Peringatan Keamanan

LD50: 5.1mg/kg in rabbit, intravenous; 18mg/kg in rabbit, oral; 207mg/kg in rabbit, parenteral; 63mg/kg in rat, subcutaneous (Archives Internationales de Pharmacodynamie et de Therapie. Vol. 200, Pg. 359, 1972.) Levobupivacaine appears to cause less myocardial depression than both bupivacaine and ropivacaine, despite being in higher concentrations.

Levobupivacaine

DB01002

small molecule approved investigational

Deskripsi

Levobupivacaine is an amino-amide local anaesthetic drug belonging to the family of n-alkylsubstituted
pipecoloxylidide. It is the S-enantiomer of bupivacaine. Levobupivacaine hydrochloride is commonly marketed by AstraZeneca under the trade name Chirocaine. In particular, the specific levobupivacaine enantiomer is a worthwhile pursuit because it demonstrates less vasodilation and possesses a greater length of action in comparison to bupivacaine. It is approximately 13 per cent less potent (by molarity) than racemic bupivacaine.Levobupivacaine is indicated for local anaesthesia including infiltration, nerve block, ophthalmic, epidural and intrathecal anaesthesia in adults; and infiltration analgesia in children. When administered appropriately, the occurrence of adverse effects is not anticipated much if at all. In general, the majority of potential adverse effects are predominantly associated with inappropriate administration methods that may cause systemic exposure and/or toxicity associated with overexposure to an anesthetic. Regardless, allergic reactions may also occur - although only rarely.

Struktur Molekul 2D

Berat 288.4277
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) 3.3 hours
Volume Distribusi 66.91 ±18.23 L [after intravenous administration of 40 mg in healthy volunteers]
Klirens (Clearance) 39.06 ±13.29 L/h [after intravenous administration of 40 mg in healthy volunteers]

Absorpsi

The plasma concentration of levobupivacaine following therapeutic administration depends on dose and also on route of administration, because absorption from the site of administration is affected by the vascularity of the tissue. Peak levels in blood were reached approximately 30 minutes after epidural administration, and doses up to 150 mg resulted in mean Cmax levels of up to 1.2 µg/mL.

Metabolisme

Levobupivacaine is extensively metabolized with no unchanged levobupivacaine detected in urine or feces. In vitro studies using 14 C levobupivacaine showed that CYP3A4 isoform and CYP1A2 isoform mediate the metabolism of levobupivacaine to desbutyl levobupivacaine and 3-hydroxy levobupivacaine, respectively. In vivo, the 3-hydroxy levobupivacaine appears to undergo further transformation to glucuronide and sulfate conjugates. Metabolic inversion of levobupivacaine to R(+)-bupivacaine was not evident both in vitro and in vivo.

Rute Eliminasi

Following intravenous administration, recovery of the radiolabelled dose of levobupivacaine was essentially quantitative with a mean total of about 95% being recovered in urine and feces in 48 hours. Of this 95%, about 71% was in urine while 24% was in feces.

