Bupivacaine Liposomal Suspension for Injection

What is this medication?

BUPIVACAINE LIPOSOMAL (bue PIV a kane LIP oh som al) is an anesthetic. It causes loss of feeling in the skin or other tissues. It is used to prevent and to treat pain from some procedures.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): EXPAREL

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• G6PD deficiency
• heart disease
• kidney disease
• liver disease
• low blood pressure
• lung or breathing disease, like asthma
• an unusual or allergic reaction to bupivacaine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This medicine is injected into the affected area. It is given by a health care provider in a hospital or clinic setting.

Talk to your health care provider about the use of this medicine in children. While it may be given to children as young as 6 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply.

What may interact with this medication?

This medicine may interact with the following medications:

• acetaminophen
• certain antibiotics like dapsone, nitrofurantoin, aminosalicylic acid, sulfonamides
• certain medicines for seizures like phenobarbital, phenytoin, valproic acid
• chloroquine
• cyclophosphamide
• flutamide
• hydroxyurea
• ifosfamide
• metoclopramide
• nitric oxide
• nitroglycerin
• nitroprusside
• nitrous oxide
• other local anesthetics like lidocaine, pramoxine, tetracaine
• primaquine
• quinine
• rasburicase
• sulfasalazine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medicine.

Be careful to avoid injury while the area is numb, and you are not aware of pain.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• seizures
• signs and symptoms of a dangerous change in heartbeat or heart rhythm like chest pain; dizziness; fast, irregular heartbeat; palpitations; feeling faint or lightheaded; falls; breathing problems
• signs and symptoms of methemoglobinemia such as pale, gray, or blue colored skin; headache; fast heartbeat; shortness of breath; feeling faint or lightheaded, falls; tiredness

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• anxious
• back pain
• changes in taste
• changes in vision
• constipation
• dizziness
• fever
• nausea, vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This drug is given in a hospital or clinic and will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.