Exparel

Exparel is an injectable anesthetic used to prevent and decrease pain after surgery. Exparel can cause temporary loss of sensation or motor activity in the area of the body where it is injected.

Exparel Overview

Reviewed: October 31, 2014
Updated: 

Exparel is a prescription medication used to prevent post-surgical pain.

Exparel belongs to groups of drugs called local and regional anesthetics. These work by blocking the generation of nerve impulses that cause pain.

Exparel is a version of bupivacaine that is encapsulated in a fat delivery (liposomal) system that breaks down slowly in the body, which allows the extended release of the anesthetic over 48 to 96 hours.

This medication is available in an injectable form to be given directly into the surgical site (infiltration) or a general area (nerve block) by a healthcare professional as a one time dose. 

Common side effects of Exparel include nausea, constipation, and vomiting.

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Exparel Cautionary Labels

precautions

Uses of Exparel

Exparel is a prescription medication used to control pain after surgery. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Manufacturer

Exparel Drug Class

Exparel is part of the drug class:

Side Effects of Exparel

Serious side effects have been reported with Exparel. See the “Exparel Precautions” section.

Common side effects of Exparel include the following:

  • Nausea
  • Constipation
  • Vomiting
  • Chills

This is not a complete list of Exparel side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Exparel Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • Lidocaine or other non-bupivacaine anesthetics. Exparel may be given at least 20 minutes or more following local administration of lidocaine. Avoid additional use of local anesthetics within 96 hours following Exparel.

This is not a complete list of Exparel drug interactions. Ask your doctor or pharmacist for more information.

Exparel Precautions

Serious side effects have been reported with Exparel including the following:

  • Central nervous system reactions. Tell your healthcare provider right away if you have some or all of the following symptoms of central nervous system reactions.
    • Restlessness, anxiety, dizziness, ringing in the ears, blurred vision, or tremors
    • Depression
    • Drowsiness or loss of consciousness
    • Nausea, vomiting, chills, or constriction of the pupils
  • Cardiovascular system reactions. Tell your healthcare provider right away if you have some or all of the following symptoms of cardiovascular system reactions.
    • Decreased blood pressure
    • Decreased heart rate
    • Ventricular arrhythmias
    • Cardiac arrest
  • Allergic-type reactions. Tell your healthcare provider right away if you have some or all of the following symptoms of allergic-type reactions.
    • Itching, hives, and redness
    • Swelling of the throat or face
    • Increased heart rate
    • Sneezing
    • Nausea
    • Vomiting
    • Dizziness
    • Loss of consciousness
    • Excessive sweating
    • Elevated temperature or fever
  • Neurologic reactions. Tell your healthcare provider right away if you have some or all of the following symptoms of neurologic reactions.
    • Decreased heart rate
    • Urinary retention
    • Fecal and urinary incontinence
    • Persistent anesthesia
    • Tingling in the extremities
    • Weakness
    • Paralysis of the lower extremities
    • Headache
    • Backache
    • Septic meningitis

This medication can cause drowsiness, dizziness, and blurred vision. Do not drive or operate heavy machinery until you know how this medication affects you.

Do not take Exparel if you are allergic to Exparel or to any of its ingredients. 

This injection is contraindicated in obstetrical paracervical block anesthesia.

Exparel Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of bupivacaine, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before receiving Exparel, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are allergic to Exparel or to any of its ingredients
  • have or have had liver problems
  • have or have had heart problems
  • are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Exparel and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Exparel and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

This medication has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from Exparel, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Exparel Usage

Receive Exparel exactly as prescribed.

This medication is available in an injectable form to be administered by injection via local infiltration or peripheral nerve block by a healthcare professional. The dose, frequency, and route of administration will vary, depending on the indication for use.

Exparel Dosage

Take this medication exactly as prescribed by your doctor. 

The dose your doctor recommends may be based on the following:

  • the condition being treated
  • other medical conditions you have
  • other medications you are taking
  • how you respond to this medication
  • your weight
  • size of the surgical site

The dose, frequency, and route of administration will vary, depending on the indication for use.

Exparel Overdose

Since this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

  • Local and regional anesthetics, including interscalene brachial plexus nerve block, should only be administered by clinicians who are experienced in the diagnosis and management of dose-related toxicity and acute emergencies that might arise from the agent being used.
  • Emergency resuscitative equipment and personnel should be available when local anesthetics are administered.