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How to use EXPAREL
  • EXPAREL is intended for single-dose administration only
  • EXPAREL should be administered with a 25 gauge or larger bore needle
  • Vials of EXPAREL should be inverted to re-suspend the particles immediately prior to withdrawal from the vial
  • EXPAREL should be used within 4 hours of preparation in a syringe1

Non-Opioid Postsurgical Pain Control, You Control

Diagram illustrating how to administer EXPAREL

You Control the Administration

EXPAREL should be injected slowly into soft tissues of the surgical site using a deep tissue administration technique. Aspirate frequently to check for blood and minimize the risk of intravascular injection.1

  • Consider infiltrating above and below the fascia to treat pain that originates from cutting through the musculature and fascia
  • Consider infiltrating into the subcutaneous tissue along the length of the surgical site to treat pain originating from the initial surgical incision

You Control the Volume

The volume of EXPAREL may be expanded with up to 280 mL of normal sterile saline to ensure sufficient coverage of larger surgical sites.

  • The recommended dose of EXPAREL is based on the surgical site and the volume required to cover the area
    • The maximum dosage should not exceed 266 mg (one 20 mL vial)

EXPAREL Administration Precautions

  • Do not admix EXPAREL with other drugs prior to administration1
  • When administering lidocaine or other non-bupivacaine based local anesthetics into the surgical site, wait at least 20 minutes before administering EXPAREL1
  • Allow topical antiseptics (e.g., Betadine®) to dry before administering EXPAREL into the same surgical site
  • When using bupivacaine HCl before EXPAREL, use no more than 50% of the total EXPAREL dose (as reference, 50 mL of 0.25% and 25 mL of 0.5% bupivacaine HCl both equate to a total dose of 125 mg)
  • When using bupivacaine HCl before EXPAREL, the mg dose of bupivacaine HCl should be ≤50% of the mg dose of EXPAREL
    • Toxic effects of these drugs are additive and their administration should be used with caution, including monitoring for neurological and cardiovascular effects related to toxicity
    • As reference, 50 mL 0.25% or 25 mL 0.5% bupivacaine HCl each equate to 125 mg

Studies conducted with EXPAREL demonstrated that the most common implantable materials (polypropylene, PTFE, silicone, stainless steel, and titanium) are not affected by the presence of EXPAREL any more than they are by saline. None of the materials studied had an adverse effect on EXPAREL.1

Do Not Interchange with Other Formulations of Bupivacaine

Different formulations of bupivacaine are not bioequivalent, even if the milligram strength is the same. Therefore, it is not possible to convert dosing from any other formulations of bupivacaine to EXPAREL.1

These are not all of the potential important safety considerations for EXPAREL, please see the full Prescribing Information.

To report an adverse event, e-mail or dial 1-855-RX-EXPAREL (1-855-793-9727).

For medical inquiries related to EXPAREL, contact Medical Information at or 1-855-RX-EXPAREL (1-855-793-9727).


  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.

Important Safety Information

EXPAREL is indicated for single-dose administration into the surgical site to produce postsurgical analgesia.

EXPAREL is contraindicated in obstetrical paracervical block anesthesia. EXPAREL has not been studied for use in patients younger than 18 years of age.

Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL.

Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations.

In clinical trials, the most common adverse reactions (incidence =10%) following EXPAREL administration were nausea, constipation, and vomiting.

Studies demonstrating the safety and efficacy of EXPAREL were conducted in hemorrhoidectomy and bunionectomy; EXPAREL has not been demonstrated to be safe and effective in other procedures.

Please see the full Prescribing Information for EXPAREL.


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