Mepivacaine
Also known as: Intra-epicaine · Mepivacaine hydrochloride · Mepivacainum
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Local or perineural blockade | Inject the minimal volume required to achieve an effect | Local/Perineural | Single dose | 100-120 min | 🌍 EU |
| Intra-articular analgesia (e.g., prior to arthroscopy) | 2 mg/kg of the 2% solution | Intra-articular | Single dose | 100-120 min | 🌍 EU |
- Local or perineural blockade: Toxic doses have not been established in companion animals.
- Intra-articular analgesia (e.g., prior to arthroscopy): Injected into the elbow joint prior to arthroscopy; found to decrease the haemodynamic response to surgery.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Local or perineural blockade | Inject the minimal volume required to achieve an effect | Local/Perineural | Single dose | 100-120 min | 🌍 EU |
- Local or perineural blockade: Toxic doses have not been established in companion animals.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Mepivacaine is an amide-type local anesthetic used for perineural blockade, local infiltration, and intra-articular analgesia.
Key Clinical Features:
- It has less intrinsic vasodilator activity than lidocaine and is considered less irritant to tissues.
- It possesses equivalent potency to lidocaine but has a slightly longer duration of action (100-120 minutes).
- Unlike some other local anesthetics, it does not require the addition of adrenaline (epinephrine) to prolong its effect.
Clinical Warning: Mepivacaine must never be injected intravenously. Inadvertent IV injection can lead to severe systemic toxicity, including convulsions and cardiac arrest.
Mechanism of action
Local anesthetic action is dependent on the reversible blockade of the voltage-gated sodium channels → prevents the influx of sodium ions → prevents the propagation of an action potential along the nerve fiber.
Sensory nerve fibers are blocked before motor nerve fibers, allowing a selective sensory blockade at low doses.
Safety & warnings
Contraindications
- Intravenous (IV) injection
Adverse effects
- Convulsions (associated with inadvertent IV injection or overdose)
- Cardiac arrest (associated with inadvertent IV injection or overdose)
Precautions
Strictly avoid intravenous injection. Inadvertent IV administration may cause severe central nervous system and cardiovascular toxicity.
Clinical Pearl: Toxic doses of mepivacaine have not been definitively established in companion animals; therefore, always use the minimal effective volume and carefully calculate maximum safe doses based on general amide local anesthetic guidelines.
Monitoring
- Heart rate and rhythm (ECG)
- Blood pressure
- Neurological status (monitor for signs of toxicity such as muscle twitching or seizures)
Pharmacokinetics
Half-life
Absorption
Rapidly absorbed from the site of local injection. Rate depends on vascularity of the tissue.
Distribution
Distributes to all body tissues; crosses the blood-brain barrier and placenta.
Metabolism
Hepatic metabolism (amide-type local anesthetic).
Elimination
Excreted primarily via the kidneys as metabolites.
Overdose
Toxic doses of mepivacaine have not been established in companion animals. Inadvertent intravenous injection or massive overdose may cause severe systemic toxicity, manifesting as convulsions and/or cardiac arrest. Treatment is supportive and symptomatic (e.g., seizure control, cardiovascular support, potentially intravenous lipid emulsion therapy).
Available products
Formulations
- Injectable: 2% solution
Veterinary
- Intra-epicaine 2% solution (Authorized for horses in the UK/EU)
Regulatory status
Authorized primarily for horses; used off-label in companion animals.
POM-V (Prescription Only Medicine - Veterinarian)
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Normal precautions should be observed. Store according to manufacturer guidelines, typically at room temperature and protected from light.
Client information
Mepivacaine is a local anesthetic used by your veterinarian to numb specific areas, such as joints or nerves, usually during surgery or diagnostic procedures. It is administered in the clinic. Monitor your pet for any signs of discomfort, unusual behavior, or weakness after returning home, and contact your veterinarian if you have any concerns.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.