2. clinical information
  3. dosing

NAROPIN dosing information1

Effective NAROPIN dosing for surgical anesthesia, labor pain, and postoperative pain management.

SURGICAL ANESTHESIA

Lumbar Epidural Administration
 
CONC.
MG/ML (%)		 VOLUME
ML		 DOSE
MG		 ONSET
MIN		 DURATION
HOURS
Surgery
5 (0.5%) 15–30 75–150 15–30 2–4
7.5 (0.75%) 15–25 11–188 10–20 3–5
10 (1%) 15–20 150–200 10–20 4–6
Lumbar Epidural Administration
Caesarean Section
5 (0.5%) 20–30 100–150 15–25 2–4
7.5 (0.75%) 15–20 113–150 10–20 3–5
Thoracic Epidural Administration
Surgery
5 (0.5%) 5–15 25–75 10–20 n/a*
7.5 (0.75%) 5–15 38–113 10–20 n/a*
Major Nerve Block†
(eg, brachial plexus block)
5 (0.5%) 35–50 175–250 15–30 5–8
7.5 (0.75%) 10–40 75–300 10–25 6–10
Field Block
(eg, minor nerve blocks and infiltration)
5 (0.5%) 1–40 5–200 1–15 2–6

LABOR & DELIVERY

Lumbar Epidural Administration
 
CONC.
MG/ML (%)		 VOLUME
ML		 DOSE
MG		 ONSET
MIN		 DURATION
HOURS
Initial Dose
2 (0.2%) 10–20 20–40 mg/h 10–15 0.5–1.5
Continuous Infusion‡
2 (0.2%) 6–14 mL/h 12–28 mg/h n/a* n/a*
Incremental Injections (top-up)‡
2 (0.2%) 10–15 mL/h 20–30 mg/h n/a* n/a*

ACUTE PAIN MANAGEMENT

Post-Operative Pain Management
Lumbar Epidural Administration
 
CONC.
MG/ML (%)		 VOLUME
ML		 DOSE
MG		 ONSET
MIN		 DURATION
HOURS
Continuous Infusion§
2 (0.2%) 6–14 mL/h 12–28 mg/h n/a* n/a*
Thoracic Epidural Administration
Continuous Infusion§
2 (0.2%) 6–14 mL/h 12–28 mg/h n/a* n/a*
Infiltration
(eg, minor nerve block)
2 (0.2%) 1–100 2–200 1–5 2–6
5 (0.5%) 1–40 5–200 1–5 2–6

*Not Applicable.

†The dose for a major nerve block must be adjusted according to site of administration and patient status. Supraclavicular brachial plexus block may be associated with a higher frequency of serious adverse reactions, regardless of the local anesthetic used (SEE PRECAUTIONS).

‡Median dose 21 mg per hour was administered by continuous infusion or by incremental injections (top-ups) over a median delivery time of 5.5 hours.

§Cumulative doses up to 770 mg of NAROPIN over 24 hours (intraoperative block plus postoperative infusion). Continuous epidural infusion at rates up to 28 mg per hour for 72 hours have been well tolerated in adults; ie, 2016 mg plus surgical dose of approximately 100–150 mg as top-up.

Reference

1. NAROPIN Prescribing Information.

Important Safety Information

Using NAROPIN beyond recommended doses to increase motor block or duration of sensory block may negate its favorable cardiovascular advantages, in the event that an inadvertent intravascular injection occurs. NAROPIN may be associated with adverse reactions which are characteristic of those associated with other amide-type local anesthetics.1 In clinical trials, side effects were mild and transient and may reflect the procedures, patient health status, and/or other medications used. Adverse events reported at a rate of ≥5%: hypotension, nausea, vomiting, bradycardia, fever, pain, postoperative complications, anemia, paresthesia, headache, pruritus, and back pain.

There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. NAROPIN is not approved for this use.

Please see Full Prescribing Information.

1. NAROPIN Prescribing Information Data on file.

NAROPIN is indicated for the production of local or regional anesthesia for surgery and acute pain management.

NAROPIN and logo are registered trademarks of Fresenius Kabi USA, LLC. ©2015, Fresenius Kabi USA, LLC. All Rights Reserved.