Interaksi Obat

2330 Data
Duloxetine The risk or severity of orthostatic hypotension and syncope can be increased when Levobupivacaine is combined with Duloxetine.
Levodopa The risk or severity of hypotension and orthostatic hypotension can be increased when Levobupivacaine is combined with Levodopa.
Risperidone Levobupivacaine may increase the hypotensive activities of Risperidone.
Deferasirox The serum concentration of Levobupivacaine can be increased when it is combined with Deferasirox.
Peginterferon alfa-2b The serum concentration of Levobupivacaine can be increased when it is combined with Peginterferon alfa-2b.
Leflunomide The serum concentration of Levobupivacaine can be decreased when it is combined with Leflunomide.
Teriflunomide The serum concentration of Levobupivacaine can be decreased when it is combined with Teriflunomide.
Buprenorphine Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.
Doxylamine Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Dronabinol Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Droperidol Droperidol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Hydrocodone Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.
Hydroxyzine Hydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Magnesium sulfate The therapeutic efficacy of Levobupivacaine can be increased when used in combination with Magnesium sulfate.
Methotrimeprazine Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.
Metyrosine Levobupivacaine may increase the sedative activities of Metyrosine.
Minocycline Minocycline may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Mirtazapine Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.
Nabilone Nabilone may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Orphenadrine Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
Paraldehyde Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
Perampanel Perampanel may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Pramipexole Levobupivacaine may increase the sedative activities of Pramipexole.
Ropinirole Levobupivacaine may increase the sedative activities of Ropinirole.
Rotigotine Levobupivacaine may increase the sedative activities of Rotigotine.
Rufinamide The risk or severity of adverse effects can be increased when Rufinamide is combined with Levobupivacaine.
Sodium oxybate The risk or severity of CNS depression can be increased when Levobupivacaine is combined with Sodium oxybate.
Suvorexant Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.
Tapentadol Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Thalidomide Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
Zolpidem Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.
Methadone The risk or severity of adverse effects can be increased when Methadone is combined with Levobupivacaine.
Abiraterone The serum concentration of Levobupivacaine can be increased when it is combined with Abiraterone.
Nicorandil Nicorandil may increase the hypotensive activities of Levobupivacaine.
Cyproterone acetate The metabolism of Levobupivacaine can be increased when combined with Cyproterone acetate.
Ethanol Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Ethanol.
Azelastine Levobupivacaine may increase the central nervous system depressant (CNS depressant) activities of Azelastine.
Brimonidine Brimonidine may increase the central nervous system depressant (CNS depressant) activities of Levobupivacaine.
Sibutramine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sibutramine.
Milnacipran The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Milnacipran.
Desvenlafaxine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Desvenlafaxine.
Levomilnacipran Levobupivacaine may decrease the excretion rate of Levomilnacipran which could result in a higher serum level.
Citalopram The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Citalopram.
Nefazodone The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Nefazodone.
Trazodone The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Trazodone.
Sertraline The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Sertraline.
Escitalopram The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Escitalopram.
Zimelidine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Zimelidine.
Dapoxetine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Dapoxetine.
Seproxetine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Seproxetine.
Indalpine The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Indalpine.
Ritanserin The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ritanserin.
Alaproclate The risk or severity of adverse effects can be increased when Levobupivacaine is combined with Alaproclate.
Technetium Tc-99m tilmanocept Levobupivacaine may decrease effectiveness of Technetium Tc-99m tilmanocept as a diagnostic agent.
Linezolid The risk or severity of methemoglobinemia can be increased when Linezolid is combined with Levobupivacaine.
Furazolidone Furazolidone may increase the orthostatic hypotensive activities of Levobupivacaine.
Procaine The risk or severity of methemoglobinemia can be increased when Procaine is combined with Levobupivacaine.
