Comparative Pharmacology
Head-to-head clinical analysis: EXPAREL versus XYLOCAINE PRESERVATIVE FREE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXPAREL versus XYLOCAINE PRESERVATIVE FREE.
EXPAREL vs XYLOCAINE PRESERVATIVE FREE
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 stabilizes the neuronal membrane by inhibiting sodium ion influx, thereby blocking impulse initiation and conduction. It binds to voltage-gated sodium channels in the inactivated state, preventing depolarization and propagation of action potentials.
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 dose: 1-30 mL of 1% or 2% solution (10-600 mg) via subcutaneous infiltration, peripheral nerve block, or epidural; max 4.5 mg/kg (300 mg without epinephrine, 7 mg/kg [500 mg] with epinephrine) per 2-hour period.
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 approximately 1.5-2 hours in adults; prolonged in hepatic impairment (up to 3-4 hours) and congestive heart failure.
Renal (approximately 96% as metabolites, <10% unchanged). Biliary/fecal excretion is negligible.
Renal excretion of metabolites (90-95% as metabolites, <5% unchanged); biliary/fecal excretion minimal (<1%).
Category C
Category C
Local Anesthetic
Local Anesthetic