Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 1 AND DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 1 AND DEXTROSE 5 IN PLASTIC CONTAINER.
EXPAREL vs LIDOCAINE HYDROCHLORIDE 0.1% AND DEXTROSE 5% IN PLASTIC CONTAINER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Liposomal bupivacaine is a local anesthetic that blocks sodium channels in nerve cell membranes, inhibiting nerve impulse conduction and providing prolonged analgesia.
Lidocaine is a sodium channel blocker, which stabilizes neuronal membranes and inhibits the initiation and conduction of nerve impulses. Dextrose 5% provides caloric support.
Local infiltration: up to 266 mg (20 mL) as a single dose; interscalene brachial plexus block: up to 133 mg (10 mL); femoral nerve block: up to 133 mg (10 mL). Maximum dose 266 mg. Administer via slow injection with frequent aspiration.
Intravenous: 50-100 mg bolus (1-2 mg/kg) over 2-3 minutes, followed by continuous infusion at 1-4 mg/min (20-50 mcg/kg/min). Total maximum dose: 300 mg over 1 hour.
None Documented
None Documented
Terminal elimination half-life is 12-48 hours (mean ~24 hours), reflecting prolonged release from the multivesicular liposome depot.
Terminal elimination half-life: 1.5–2.0 hours in adults with normal hepatic function. In patients with hepatic impairment or heart failure, half-life may be prolonged (>3 hours). Clinical context: short half-life requires continuous infusion for sustained antiarrhythmic effect.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: approximately 10% unchanged; hepatic metabolism to 4-hydroxy-2,6-xylidine and glycylxylidide, which are excreted renally. Total renal excretion of metabolites and parent drug accounts for >95% of the dose. Fecal excretion is minimal (<5%).
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)