Overview

EXPAREL is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.1

Proprietary multivesicular liposome (pMVL) technology

EXPAREL utilizes a drug delivery technology called pMVL, which allows the active drug to be released over a desired period without any alteration to the molecular structure.2

The multivesicular liposomal formulation of bupivacaine slowly releases bupivacaine over time and provides long-lasting analgesia in the first few days after surgery for postsurgical pain.3,4

pMVL is an advanced drug-delivery platform that encapsulates drugs without altering their molecular structure and then releases them over a desired period.2 pMVL technology achieves targeted analgesia at the surgical site, providing safe and consistent levels of bupivacaine.2

PMVL image

Explore EXPAREL resources to learn more

Prescribing Information EXPAREL Dossier Fast Facts

References

  1. EXPAREL [Prescribing Information]. San Diego, CA: Pacira Pharmaceuticals, Inc.; 2023.
  2. Bramlett K, Onel E, Viscusi ER, Jones K. A Randomized, Double-Blind, Dose-Ranging Study Comparing Wound Infiltration of DepoFoam Bupivacaine, an Extended-Release Liposomal Bupivacaine, to Bupivacaine HCl for Postsurgical Analgesia in Total Knee Arthroplasty. Knee. 2012;19(5):530-536.
  3. Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial. J Arthroplasty. 2018;33(1):90-96.
  4. Patel MA, Gadsden JC, Nedeljkovic SS, Bao X, Zeballos JL, Yu V, Ayad SS, Bendtsen TF. Brachial Plexus Block With Liposomal Bupivacaine for Shoulder Surgery Improves Analgesia and Reduces Opioid Consumption: Results From a Multicenter, Randomized, Double-Blind, Controlled Trial. Pain Med. 2020;21(2):387-400.

Discover EXPAREL

Explore information about EXPAREL across indication and approved uses, safety and adverse events, dosing and administration, compatibility and/or concomitant studies, pharmacokinetics, content, storage and stability, and comparator studies to learn more.

  • Indication and Approved Uses

    Find information related to EXPAREL indication and approved uses.

    View materials right-arrow

  • Safety and Adverse Events

    Find information related to EXPAREL safety and adverse events.

    View materials right-arrow

  • Dosing and Administration

    Find information related to EXPAREL dosing and administration.

    View materials right-arrow

  • Compatibility and/or Concomitant Use

    Find information related to EXPAREL compatibility and concomitant use with local anesthetics and other drugs and materials.

    View materials right-arrow

  • Pharmacokinetics

    Find information related to EXPAREL pharmacokinetics.

    View materials right-arrow

  • Content, Storage, and Stability

    Find information related to EXPAREL content, storage, and stability.

    View materials right-arrow

  • Comparator Studies

    Find information on EXPAREL comparator studies, including comparison to other drugs or formulations, and summary of clinical trial and real-world data.

    View materials right-arrow

  • Pharmacoeconomics

    Find information on EXPAREL pharmacoeconomic studies.

    View materials right-arrow

Fascial Plane Block and Local Infiltration

EXPAREL is used for a wide variety of fascial plane blocks, including erector spinae plane (ESP) block, transversus abdominis plane (TAP) block, pectoral (PEC) plane block, and quadratus lumborum (QL) block.

  • Erector Spinae Plane (ESP) Block

    Find information related to EXPAREL use in fascial plane erector spinae plane (ESP) block.

    View materials right-arrow

  • Transversus Abdominis Plane (TAP) Block

    Find information related to EXPAREL use in fascial plane transversus abdominis plane (TAP) block.

    View materials right-arrow

  • Pectoral (PEC) Plane Block

    Find information related to EXPAREL use in pectoral (PEC) plane block.

    View materials right-arrow

  • Quadratus Lumborum (QL) Block

    Find information related to EXPAREL use in quadratus lumborum (QL) block.

