Marcain Polyamp Steripack 0.25%

Read all of this leaflet carefully before this medicine is given to you because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or nurse.
• If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1. What Marcain Polyamp Steripack is and what it is used for
2. What you need to know before Marcain Polyamp Steripack is given to you
3. How Marcain Polyamp Steripack is given to you
4. Possible side effects
5. How to store Marcain Polyamp Steripack
6. Contents of the pack and other information

You must not be given Marcain Polyamp Steripack:

• If you are allergic to bupivacaine hydrochloride or any of the other ingredients of this medicine (listed in section 6).
• If you are allergic to any other local anaesthetics of the same class (such as lidocaine or ropivacaine).
• If you have a skin infection near to where the injection will be given.
• If you have something called cardiogenic shock (a condition where the heart is unable to supply enough blood to the body).
• If you have something called hypovolaemic shock (very low blood pressure leading to collapse).
• If you have problems with clotting of your blood.
• If you have diseases of the brain or spine such as meningitis, polio or spondylitis.
• If you have a severe headache caused by bleeding inside the head (intracranial haemorrhage).
• If you have problems with your spinal cord due to anaemia.
• If you have blood poisoning (septicaemia).
• If you have had a recent trauma, tuberculosis or tumours of the spine.

You must not be given Marcain Polyamp Steripack if any of the above apply to you. If you are not sure, talk to your doctor or nurse before you are given Marcain Polyamp Steripack.

Warnings and precautions

Talk to your doctor or nurse before having Marcain Polyamp Steripack:

• If you have heart, kidney or liver problems. This is because your doctor may need to adjust the dose of Marcain Polyamp Steripack.
• If you have a swollen stomach due to more fluid than normal.
• If you have a stomach tumour.
• If you have been told that you have decreased volume of blood (hypovolaemia).
• If you have fluid in your lungs.

Children

• In children aged less than 12 years as some injections of Marcain Polyamp Steripack in order to numb parts of the body during surgery are not established in younger children. The use of Marcain Polyamp Steripack is not established in children less than 1 year of age.

If you are not sure if any of the above apply to you, talk to your doctor or nurse before you are given Marcain Polyamp Steripack.

Other medicines and Marcain Polyamp Steripack

Tell your doctor if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because Marcain Polyamp Steripack can affect the way some medicines work and some medicines can have an effect on Marcain Polyamp Steripack.

In particular, tell your doctor if you are taking any of the following medicines:

• Medicines used to treat an uneven heart beat (arrhythmia) such as lidocaine, mexiletine or amiodarone.
• Medicines used to stop blood clots (anti-coagulants).

Your doctor needs to know about these medicines to be able to work out the correct dose of Marcain Polyamp Steripack for you.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think that you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Driving and using machines

Marcain Polyamp Steripack may make you feel sleepy and affect the speed of your reactions. After you have been given Marcain Polyamp Steripack, you should not drive or use tools or machines until the next day.

Marcain Polyamp Steripack contains sodium

Marcain Polyamp Steripack contains up to 3.15 milligrams (mg) of sodium in each millilitre (ml), equivalent to 31.4 mg per 10 ml ampoule. Your doctor will take this into account if you are on a sodium controlled diet.

If you have been given too much Marcain Polyamp Steripack

Serious side effects from getting too much Marcain Polyamp Steripack are unlikely. They need special treatment and the doctor treating you is trained to deal with these situations. The first signs of being given too much Marcain Polyamp Steripack are usually as follows:

• Feeling dizzy or light-headed
• Numbness of the lips and around the mouth.
• Numbness of the tongue.
• Hearing problems.
• Problems with your sight (vision).

To reduce the risk of serious side effects, your doctor will stop giving you Marcain Polyamp Steripack as soon as these signs appear. This means that if any of these happen to you, or you think you have received too much Marcain Polyamp Steripack, tell your doctor immediately.

More serious side effects from being given too much Marcain Polyamp Steripack include twitching of your muscles, fits (seizures), and loss of consciousness.

Other possible side effects:

Very common (may affect more than 1 in 10 people)

• Low blood pressure. This might make you feel dizzy or light-headed.
• Feeling sick (nausea).

Common (may affect up to 1 in 10 people)

• Being sick (vomiting).
• Feeling dizzy.
• Pins and needles.
• High blood pressure (hypertension).
• Slow heart beat.
• Problems passing water.

Uncommon (may affect up to 1 in 100 people)

• Feeling light-headed.
• Fits (seizures).
• Numbness of the tongue or around the mouth.
• Ringing in the ears or being sensitive to sound.
• Difficulty speaking.
• Blurred sight (vision).
• Loss of consciousness.
• Shaking (tremors).
• Twitching of your muscles.

Rare (may affect up to 1 in 1,000 people)

• Double vision.
• Nerve damage that may cause changes in sensation or muscle weakness (neuropathy). This may include peripheral nerve damage.
• A condition called arachnoiditis (inflammation of the membrane that surrounds the spinal cord). The signs include a stinging or burning pain in the lower back or legs and tingling, numbness or weakness in the legs.
• Weak or paralysed legs.
• Uneven heart beat (arrhythmias). This could be life-threatening.
• Slowed or stopped breathing or stopped heart beat. This could be life-threatening.

Possible side effects seen with other local anaesthetics which might also be caused by Marcain Polyamp Steripack include:

• Problems with your liver enzymes. This may happen if you have long-term treatment with this medicine.
• Damaged nerves. Rarely this may cause permanent problems.
• Blindness which is not permanent or problems with the muscles of the eyes that are long-lasting. This may happen with some injections given around the eyes.

Do not be concerned by this list of possible side effects. You may not get any of them.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

What Marcain Polyamp Steripack contains

The active ingredient is bupivacaine hydrochloride. Marcain Polyamp Steripack comes in two strengths: 2.5 mg or 5 mg of bupivacaine hydrochloride per ml of solution.

The other ingredients are sodium chloride, sodium hydroxide, hydrochloric acid and water for injections.

What Marcain Polyamp Steripack looks like and contents of the pack

Marcain Polyamp Steripack is a solution for injection. It comes in 10 ml or 20 ml plastic ampoules in cartons of 5 or 10. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

The Marketing Authorisations for Marcain Polyamp Steripack 0.25% and 0.5% are held by

Marcain Polyamp Steripack 0.25% and 0.5% is manufactured by

and

To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge:

0800 198 5000 (UK only)

Please be ready to give the following information:

Product name Reference number

Marcain Polyamp Steripack 0.25% 39699/0078

Marcain Polyamp Steripack 0.5% 39699/0079

This is a service provided by the Royal National Institute of Blind People.