EXPAREL® FOR LOCAL INFILTRATION IN ORAL SURGERY

A non-opioid option that delivers effective, long-lasting postsurgical pain control1

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

EXPAREL is not indicated for nerve block.

EXPAREL offers an effective, long-lasting, non-opioid option in postsurgical pain management that can1:

  • Reduce pain during the first few days after surgery, when most patients report moderate-to-severe pain1,2
  • Help decrease the need for opioids after surgery1,*
  • Play an important part in your multimodal regimen


EXPAREL uses the DepoFoam® liposomal drug delivery system to release bupivacaine over time and extend the therapeutic effect. See how DepoFoam works 

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

Please see Important Safety Information below.

Resources In Oral Surgery

Oral Surgery Brochure 

This summary overview of EXPAREL provides key efficacy and safety data and includes guidance on dosing and administration in oral surgery.

FAQs 

Review FAQs about study results and administration for EXPAREL in oral surgery.

Opioid-sparing Pain Management in Oral Surgery 

This brief article explores key issues related to pain management after oral surgery, and the preference among many surgical patients for non-opioid pain control.

EXPAREL Fast Facts 

Get the facts about proper administration, storage, and handling of EXPAREL for the entire staff.

Administering EXPAREL—Technique Is Critical

Because DepoFoam technology makes EXPAREL unique, compared with other local analgesics, technique and administration are important when infiltrating into the surgical site. EXPAREL is best administered using a series of injections to effectively cover the surgical area, since it does not diffuse throughout tissues in the same manner as traditional bupivacaine.

Third Molar Extraction Case Report 

Review an example of how Dr Stuart Lieblich administered EXPAREL in a third molar extraction case.

Infiltration Technique for EXPAREL 

Watch a video to see how EXPAREL is injected in a third molar surgery.

Infiltration Technique: EXPAREL vs. Local Anesthetics 

This video provides a detailed look at the EXPAREL infiltration technique vs. other local anesthetics in oral surgery.

Video Resources

DepoFoam Mechanism of Action 

Watch this short video to learn how EXPAREL utilizes DepoFoam multivesicular liposomal drug delivery technology to deliver bupivacaine for postsurgical pain control.

Increased Scrutiny Around Opioids 

Hear your oral surgery colleagues discuss challenges stemming from changing guidelines for prescribing opioids.

Patients Are Seeking Alternatives to Opioids 

Listen to a discussion of patient concerns about being prescribed opioids and why opioids may not be appropriate for some patient types.

Discussing EXPAREL With Patients—Value vs Cost 

Hear how your colleagues have talked to their patients about the benefits and cost of EXPAREL.

Patient Tools

EXPAREL Postsurgical Patient Fact Sheet 

Provide this tear sheet to patients who receive EXPAREL after surgery, along with any other discharge information.

Managing Your Pain Brochure  EXPAREL® Patient Fact Sheet

Share a waiting room leave-behind with patients to provide background information for managing their pain.

EXPAREL Patient Waiting Room Video Streaming Version 

This short video will help your oral surgery patients understand how EXPAREL can provide them with long-lasting pain control after surgery.

EXPAREL Patient Waiting Room Video Downloadable Version 

Download the EXPAREL Patient Waiting Room video for use in your waiting rooms, exam rooms or during consultation. This short video will help your oral surgery patients understand how EXPAREL can provide them with long-lasting pain control after surgery.

Ordering EXPAREL

Find information for ordering EXPAREL directly from Pacira Pharmaceuticals, Inc.

News From Pacira Pharmaceuticals, Inc.

Find recent news about EXPAREL and upcoming presentations by Pacira.

Ordering
EXPAREL

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Important Notice

This site is for informational purposes only and is intended to address medical questions from healthcare professionals in the United States.

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, submit a request to Medical Information or call 1-855-RX-EXPAREL (1-855-793-9727).

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

References

  1. Gorfine SR, Onel E, Patou G, Krivokapic ZV. Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Dis Colon Rectum. 2011;54(12):1552-1559.
  2. Beauregard L, Pomp A, Choinère M. Severity and impact of pain after day-surgery. Can J Anaesth.1998;45(4):304-311.
  3. Chahar P, Cummings KC, III. Liposomal bupivacaine formulation: a review of a new bupivacaine formulation. J Pain Res. 2012;5:257-264.
  4. Lambert B, Los K. DepoFoam® multivesicular liposomes for the sustained release of macromolecules. In: Rathbone MJ, Hadgraft J Robert MS, Lane ME, eds. Modfied-release Drug Delivery Technology. vol 2. 2nd ed. New York, NY: Informa Healthcare; 2008:207-214.
  5. Data on file. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; May 2016.

Important Safety Information

Warnings and Precautions Specific to EXPAREL

Warnings and Precautions for Bupivacaine-Containing Products

Please refer to full Prescribing Information.

Important Safety Information

Medical Information

US healthcare professionals Click Here

Non-US healthcare professionals can submit a request to medinfo@pacira.com

If you are not a healthcare professional, please discuss any questions you have regarding your health or treatment with your physician, pharmacist, nurse, or other healthcare professional.

Important information about EXPAREL®

The FDA confirms that EXPAREL has always been approved for "administration into the surgical site to produce postsurgical analgesia" for use in a variety of surgeries not limited to those studied in its pivotal trials.

"We are pleased to announce a successful collaboration with the FDA to resolve this matter in an expeditious and meaningful way that allows us to get back to the important task at hand—reducing postsurgical opioid exposure by providing a non-opioid option like EXPAREL to as many patients as appropriate."

- Dave Stack, Chief Executive Officer and Chairman of Pacira

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

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia
  • In clinical trials, the most common adverse reactions (incidence ≥10%) following EXPAREL administration were nausea, constipation, and vomiting
  • EXPAREL is not recommended to be used in the following patient population: patients <18 years old and/or pregnant patients
  • 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

Warnings and Precautions Specific to EXPAREL

  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks, or intravascular or intra-articular use
  • 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. Formulations of bupivacaine other than EXPAREL should not be administered within 96 hours following administration of EXPAREL

Warnings and Precautions for Bupivacaine-Containing Products

  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesias. CNS reactions are characterized by excitation and/or depression
  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability which may lead to dysrhythmias sometimes leading to death
  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients
  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use

Please refer to full Prescribing Information.

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