Tranylcypromine Tranylcypromine may increase the orthostatic hypotensive activities of Levobupivacaine.
Phenelzine Phenelzine may increase the orthostatic hypotensive activities of Levobupivacaine.
Minaprine Minaprine may increase the orthostatic hypotensive activities of Levobupivacaine.
Selegiline Selegiline may increase the orthostatic hypotensive activities of Levobupivacaine.
Procarbazine The risk or severity of methemoglobinemia can be increased when Procarbazine is combined with Levobupivacaine.
Moclobemide Moclobemide may increase the orthostatic hypotensive activities of Levobupivacaine.
Isocarboxazid Isocarboxazid may increase the orthostatic hypotensive activities of Levobupivacaine.
Rasagiline Rasagiline may increase the orthostatic hypotensive activities of Levobupivacaine.
Pargyline Pargyline may increase the orthostatic hypotensive activities of Levobupivacaine.
Clorgiline Clorgiline may increase the orthostatic hypotensive activities of Levobupivacaine.
Iproniazid Iproniazid may increase the orthostatic hypotensive activities of Levobupivacaine.
Nialamide Nialamide may increase the orthostatic hypotensive activities of Levobupivacaine.
Safinamide Safinamide may increase the orthostatic hypotensive activities of Levobupivacaine.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the orthostatic hypotensive activities of Levobupivacaine.
Methylene blue Methylene blue may increase the orthostatic hypotensive activities of Levobupivacaine.
Hydracarbazine Hydracarbazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Pirlindole Pirlindole may increase the orthostatic hypotensive activities of Levobupivacaine.
Toloxatone Toloxatone may increase the orthostatic hypotensive activities of Levobupivacaine.
Benmoxin Benmoxin may increase the orthostatic hypotensive activities of Levobupivacaine.
Mebanazine Mebanazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Octamoxin Octamoxin may increase the orthostatic hypotensive activities of Levobupivacaine.
Pheniprazine Pheniprazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Phenoxypropazine Phenoxypropazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Pivhydrazine Pivhydrazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Safrazine Safrazine may increase the orthostatic hypotensive activities of Levobupivacaine.
Caroxazone Caroxazone may increase the orthostatic hypotensive activities of Levobupivacaine.
Harmaline Harmaline may increase the orthostatic hypotensive activities of Levobupivacaine.
Brofaromine Brofaromine may increase the orthostatic hypotensive activities of Levobupivacaine.
Benzatropine Benzatropine may decrease the excretion rate of Levobupivacaine which could result in a higher serum level.
Lamotrigine The risk or severity of methemoglobinemia can be increased when Lamotrigine is combined with Levobupivacaine.
Propantheline Propantheline may decrease the excretion rate of Levobupivacaine which could result in a higher serum level.
Dicyclomine Dicyclomine may decrease the excretion rate of Levobupivacaine which could result in a higher serum level.
Tolterodine Levobupivacaine may decrease the excretion rate of Tolterodine which could result in a higher serum level.
Promethazine The risk or severity of CNS depression can be increased when Levobupivacaine is combined with Promethazine.
Doxacurium The risk or severity of CNS depression can be increased when Levobupivacaine is combined with Doxacurium.
Flavoxate Levobupivacaine may decrease the excretion rate of Flavoxate which could result in a higher serum level.
Tiotropium Levobupivacaine may decrease the excretion rate of Tiotropium which could result in a higher serum level.
Fesoterodine Levobupivacaine may decrease the excretion rate of Fesoterodine which could result in a higher serum level.
Aclidinium Levobupivacaine may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Trimebutine Levobupivacaine may decrease the excretion rate of Trimebutine which could result in a higher serum level.
Imidafenacin Levobupivacaine may decrease the excretion rate of Imidafenacin which could result in a higher serum level.
Propiverine Levobupivacaine may decrease the excretion rate of Propiverine which could result in a higher serum level.
Nicardipine The risk or severity of adverse effects can be increased when Nicardipine is combined with Levobupivacaine.

Target Protein

Sodium channel protein type 10 subunit alpha SCN10A

Referensi & Sumber

Synthesis reference: Hooshang Shahriari Zavareh, Graham Anthony Charles Frampton, "Process for preparing levobupivacaine and analogues thereof." U.S. Patent US5777124, issued February, 1985.
Artikel (PubMed)
  • PMID: 18728849
    Burlacu CL, Buggy DJ: Update on local anesthetics: focus on levobupivacaine. Ther Clin Risk Manag. 2008 Apr;4(2):381-92.
  • PMID: 18788503
    Leone S, Di Cianni S, Casati A, Fanelli G: Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed. 2008 Aug;79(2):92-105.

Contoh Produk & Brand

Produk: 0 • International brands: 2
International Brands
  • Chirocaine — Abbott Laboratories
  • Novabupi

Sekuens Gen/Protein (FASTA)

Sekuens dimuat saat dibutuhkan agar halaman tetap ringan.
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