Skip to Content


Generic Name: bupivacaine liposome (bue PIV a kane LYE poe some)
Brand Names: Exparel

What is Exparel?

Exparel (bupivacaine) is an anesthetic (numbing medicine) that blocks nerve impulses in your body.

Exparel is used as a local (in only one area) anesthetic to numb an area of your body for a minor surgery such as bunion removal or hemorrhoid surgery.

Exparel may also be used for purposes not listed in this medication guide.

Important information

Before receiving Exparel, tell your doctor if you have liver disease, heart disease, a heart rhythm disorder, or a history of seizures.

Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine.

You will be watched closely after receiving Exparel, to make sure you do not have a reaction to the medication. Call your doctor if you have joint pain or stiffness, or weakness in any part of your body that occurs after your surgery, even months later.

Before taking this medicine

Tell your doctor if you have ever had an allergic reaction to any type of numbing medicine.

To make sure Exparel is safe for you, tell your doctor if you have ever had:

  • liver disease;

  • kidney disease;

  • heart disease;

  • a heart rhythm disorder; or

  • seizures.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.

Bupivacaine liposome can pass into breast milk but effects on the nursing baby are not known. Tell your doctor if you are breast-feeding a baby.

How is Exparel given?

Exparel is given as an injection placed into an area near your surgical incision. You will receive this injection in a hospital or surgical setting.

Exparel can have long-lasting or delayed effects. For at least 4 days (96 hours) after your surgery, tell any doctor or dentist who treats you that you recently received a bupivacaine liposome injection.

Call your doctor if you have joint pain or stiffness, or weakness in any part of your body that occurs after your surgery, even months later.

Exparel dosing information

Usual Adult Dose for Pain:

Exparel is intended for single-dose administration only for post surgical analgesia. The recommended dose of Exparel is based on the surgical site and the volume required to cover the area:

Bunionectomy: 7 mL infiltrated into the tissues surrounding the osteotomy and 1 mL into the subcutaneous tissue.

Hemorrhoidectomy: Dilute 20 mL of Exparel with 10 mL of saline, for a total of 30 mL, and divide the mixture into six 5 mL aliquots. Perform the anal block by visualizing the anal sphincter as a clock face and slowly infiltrating one aliquot to each of the even numbers.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Since Exparel is used as a single dose, it does not have a daily dosing schedule.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving Exparel?

For at least 4 days (96 hours) after surgery, you may need to avoid using any pain or numbing medicines that contain lidocaine. This includes skin patches, sprays, creams, ointments, or gels applied to the skin. Follow your doctor's instructions.

Exparel side effects

Get emergency medical help if you have signs of an allergic reaction to Exparel: hives, red rash, itching; sneezing, difficulty breathing; severe dizziness, vomiting; swelling of your face, lips, tongue, or throat.

You will be watched closely after receiving Exparel, to make sure you do not have a reaction to the medicine. Tell your caregivers at once if you have any of these signs of a serious side effect:

  • ringing in your ears;

  • feeling restless or anxious;

  • feeling like you might pass out;

  • speech or vision problems, a metallic taste in your mouth;

  • numbness or tingling around your mouth;

  • tremors, twitching, mood changes;

  • fast heart rate, feeling short of breath, feeling unusually hot or cold;

  • numbness, weakness, or loss of movement where the injection was given; or

  • if you still feel numb several hours after your surgery.

Common Exparel side effects include:

  • nausea;

  • vomiting; or

  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Exparel?

It is not likely that other drugs you take orally or inject will interact with a single injection of bupivacaine liposome for local anesthesia. But many drugs can interact with each other.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • topical (applied to the skin) medicine that contains lidocaine.

This list is not complete. Other drugs may interact with bupivacaine liposome, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Exparel.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Exparel only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2018 Cerner Multum, Inc. Version: 3.02. Revision Date: 2017-07-26, 1:19:15 PM.