Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus PRILOCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus PRILOCAINE HYDROCHLORIDE.
EXPAREL vs PRILOCAINE HYDROCHLORIDE
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.
Prilocaine hydrochloride is an amino amide local anesthetic that reversibly blocks sodium channels in nerve cell membranes, inhibiting nerve impulse propagation.
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.
Adults: 4 mg/kg (max 200 mg) via infiltration or nerve block; may repeat after 2 hours with 50% of initial dose.
None Documented
None Documented
Terminal elimination half-life is 12-48 hours (mean ~24 hours), reflecting prolonged release from the multivesicular liposome depot.
Terminal half-life: 1.5-2 hours (adults, normal hepatic function). Prolonged in neonates (up to 8-12 hours) due to immature hepatic metabolism and reduced clearance; may cause methemoglobinemia. Hepatic impairment increases half-life.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal: ~95% as metabolites (primarily o-toluidine and 4-hydroxy-2-methylaniline) and <5% unchanged. Biliary/fecal: minimal (<2%).
Category C
Category C
Local Anesthetic
Local Anesthetic