bupivacaine + fentanyl citrate at a glance
Medicine class
Amide local anaesthetic plus opioid analgesic
Licensed uses
Maintaining epidural pain relief after surgery and during labour
Administration
Continuous epidural infusion under the supervision of clinicians experienced in regional anaesthesia
Monitoring
Breathing, alertness, blood pressure, pulse, pain relief, numbness and weakness are monitored
What is bupivacaine + fentanyl citrate used for?
This formulation is licensed for continuous epidural use to maintain analgesia in adults.
Maintaining pain relief after surgery
Maintaining epidural pain relief during labour
How does bupivacaine + fentanyl citrate work?
Bupivacaine blocks pain-signal conduction near the spinal nerves. Fentanyl activates opioid receptors and strengthens the epidural pain relief.
How to take bupivacaine + fentanyl citrate
A trained clinician gives this through an epidural catheter and infusion pump in hospital. It is not swallowed or self-injected. Report inadequate pain relief, increasing weakness, breathing difficulty, marked drowsiness or unusual sensations promptly.
For continuous epidural infusion only; not for intravenous use or bolus injection.
Food does not affect administration.
Use a patient-controlled epidural button only as instructed by the clinical team.
bupivacaine + fentanyl citrate side effects
Common or expected effects
- Low blood pressure, sometimes with nausea or light-headedness
- Nausea or vomiting
- Dizziness, drowsiness, sedation or confusion
- Tingling or altered sensation
- Slow or fast heartbeat
- Difficulty passing urine
- Itching
- Heavy or weak legs
Get urgent medical advice
- Slow or stopped breathing, severe drowsiness or loss of consciousness
- Seizures or signs of local-anaesthetic toxicity
- Severe bradycardia, abnormal heart rhythm, cardiovascular collapse or cardiac arrest
- Severe allergic reaction, bronchospasm or anaphylaxis
- Persistent or worsening loss of movement, sensation, or bladder or bowel control
bupivacaine + fentanyl citrate in pregnancy
This combination is licensed to maintain epidural analgesia during labour, with maternal and fetal monitoring. Fentanyl around delivery can depress the newborn’s breathing, so neonatal support must be available. Repeated or prolonged opioid exposure can cause neonatal withdrawal. Use at other stages of pregnancy requires specialist assessment.
bupivacaine + fentanyl citrate while breastfeeding
The product information advises against use in nursing women because fentanyl enters breast milk and may depress an infant’s breathing. UK specialist guidance considers short-term epidural fentanyl compatible with breastfeeding with infant monitoring. The maternity or anaesthetic team should assess your situation. Seek urgent help if the baby becomes unusually sleepy or has breathing difficulty.
bupivacaine + fentanyl citrate interactions
The clinical team should review prescription, non-prescription and recreational substances before starting the epidural.
Benzodiazepines and other sedatives
Sedation and respiratory depression can increase, potentially causing coma or death.
Other opioids, general anaesthetics, barbiturates, neuroleptics, gabapentin or pregabalin
Central nervous system and breathing suppression may increase or last longer.
Alcohol
May increase fentanyl-related sedation and respiratory depression; acute alcoholism is a contraindication.
Common questions about bupivacaine + fentanyl citrate
Answers are fully visible for fast scanning and source review.
What is bupivacaine + fentanyl citrate used for?
It maintains epidural pain relief after surgery or during labour.
How is it given?
A trained clinician gives it continuously through an epidural catheter and pump in hospital.
Can it be injected into a vein?
No. This formulation is for epidural infusion only, not intravenous or bolus administration.
Can it make my legs feel heavy?
Yes. Epidural local anaesthetic can cause temporary heaviness, numbness or weakness, which staff monitor before you move or walk.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.