    View materials right-arrow

Nerve Block

The indication for EXPAREL allows for use across surgical procedures to provide regional analgesia, via nerve blocks, in adults as an interscalene brachial plexus nerve block, a sciatic nerve block in the popliteal fossa, and an adductor canal block.

  • Interscalene Brachial Plexus Nerve Block (Upper Extremity Block)

    Find information related to EXPAREL use in upper extremity nerve block and interscalene brachial plexus plane block (ISBPB).

    View materials right-arrow

  • Sciatic Nerve Block in the Popliteal Fossa

    Find information related to EXPAREL use in sciatic nerve block in the popliteal fossa.

    View materials right-arrow

  • Adductor Canal Block

    Find information related to EXPAREL use in adductor canal block (ACB)

    View materials right-arrow

  • Other

    Find information related to EXPAREL use in other nerve blocks.

    View materials right-arrow

General Surgery

Explore information about EXPAREL across a variety of general surgery types: abdominal, bariatric and gastrointestinal, cardiothoracic and pulmonary, colorectal, hemorrhoidectomy, hernia, tonsillectomy, urology, liver and prostate

  • Abdominal

    Find information related to EXPAREL use in abdominal surgeries, including appendectomy, abdominal oncologic resection, and abdominal wall reconstruction.

    View materials right-arrow

  • Bariatric and Gastrointestinal

    Find information related to EXPAREL use in bariatric surgeries, including laparoscopic, gastrointestinal, and weight loss surgery.

    View materials right-arrow

  • Cardiothoracic and Pulmonary

    Find information related to EXPAREL use in cardiothoracic and pulmonary surgeries, including epicardial interventions, sternotomy, pulmonary or lung resection, video-assisted thoracoscopic surgeries, robot-assisted surgeries, thoracic surgeries, and thoracotomy.

    View materials right-arrow

  • Colorectal

    Find information related to EXPAREL use in colorectal surgeries, including colorectal resection, colectomy, and ileostomy reversal.

    View materials right-arrow

  • Hemorrhoid

    Find information related to EXPAREL use in hemorrhoidectomy and post-hemorrhoidectomy pain management.

    View materials right-arrow

  • Hernia

    Find information related to EXPAREL use in herniorrhaphy, including abdominal wall reconstruction, abdominal umbilical hernia repair, ventral hernia repair, and inguinal herniorrhaphy.

    View materials right-arrow

  • Tonsillectomy

    Find information related to EXPAREL use in tonsillectomy.

    View materials right-arrow

  • Urology, Liver, and Prostate

    Find information related to EXPAREL use in urological, hepatic, or prostate surgery, including urogynecology, liver donation and hepatectomy, midurethral or retropubic sling placement, donor nephrectomy, renal or kidney surgery, radical cystectomy, and prostatectomy.

    View materials right-arrow

Orthopedics

Explore information about EXPAREL across a variety of orthopedic procedures: knee (total knee arthroplasty [TKA]), hip (total hip arthroplasty), shoulder (total or reverse shoulder arthroplasty), spine, foot and ankle, hand and wrist.

  • Knee

    Find information related to EXPAREL use in total knee arthroplasty (TKA) and anterior cruciate ligament (ACL) surgery.

    • Infiltration

      Filter information on EXPAREL use in TKA surgery by infiltration.

      View materials right-arrow

    • Adductor Canal Block

      Filter information on EXPAREL use in TKA surgery by adductor canal block (ACB).

      View materials right-arrow

  • Hip

    Find information related to EXPAREL use in total hip arthroplasty and orthopedic hip surgery.

    View materials right-arrow

  • Shoulder

    Find information related to EXPAREL use in shoulder surgeries, including total shoulder arthroplasty or reverse shoulder arthroplasty.

    • Infiltration

      Filter information on EXPAREL use in shoulder surgery by infiltration.

      View materials right-arrow

    • Interscalene Brachial Plexus (ISBP) Block

      Filter information on EXPAREL use in shoulder surgery by interscalene brachial plexus (ISBP) nerve block.

