end of the dosage range.

Renal_impairment

No specific dose adjustments are usually required for renal impairment, but caution is advised. Metabolites are renally excreted.

How to Take

Intrathecal (subarachnoid) injection, administered by trained personnel. Patient positioning is critical for achieving desired spread of anaesthesia.

Mechanism of Action

Bupivacaine blocks the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, thereby reversibly stabilizing the membrane and inhibiting depolarization.

Pharmacokinetics

Onset

Spinal anaesthesia: 2-10 minutes

Excretion

Mainly excreted in urine as metabolites, with a small percentage of unchanged drug.

Half life

Plasma elimination half-life is approximately 1.5 to 5.5 hours in adults.

Absorption

Rapid systemic absorption occurs after epidural administration; spinal administration results in lower systemic levels due to smaller doses and distribution within CSF.

Metabolism

Primarily metabolized in the liver by cytochrome P450 3A4 (CYP3A4) to 2,6-pipecoloxylidine (PPX) and other metabolites.

Side Effects

Contraindications

Hypersensitivity to bupivacaine or other amide-type local anesthetics
Intravenous regional anaesthesia (IVRA)
Local infection at the site of injection
Septicemia
Cardiogenic shock, hypovolemic shock

Drug Interactions

Other local anesthetics

Additive systemic toxicity if given concurrently or in rapid succession.

Antiarrhythmics (Class III, e.g., Amiodarone)

Increased risk of cardiac toxicity.

CYP3A4 inhibitors (e.g., Ketoconazole, Verapamil)

May increase bupivacaine plasma concentrations, leading to increased risk of toxicity.

Storage

Store at room temperature (15-30°C), protect from light. Do not freeze. Keep out of reach of children.

Overdose

Symptoms include CNS excitation (convulsions, tremors) followed by depression, cardiovascular depression (hypotension, bradycardia, cardiac arrest). Management involves maintaining airway, oxygenation, managing seizures, and supporting cardiovascular function, often with lipid emulsion therapy.

Pregnancy & Lactation

Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Small amounts excreted in breast milk; caution advised. Consultation with an anaesthesiologist is essential.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

4 ml ampoule (pack of 5 or 10)

Shelf Life

Typically 2-3 years when stored correctly.

Availability

Hospitals, Clinics, Surgical Centers

Approval Status

Approved by regulatory bodies worldwide, including FDA and DGDA (Bangladesh)

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of bupivacaine for spinal anaesthesia. Ongoing research focuses on optimizing dosage, patient outcomes, and novel delivery methods.

Lab Monitoring

Monitoring of vital signs (heart rate, blood pressure, oxygen saturation) during and after administration
Neurological assessment for onset, spread, and regression of block

Doctor Notes

Careful assessment of patient's medical history, especially cardiovascular and neurological conditions, is crucial.
Strict aseptic technique is essential during administration to prevent infection.
Monitor patient closely for signs of systemic toxicity (CNS and cardiovascular) after injection.

Patient Guidelines

Inform the medical team about all current medications and medical conditions
Report any unusual sensations or discomfort during or after the procedure
Remain still during the injection process as instructed

Missed Dose Advice

Not applicable as it is a single-dose administration for specific procedures by medical professionals.

Driving Precautions

Do not drive or operate machinery for at least 24 hours (or as advised by doctor) after spinal anaesthesia, due to potential residual effects on motor function and alertness.