Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus PARACAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus PARACAINE.
EXPAREL vs PARACAINE
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.
Local anesthetic that reversibly blocks sodium channels in neuronal membranes, inhibiting nerve impulse conduction.
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.
10-20 mg orally every 4-6 hours as needed; maximum 80 mg/day.
None Documented
None Documented
Terminal elimination half-life is 12-48 hours (mean ~24 hours), reflecting prolonged release from the multivesicular liposome depot.
Clinical Note
moderateProparacaine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Fluticasone propionate."
Clinical Note
moderateProparacaine + Clemastine
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Clemastine."
Clinical Note
moderateProparacaine + Venlafaxine
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Venlafaxine."
Clinical Note
moderate2.5 hours; prolonged to 8 hours in cirrhosis due to reduced hepatic metabolism
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: 90% (70% unchanged, 20% as paracainol glucuronide); Biliary/Fecal: 10%
Category C
Category C
Local Anesthetic
Local Anesthetic
Proparacaine + Nefazodone
"The risk or severity of adverse effects can be increased when Proparacaine is combined with Nefazodone."