      View materials right-arrow

  • Spine

    Find information related to EXPAREL use in orthopedic spine surgery, including lumbar laminectomy, spinal decompression, and lumbar spinal fusion.

    View materials right-arrow

  • Foot and Ankle

    Find information related to EXPAREL use in foot and ankle surgery, including bunionectomy.

    View materials right-arrow

  • Hand and Wrist

    Find information related to EXPAREL use in hand and wrist surgeries, including treatment of digital ischemia.

    View materials right-arrow

Pediatrics

Explore information about EXPAREL in a variety of pediatric procedures: general pediatric use and safety, cardiothoracic, spine, oral and maxillofacial surgery (dental, cleft palate)

  • General Pediatric Use and Safety

    Find information related to EXPAREL use and safety in general pediatric surgery.

    View materials right-arrow

  • Cardiothoracic

    Find information related to EXPAREL use in pediatric cardiothoracic surgery, including cardiac surgery and Nuss procedure.

    View materials right-arrow

  • Spine

    Find information related to EXPAREL use in pediatric spine surgery, including spinal fusion and idiopathic scoliosis.

    View materials right-arrow

  • Oral and Maxillofacial Surgery (Dental, Cleft Palate)

    Find information related to EXPAREL use in pediatric oral and maxillofacial surgery (OMFS), including dental procedures, palatoplasty or cleft palate, and craniofacial surgery.

    View materials right-arrow

Breast and Plastics

Explore information about EXPAREL in a variety of breast surgery types and plastic surgeries: breast surgery (reconstruction, augmentation, mastectomy), abdominoplasty, other plastic surgeries.

  • Breast Surgery (Reconstruction, Augmentation, Mastectomy)

    Find information related to EXPAREL use in breast surgery, including breast reconstruction, breast augmentation surgery, mastectomy, and gender-affirming mastectomy.

    View materials right-arrow

  • Abdominoplasty

    Find information related to EXPAREL use in abdominoplasty and reconstructive plastic surgery.

    View materials right-arrow

  • Other Plastic Surgeries

    Find information related to EXPAREL use in other aesthetic surgeries, including skin grafts and penile prosthesis implantation.

    View materials right-arrow

Women's Health

Explore information about EXPAREL use in Women's health: cesarean section (C-section), obstetrics and gynecology (OBGYN), and gynecological oncology.

  • Cesarean Section (C-Section)

    Find information related to EXPAREL use in Cesarean delivery or C-section, including pain control post C‑section.

    View materials right-arrow

  • Obstetrics and Gynecology (OBGYN) and Gynecological Oncology

    Find information related to EXPAREL use in OBGYN surgeries and gynecological oncology, including hysterectomy, sacrocolpopexy, laparotomy for gynecological malignancies, and sling placement.

    View materials right-arrow

Oral and Maxillofacial Surgery (OMFS)

Explore information about EXPAREL in wisdom teeth extraction (third molar extraction).

  • Wisdom Teeth Extraction (Third Molar Extraction)

    Find information related to EXPAREL use in dental procedures: third molar extraction.

    View materials right-arrow

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia.
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation.
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia.
  • Do not admix lidocaine or other non-bupivacaine local anesthetics with EXPAREL. EXPAREL may be administered at least 20 minutes or more following local administration of lidocaine.
  • EXPAREL is not recommended to be used in the following patient populations: patients <6 years old for infiltration, patients younger than 18 years old for nerve blocks, and/or pregnant patients.
  • Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease.

Warnings and Precautions Specific to EXPAREL

  • Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL.
  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks other than interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and adductor canal block, or intravascular or intra-articular use.
  • The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration depending on the site of injection and dosage administered and may last for up to 5 days, as seen in clinical trials.

Warnings and Precautions for Bupivacaine-Containing Products

  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesia. CNS reactions are characterized by excitation and/or depression.
  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability, which may lead to dysrhythmias, sometimes leading to death.
  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients.
  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use.
  • Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use.

For more information

View Prescribing Information
View Prescribing Information