Reactions to Vivacaine® are characteristic of those used with other amide-type local anesthetics. A major cause of reactions to this group of drugs is excessive plasma levels, which may be due to overdosage, inadvertent intravascular injection or slow metabolic degradation. Vivacaine® is contraindicated in patients with a known hypersensitivity to it or any local anesthetic agent of the amide type or to other components of Vivacaine® solutions. Local anesthetics should be employed only by clinicians who are well versed in diagnosis and management of dose-related toxicity and other acute emergencies which might arise from the block to be employed, and then only after insuring the immediate availability of oxygen, other resuscitative drugs, cardiopulmonary resuscitative equipment, an the personnel resources needed for proper management of toxic reactions and related emergencies. Vivacaine® contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. Please seen the Package Insert for prescribing information.