What the FDA labels say about taking them together

Bupivacaine and ropivacaine

Bupivacaine's FDA label of April 14, 2026 names ropivacaine in its drug interactions section, and ropivacaine's label names bupivacaine too. The ropivacaine label: “Historically, pregnant patients were reported to have a high risk for cardiac arrhythmias, cardiac/circulatory arrest and death when 0.75% bupivacaine was inadvertently rapidly injected intravenously.”

Check it at the source: the bupivacaine FDA label on DailyMed (effective April 14, 2026, Hospira, Inc.); the ropivacaine FDA label on DailyMed (effective August 6, 2024, Fresenius Kabi USA, LLC).

What does the bupivacaine label say about ropivacaine?

Bupivacaine label, drug interactions
Class: Local anesthetics; Examples: articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine

Source: FDA drug label (BUPIVACAINE HYDROCHLORIDE), Hospira, Inc., effective April 14, 2026 (SPL set bb44c7e1-d911-4788-908f-09b7b271969b), via openFDA; the full label on DailyMed

What does the ropivacaine label say about bupivacaine?

Ropivacaine label, drug interactions
Class: Local anesthetics; Examples: articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine

Ropivacaine label, warnings and precautions
Historically, pregnant patients were reported to have a high risk for cardiac arrhythmias, cardiac/circulatory arrest and death when 0.75% bupivacaine (another member of the amino amide class of local anesthetics) was inadvertently rapidly injected intravenously.

Source: FDA drug label (Naropin), Fresenius Kabi USA, LLC, effective August 6, 2024 (SPL set 23d2d448-a744-4877-9f2d-7e57c198da89), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

26Bupivacaine generic labelers

18Ropivacaine generic labelers

	Bupivacaine	Ropivacaine
Labeled for	n/a	Pain
Boxed warning	Yes	No
Pharmacy cost (NADAC)	$0.086 per mL 0.5% vial	n/a
Shortage now	In shortage	In shortage

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?

Bupivacaine: the full record
Ropivacaine: the full record
Check more medicines together: up to five at once