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About DepoFoam®

About DepoFoam®

Innovative DepoFoam Technology Delivers Bupivacaine Over Time

Pacira Pharmaceuticals, Inc., makers of EXPAREL®, own the proven product delivery technology, DepoFoam. DepoFoam has been used safely in two other products, and has a demonstrated safety record and history of regulatory approvals in the United States, Europe, and several other countries around the world.

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DepoFoam® DepoFoam® technology extends pharmacokinectics
  • EXPAREL uses DepoFoam, a multivesicular liposomal drug delivery technology, to encapsulate bupivacaine
  • Following injection, bupivacaine is released over time as the DepoFoam lipid membranes erode and reorganize
  • In EXPAREL, DepoFoam is <3% lipid, biodegradable, and biocompatible

How it Works

The DepoFoam carrier matrix is made up of microscopic, polyhedral particles composed of numerous, non-concentric, internal aqueous chambers that encapsulate drugs without altering their molecular structure and then release them over a desired period of time. Each chamber is separated from adjacent chambers by lipid membranes. Following injection, the DepoFoam particles release medication over time due to erosion and/or reorganization of the lipid membranes.

DepoFoam-based drugs are formulated as ready-to-use, aqueous suspensions allowing for simple injection through needles with a bore size as narrow as 25 gauge.

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

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Reimbursement Guide

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How to use EXPAREL

How to Use EXPAREL

Learn about the technique clinicians are using to administer EXPAREL. > More


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

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How to use EXPAREL

How to Use EXPAREL

Learn about the technique clinicians are using to administer EXPAREL.. > More


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

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

[an error occurred while processing this directive]

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

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Learn About EXPAREL

Watch this short animation to see how EXPAREL works. > More


How to Use EXPAREL

Learn about the technique clinicians are using to administer EXPAREL. > More


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

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Sign up to receive updates on EXPAREL

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How to use EXPAREL

How to Use EXPAREL

Learn about the technique clinicians are using to administer EXPAREL. > More


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

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Learn About EXPAREL

Video animation illustrating how EXPAREL works

Watch this short animation to see how EXPAREL works. > More


Sign up to receive updates on EXPAREL

Sign Up

Sign up to receive updates on EXPAREL. > Sign Up


How to use EXPAREL

How to Use EXPAREL

Learn about the technique clinicians are using to administer EXPAREL. > More


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

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

[an error occurred while processing this directive]

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

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Clinical Studies

Clinical Studies

See the clinical data from the pivotal soft tissue trial for EXPAREL. > More


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

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Sign Up

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Sign up to receive updates on EXPAREL. > Sign Up


Clinical Studies

Clinical Studies

See the clinical data from the pivotal soft tissue trial for EXPAREL. > More


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

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

[an error occurred while processing this directive]

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

[an error occurred while processing this directive]

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

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Is EXPAREL Right for My Patients

Is EXPAREL Right for My Patients?

Find out if EXPAREL could meet a need in your practice. > More


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

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Is EXPAREL Right for My Patients?

Find out if EXPAREL could meet a need in your practice. > More


Clinical Studies

See the clinical data from the pivotal soft tissue trial for EXPAREL. > More


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

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EXPAREL Efficacy

EXPAREL Efficacy

Find out more about the efficacy of EXPAREL. > More


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

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

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Benefits of EXPAREL

The EXPAREL Difference

Learn about the benefits of this innovative, non-opioid analgesic. > More


Is EXPAREL Right for My Patients

Is EXPAREL Right for My Patients?

Find out if EXPAREL could meet a need in your practice. > More


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

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

[an error occurred while processing this directive]

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

[an error occurred while processing this directive]

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

[an error occurred while processing this directive]
Benefits of EXPAREL

The EXPAREL Difference

Learn about the benefits of this innovative, non-opioid analgesic. > More


Is EXPAREL Right for My Patients

Is EXPAREL Right for My Patients?

Find out if EXPAREL could meet a need in your practice. > More


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

[an error occurred while processing this directive]
Benefits of EXPAREL

The EXPAREL Difference

Learn about the benefits of this innovative, non-opioid analgesic. > More


Is EXPAREL Right for My Patients

Is EXPAREL Right for My Patients?

