Exparel

Generic name: Bupivacaine Liposome
Dosage form: injection for infiltration or perineural use
Drug class: Local injectable anesthetics

Usage of Exparel

Exparel (Bupivacaine) is an anesthetic (numbing medicine) that is used after surgery to provide:

Local analgesia (pain relief in a small area) via infiltration for adults and children aged 6 and older

Regional analgesia (pain relief in a larger area) in adults via:

An interscalene brachial plexus nerve block

A sciatic nerve block in the popliteal fossa

An adductor canal block.

Exparel contains the local anesthetic bupivacaine that works to produce postsurgical analgesia by blocking the generation and the conduction of nerve impulses. Exparel uses the DepoFoam® proprietary multivesicular liposome (pMVL) technology to deliver bupivacaine for an extended period, providing analgesia for up to 72 hours after a single dose.

Exparel was first FDA-approved on October 28, 2011.

Before taking Exparel

You should not be treated with Exparel if you are allergic to bupivacaine.

Before receiving Exparel, tell your doctor if you have had:

an allergic reaction to any type of numbing medicine

liver disease

kidney disease

heart disease

a heart rhythm disorder or

seizures.

May cause fetal harm. Tell your doctor if you are pregnant.

It may not be safe to breastfeed a baby while you are using this medicine. Ask your doctor about any risks.

Relate drugs

How to use Exparel

Exparel is given as an injection placed into an area near your surgical incision. You will receive this injection in a hospital or surgical setting.

See full prescribing information for dosage information.

For local infiltration, the maximum recommended dosage in adults is 266mg.

For local infiltration, the maximum recommended dosage in children aged 6 years to 17 years is 4mg/kg up to a maximum of 266mg.

For interscalene brachial plexus nerve block, the maximum recommended dosage in adults is 133mg

For sciatic nerve block in the popliteal fossa, the maximum recommended dosage in adults is 133mg

For adductor canal block, the maximum recommended dosage in adults is 133mg (10mL) admixed with 50 mg (10 mL) 0.5% bupivacaine HCl, for a total volume of 20 mL.

For nerve blocks, additional analgesics, including immediate-release local anesthetics, may be administered.

Exparel can have long-lasting or delayed effects. For at least 4 days (96 hours) after your surgery, tell any doctor or dentist who treats you that you recently received an Exparel injection.

Warnings

Do not use for obstetrical paracervical block anesthesia. The safety and effectiveness of Exparel have not been established for postsurgical regional analgesia via other nerve blocks besides the ones approved above.

Your healthcare provider will monitor your cardiovascular status, neurological status, and vital signs during and after injection of Exparel. Call your doctor if you have joint pain or stiffness, or weakness in any part of your body that occurs after your surgery, even months later.

Should be used cautiously in people with liver disease because Exparel is metabolized by the liver. Patients with severe hepatic disease are at a greater risk of developing toxic plasma concentrations.

Cases of methemoglobinemia (a rare blood disorder that affects how red blood cells deliver oxygen throughout your body) have been reported in association with local anesthetic use. Seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue-colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue.

Avoid using other local anesthetics within 96 hours of Exparel.

Because of the liposomal formulation, Exparel is not substitutable with other bupivacaine products even if the strength is the same.

You may still feel numb or be unable to move the numbed area for up to 5 days after you are treated with Exparel.

What other drugs will affect Exparel

Other drugs may interact with Exparel, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using including:

Lidocaine or other non-bupivacaine local anesthetics: Do not mix. Exparel may be administered at least 20 minutes or more following local administration of lidocaine

Bupivacaine HCl: Do not exceed a milligram dose of bupivacaine HCl solution to Exparel of 1:2 when admixing, as this may impact the pharmacokinetics and/or physicochemical properties of the drugs.

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