Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 2 AND DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 2 AND DEXTROSE 5 IN PLASTIC CONTAINER.
EXPAREL vs LIDOCAINE HYDROCHLORIDE 0.2% 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 that stabilizes neuronal membranes by inhibiting the ionic fluxes required for initiation and conduction of impulses, thereby producing local anesthesia. 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 administration: Initial dose of 1-1.5 mg/kg (up to 300 mg total) given at a rate not exceeding 50 mg/min. Followed by continuous infusion at 1-4 mg/min (20-50 mcg/kg/min) for arrhythmia management.
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 hours (prolonged to 2–3 hours in hepatic impairment; unchanged in renal impairment).
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal excretion of unchanged drug and metabolites: 10% unchanged, 90% as metabolites (primarily 4-hydroxy-2,6-xylidine and glycylxylidide). Less than 1% biliary/fecal.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)