Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER.
EXPAREL vs LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE 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 an amide-type local anesthetic that stabilizes neuronal membranes by blocking voltage-gated sodium channels, thereby inhibiting the initiation and conduction of nerve impulses. It exhibits antiarrhythmic activity by suppressing automaticity and conduction in cardiac tissues.
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.
Antiarrhythmic: 1-1.5 mg/kg IV bolus, may repeat 0.5-0.75 mg/kg in 5-10 minutes; maximum total 3 mg/kg. Followed by continuous IV infusion 1-4 mg/min. Local anesthesia: maximum 4.5 mg/kg (300 mg) without epinephrine; 7 mg/kg (500 mg) with epinephrine.
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 (normal cardiac output and hepatic function). Prolonged in heart failure (up to 10 hours), hepatic disease (up to 5–15 hours), and with continuous infusion (due to saturable metabolism).
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: ~90% as metabolites (including monoethylglycinexylidide [MEGX] and glycinexylidide [GX]) and ~10% unchanged. Biliary/fecal: <3%.
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)