Mepivacaine hydrochloride is available in 1% to 3% solutions and is indicated for infiltration anesthesia, dental procedures, peripheral nerve block, or epidural block. The onset of anesthesia is rapid, ranging from about 3 to 20 minutes for sensory block. Mepivacaine is rapidly metabolized in the liver with 50% of the administered dose excreted into the bile as metabolites. The metabolites are reabsorbed in the intestine and excreted in the kidney with only a small percentage found in the feces. Less than 5% to 10% of the administered dose is found unchanged in the urine. The primary metabolic products are the N-demethylated metabolite and the 3 and 4 phenolic metabolites excreted as their glucuronide conjugates.
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