Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus XYLOCAINE DENTAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus XYLOCAINE DENTAL.
EXPAREL vs XYLOCAINE DENTAL
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 the neuronal membrane by inhibiting sodium ion influx, thereby blocking the initiation and conduction of nerve impulses.
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.
Xylocaine Dental (lidocaine HCl 2% with epinephrine 1:100,000 or 1:50,000): For infiltration/inferior alveolar nerve block, maximum dose 3.4 mg/kg (4.5 mg/kg with epinephrine 1:100,000) not to exceed 300 mg; usual adult dose: 1–5 mL (20–100 mg) administered via oral submucosal injection.
None Documented
None Documented
Terminal elimination half-life is 12-48 hours (mean ~24 hours), reflecting prolonged release from the multivesicular liposome depot.
1.5–2 hours in adults with normal hepatic function. Prolonged to 2–3 hours in patients with hepatic impairment or congestive heart failure; may exceed 5 hours in severe hepatic disease.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal excretion of unchanged drug and metabolites accounts for >95% of the dose. Approximately 70% is excreted as the metabolite 4-hydroxy-2,6-xylidine; less than 10% is unchanged lidocaine. Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Local Anesthetic
Local Anesthetic