Find out if EXPAREL could meet a need in your practice. > More


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

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The EXPAREL Difference

Learn about the benefits of this innovative, non-opioid analgesic. > More


Patient Benefits

Learn how EXPAREL may result in patient satisfaction for your practice. > More


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

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

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

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To report Suspected Adverse Reactions, contact Pacira Pharmaceuticals, Inc. at 1-855-RX-EXPAREL (1-855-793-9727) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch

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

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

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*Pivotal studies have demonstrated the safety and efficacy of EXPAREL in patients undergoing bunionectomy or hemorrhoidectomy procedures; additional studies are underway to further demonstrate the safety and efficacy in other procedures.

The clinical benefit of the attendant decrease in opioid consumption was not demonstrated.

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

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

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References:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
  2. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
  3. Safe Use of Opioids. The Joint Commission Sentinel Event Alert. Issue 49; August 8, 2013.
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References:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
  2. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
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References:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
  2. Beauregard L, Pomp A, et al. Severity and impact of pain after day-surgery. Can J Anaesth.1998;45(4):304-311.
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Reference:

  1. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
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References:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
  2. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
  3. Golf M, Daniels SE, et al. A phase 3, randomized, placebo-controlled trial of DepoFoam® bupivacaine (extended-release bupivacaine local analgesic) in bunionectomy. Adv Ther. 2011; 28(9):776-788.
  4. Bergese SD, Onel E, Portillo J. Evaluation of DepoFoam bupivacaine for the treatment of postsurgical pain. Pain Management. November 2011; 1(6):539-547.
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References:

  1. Naseem A, Harada T,Wang D, et al. Bupivacaine extended release liposome injection does not prolong QTc interval in a thorough QT/QTc study in healthy volunteers. J Clin Pharmacol. November 4, 2011.
  2. Bergese SD, Onel E, Portillo J. Evaluation of DepoFoam bupivacaine for the treatment of postsurgical pain. Pain Management. November 2011; 1(6):539-547.
  3. American Society of Regional Anesthesia. Checklist for Treatment of Local Anesthetic Systemic Toxicity. Available at: http://www.asra.com/checklist-for-local-anesthetic-toxicity-treatment-1-18-12.pdf. Accessed June 15, 2012.
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Reference:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
[an error occurred while processing this directive]

References:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
  2. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
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Reference:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
[an error occurred while processing this directive]

Reference:

  1. EXPAREL [prescribing information]. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; 2011.
[an error occurred while processing this directive]

Reference:

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

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

  1. Pacira Pharmaceuticals, Inc. www.pacira.com. Accessed November 4, 2011.
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To report an adverse event, e-mail drugsafety@pacira.com or dial 1-855-RX-EXPAREL (1-855-793-9727).

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

Reference:

  1. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
[an error occurred while processing this directive]

Reference:

  1. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
[an error occurred while processing this directive]

References:

  1. Gorfine SR, Onel E, et al. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Diseases of the Colon & Rectum. 2011;54(12):1552-1559.
  2. Beauregard L, Pomp A, et al. Severity and impact of pain after day-surgery. Can J Anaesth.1998;45(4):304-311.
  3. Safe Use of Opioids. The Joint Commission Sentinel Event Alert. Issue 49, August 8, 2012.
  4. Schug SA, et al. Best Pract Res Clin Anaesthesiol. 2011;25(1):73-81.
  5. Passannante AN, et al. Anesthesiol Clin North America. 2005;23(3):479-491.
  6. Ingrande J, et al. Br J Anaesth. 2010;105 Suppl 1:i16-i23.
  7. Lee M, et al. Pain Physician. 2011;14(2):145-161.
  8. Rozen D, et al. J Opioid Manag. 2006;2(6):353-363.
  9. Fong HK, et al. Anesth Analg. 2006;102(4):1255-1266.
  10. National Opioid Use Guideline Group (NOUGG). Canadian guideline for safe and effective use of opioids for chronic non-cancer pain. 2010.
  11. Wilder-Smith OH. Eur J Pain. 2005;9(2):137-140.
  12. Chou R, et al. J Pain. 2009;10(2):113-130.
  13. Verhamme KM, et al. Drug Saf. 2008;31(5):373-388.
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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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