Local anaesthetics (bupivacaine, lidocaine and others)
Numbing medicines used at the dentist, in surgery and before needles. Their US labels say people with G6PD deficiency are more likely to get a blood problem called methaemoglobinaemia.
What this drug connects to
Solid lines are connections this site curates. Dashed lines mean the two ends share a research paper — worth knowing, and not a claim that one explains the other.
The genes involved
Numbing medicines such as bupivacaine (Marcaine) and lidocaine can cause methaemoglobinaemia, in which blood carries less oxygen and the skin can look bluish. The Marcaine label says people with G6PD deficiency, or with inherited methaemoglobinaemia, are more likely to show it, and that if a local anaesthetic must be used they should be watched closely. Telling the dentist or surgeon is enough to make that happen.
US prescribing information for MARCAINE (bupivacaine hydrochloride), revised July 2023, section 5.3, Methemoglobinemia; the FDA Table of Pharmacogenomic Biomarkers lists the same row for the other local anaesthetics. A label warning, not the CPIC guideline.
Variants MyGeneLog™ reports for these genes
These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.
Glycated hemoglobin levels
G6PD · rs72554664
Read more →Total cholesterol levels
G6PD · rs762517
Read more →G6PD deficiency (G6PD A-)
G6PD · rs1050828
Read more →G6PD deficiency (G6PD A+ / A- component)
G6PD · rs1050829
Read more →Systemic lupus erythematosus
G6PD · rs5945199
Read more →Hemoglobin levels
G6PD · rs5030868
Read more →Questions about Local anaesthetics (bupivacaine, lidocaine and others)
What are local anaesthetics?
They are numbing medicines: bupivacaine (Marcaine), lidocaine, ropivacaine and others, given as injections at the dentist or in surgery, or as creams before a needle.
What is methaemoglobinaemia?
It is when too much of the blood's haemoglobin is changed into a form that cannot carry oxygen. The label describes the sign as a bluish skin colour or abnormally coloured blood.
What does G6PD deficiency have to do with it?
The Marcaine label says people with G6PD deficiency, or with inherited methaemoglobinaemia, are more likely to show it. If a local anaesthetic must be used, it asks for close watching for the signs. The FDA lists the same warning for the other local anaesthetics.
Should I tell the dentist?
Yes. If you know you have G6PD deficiency, tell the dentist or surgeon before a numbing injection or cream. It does not usually mean you cannot have one; it means they will watch you more closely.
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Local anaesthetics (bupivacaine, lidocaine and others). MyGeneLog™. https://www.mygenelog.com/drugs/local-anaesthetics