Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER.
EXPAREL vs LIDOCAINE HYDROCHLORIDE 0.4% 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 amide-type local anesthetic that blocks voltage-gated sodium channels in neuronal membranes, inhibiting the initiation and conduction of nerve impulses. Dextrose provides calories and does not have pharmacological activity.
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: 1-1.5 mg/kg bolus, followed by 1-4 mg/min continuous infusion for ventricular arrhythmias. Maximum total dose: 3 mg/kg bolus; infusion for up to 24 hours. Note: 0.4% concentration = 4 mg/mL, 5% dextrose as diluent.
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 after a single dose in healthy adults. In patients with hepatic impairment, heart failure, or prolonged infusion, half-life can increase to >3 hours due to reduced clearance. Neonates: 3–6.3 hours.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: Approximately 90% of lidocaine is metabolized in the liver, and less than 10% is excreted unchanged in urine. The major metabolites (monoethylglycinexylidide and glycinexylidide) are excreted renally. Biliary/fecal excretion is minimal (<1%).
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)