Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE VISCOUS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus LIDOCAINE HYDROCHLORIDE VISCOUS.
EXPAREL vs LIDOCAINE HYDROCHLORIDE VISCOUS
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 local anesthetic that stabilizes neuronal membranes by blocking voltage-gated sodium channels, thereby inhibiting the initiation and propagation of action potentials. It also has antiarrhythmic properties (Class Ib) by accelerating repolarization and reducing automaticity 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.
Adult: 15 mL (300 mg) orally every 3 hours, not to exceed 8 doses in 24 hours. Viscous formulation swished and swallowed.
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 (adults); prolonged in heart failure (2.5–4 hours) or hepatic disease (up to 5–7 hours). Context: short t1/2 limits toxic accumulation with topical use.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: ~90% as metabolites (mainly 4-hydroxy-2,6-xylidine and glucuronides), <10% unchanged. Biliary/fecal: minor (<5%).
Category C
Category A/B
Local Anesthetic
Local Anesthetic / Antiarrhythmic (Class Ib)