The Medical Letter on Drugs and Therapeutics
Bupivacaine Liposome Injection (Exparel) for Postsurgical Pain
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The FDA has approved a new formulation (Exparel – Pacira) of the local anesthetic bupivacaine (Marcaine, and others) for use in the management of postsurgical pain in adults.

PHARMACOLOGY — The new formulation contains bupivacaine in a suspension of multivesicular liposomes (DepoFoam drug delivery system). Infiltration of the drug into the soft tissue of the surgical site produces a local analgesic effect, but also results in measurable plasma levels of bupivacaine, which can persist for 96 hours. The degree of systemic absorption is dependent on the dose administered and the vascularity of the surgical site. Bupivacaine is metabolized in the liver and excreted by the kidneys.

STANDARD TREATMENT — Postsurgical pain is generally treated with a combination of drugs with different mechanisms of action including opioids, local anesthetics, nonsteroidal anti-inflammatory ... more      

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Title: Bupivacaine Liposome Injection (Exparel) for Postsurgical Pain
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