Uses
What is Exparel used for?
Exparel (bupivacaine) is commonly used to relieve pain after you have surgery. It is used as either a local anesthetic or a nerve block to numb part of your body.
Exparel may also be used for other conditions as determined by your healthcare provider.
How does Exparel work (mechanism of action)?
Exparel works by temporarily blocking nerve signals that cause you to feel pain.
How is Exparel supplied (dosage forms)?
Exparel is available in a form that is given by a healthcare provider.
How should I store Exparel?
Exparel is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.
Side Effects
What are the most common side effects of Exparel?
The most common side effects of Exparel are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Nausea or vomiting
- Constipation
- Fever
- Headache
- Low blood pressure
- Anemia (low levels of red blood cells)
- Muscle twitching
- Blurred vision
- Itching
- Fast heartbeat
There may be other side effects of Exparel that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Exparel?
While less common, the most serious side effects of Exparel are described below, along with what to do if they happen.
Severe Allergic Reactions. Exparel may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Whole-Body Reaction to Local Anesthesia. Exparel may rarely cause a whole-body (systemic) reaction that affects your heart and brain (central nervous system). Some people may have a higher risk of this, including those with heart, liver, or kidney problems. Your healthcare provider will monitor your heart and breathing when you receive Exparel. Get help right away if you have any of the following symptoms.
- Drowsiness
- Trouble breathing
- Confusion
- Restlessness or anxiety
- Trouble speaking
- Feeling lightheaded or dizzy
- Tingling or numbness of your mouth and lips
- A metallic taste in your mouth
- Ringing in your ears
- Blurred vision
- Tremors
- Loss of consciousness
Methemoglobinemia. Exparel can cause a serious blood disorder called methemoglobinemia. Hemoglobin is a protein that normally carries oxygen in your blood. Methemoglobinemia is when you have too much of a form of hemoglobin called methemoglobin. If you have methemoglobinemia, it is harder for your body to deliver oxygen to your tissues. Get help right away if you have any of the following symptoms of methemoglobinemia.
- Changes in the color of your skin, including pale, gray, or blue colored skin (cyanosis)
- Headache
- Fast heartbeat
- Shortness of breath
- Feeling lightheaded
- Tiredness or weakness
Warnings & Precautions
Who should not use Exparel?
Allergies to Ingredients. People who are allergic to any of the following should not use Exparel.
- Exparel
- Bupivacaine
- Any of the ingredients in the specific product dispensed
Your healthcare provider can tell you all of the ingredients in Exparel.
Labor or Delivery. Exparel should not be given during labor or delivery as a specific type of anesthesia called obstetrical paracervical block anesthesia. Receiving Exparel during this time may cause harm to an unborn baby or problems during delivery.
What should I know about Exparel before using it?
Exparel is usually given by a healthcare provider in a hospital or clinic.
Exparel may cause you to temporarily lose sensation or the ability to move the part of your body near the surgical site. The effects can last for up to 5 days after you are given Exparel. Call your healthcare provider if you have any concerns.
Do not use any other medicine called a local anesthetic, such as lidocaine or benzocaine, within 4 days (96 hours) after receiving Exparel. These medicines can be found in some over-the-counter (OTC) or prescription products used to treat certain types of pain.
What should I tell my healthcare provider before using Exparel?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Exparel is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Heart problems
- Liver problems
- Kidney problems
- Lung problems
- Methemoglobinemia, or family history of methemoglobinemia
- A genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency
Other Medicines and Supplements. Exparel may interact with other medicines and supplements. Before using Exparel, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. Exparel may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. Exparel passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
How can I get more information about Exparel?
For more information about Exparel, you can visit the manufacturer’s website at www.exparel.com or call them at 855-RX-EXPAREL (855-793-9727).
Interactions
Does Exparel interact with foods or drinks?
There are no known interactions between Exparel and foods or drinks.
It is unknown if drinking alcohol will affect Exparel.
Does Exparel interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using Exparel.
- Any other local anesthetic, such as lidocaine, benzocaine, or prilocaine
- A nitrate, such as Isordil, Nitro-Dur, NitroMist, or Nitrostat, which is a medicine used to prevent chest pain caused by a type of heart disease
- A medicine used to treat cancer, such as cyclophosphamide, flutamide, hydroxyurea, ifosfamide, or rasburicase
- An antibiotic used to treat infections, such as dapsone, nitrofurantoin (Furadantin, Macrobid, Macrodantin), aminosalicylic acid (Paser), or a sulfonamide, such as sulfamethoxazole
- A medicine for malaria, such as chloroquine, primaquine, or quinine
- A medicine used for seizures, such as phenobarbital, phenytoin (Dilantin, Phenytek, and others), or divalproex sodium, valproic acid, or valproate sodium (Depakote and others)
- Acetaminophen (Tylenol), which is a medicine used for pain or fever
- Metoclopramide (Reglan and others), which is a medicine used for certain stomach problems
- Sulfasalazine (Azulfidine), which is a medicine used for certain inflammatory conditions, such as ulcerative colitis or rheumatoid arthritis
This may not be a complete list of medicines that can interact with Exparel. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Exparel?
If you or someone else has used too much Exparel, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Exparel?
Exparel is usually given by a healthcare provider in a hospital or clinic. Your healthcare provider will make sure you are receiving Exparel appropriately.
Are you currently using Exparel (bupivacaine)?
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