Exparel Side Effects

Generic name: bupivacaine liposome

Medically reviewed by Drugs.com. Last updated on Sep 10, 2024.

Note: This document provides detailed information about Exparel.

Applies to bupivacaine liposome: injection suspension Side Effects associated with bupivacaine liposome. Some dosage forms listed on this page may not apply specifically to the brand name Exparel.

Applies to bupivacaine liposome: injection suspension.

Precautions

It is very important that your doctor check your progress closely after you receive this medicine to see if the medicine is working properly. Blood tests may be needed to check for any unwanted effects.

This medicine should not be given to women during labor (obstetrical paracervical block anesthesia).

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in elderly patients or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Tell your doctor or nurse right away if you have the following symptoms with this medicine: anxiety, blurred vision, depression, drowsiness, lightheadedness, nausea or vomiting, numbness and tingling of the mouth or lips, restlessness, ringing in the ears, speech problems, or tremors.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat after receiving this medicine.

This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may also increase your risk of having serious heart and blood vessel problems (eg, heart attack, heart rhythm changes, or low blood pressure). Check with your doctor if you have chest pain or discomfort, pain or discomfort in the arms, jaw, back, or neck, dizziness, fainting, pounding, slow heartbeat, trouble breathing, or unusual tiredness or weakness.

Check with your doctor if you have joint pain, stiffness, or loss of motion of the shoulder. This may be symptoms of a serious bone or joint problem called chondrolysis.

Check with your doctor before receiving this medicine with other medicines that affect the central nervous system (CNS). The use of other medicines that affect the CNS with bupivacaine liposome (the active ingredient contained in Exparel) injection may worsen the side effects of this medicine, including dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, or muscle relaxants.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of Exparel

Along with its needed effects, bupivacaine liposome may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking bupivacaine liposome:

Other side effects of Exparel

Some side effects of bupivacaine liposome may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to bupivacaine liposome: injectable suspension.

General adverse events

The most common adverse reactions reported when administration was via infiltration were nausea, vomiting, and dizziness; when administration was via nerve block, common adverse reactions have included nausea, pyrexia, and constipation.^[Ref]

Nervous system

• Very common (10% or more): Dizziness (up to 11.3%), motor dysfunction (14.9%)
• Common (1% to 10%): Headache, somnolence, hypoesthesia, syncope, dysgeusia, sensory loss
• Frequency not reported: Tremor, dizziness postural, paresthesia, syncope, tinnitus, sedation, somnolence, convulsions^[Ref]

Convulsions have been reported following accidental intravascular injection of this drug and other amide-containing products.^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 40.2%), vomiting (up to 27.8%), constipation (up to 22%)
• Common (1% to 10%): Anal hemorrhage, painful defecation, rectal discharge, hypoesthesia oral
• Frequency not reported: Procedural nausea^[Ref]

Dermatologic

• Very common (10% or more): Pruritus (up to 15%)
• Common (1% to 10%): Pruritus generalized, hyperhidrosis,
• Frequency not reported: Erythema, rash pruritic, cold sweat, urticaria, cellulitis, wound dehiscence, wound secretion, blister, drug eruption, erythema, rash, hematoma^[Ref]

Psychiatric

• Common (1% to 10%): Insomnia, confusional state
• Frequency not reported: Anxiety, depression, agitation, restlessness^[Ref]

Cardiovascular

• Common (1% to 10%): Hypotension, tachycardia, sinus tachycardia, bradycardia, peripheral edema, hypertension
• Frequency not reported: Bradycardia, procedural hypertension, procedural hypotension, palpitations, sinus bradycardia, supraventricular extrasystoles, ventricular extrasystoles, ventricular tachycardia, blood pressure increased, blood pressure decreased, pallor, arrhythmia, atrial fibrillation, atrioventricular block first degree, bundle branch block left, bundle branch block right, cardiac arrest, deep vein thrombosis, orthostatic hypotension, electrocardiogram QT prolonged, presyncope, syncope^[Ref]

Cardiac arrest has been reported following accidental intravascular injection of this drug and other amide-containing products.^[Ref]

Hypersensitivity

• Rare (less than 0.1%): Allergic-type reactions^[Ref]

Other

• Very common (10% or more): Pyrexia (up to 23.3%)
• Common (1% to 10%): Procedural pain, lethargy, body temperature increased, feeling hot, post-procedural swelling, fatigue, fall
• Frequency not reported: Chills, pain, edema, hearing impaired, asthenia^[Ref]

Hematologic

• Common (1% to 10%): Anemia, anemia postoperative, hemorrhagic anemia, postprocedural hematoma
• Frequency not reported: White blood cell count increased^[Ref]

Hepatic

• Common (1% to 10%): Alanine aminotransferase increased, aspartate aminotransferase increased, increased hepatic enzyme

Musculoskeletal

• Common (1% to 10%): Muscle spasms, back pain, muscle twitching
• Frequency not reported: Muscular weakness, neck pain, arthralgia, back pain, joint swelling, mobility decreased, muscle spasms, muscular weakness, musculoskeletal pain^[Ref]

Immunologic

• Common (1% to 10%): Fungal infection^[Ref]

Metabolic

• Common (1% to 10%): Appetite decreased
• Frequency not reported: Oxygen saturation decreased, hypokalemia^[Ref]

Renal

• Common (1% to 10%): Blood creatinine increased^[Ref]

Respiratory

• Common (1% to 10%): Hiccups, hypoxia
• Frequency not reported: Laryngospasm, apnea, respiratory depression, respiratory failure, lung infection, pneumonia, cough, dyspnea, lung infiltration, atelectasis^[Ref]

Genitourinary

• Frequency not reported: Urinary retention, urinary incontinence, dysuria^[Ref]

Local

• Frequency not reported: Incision site edema^[Ref]

Ocular

• Frequency not reported: Vision blurred, visual impairment^[Ref]

See also:

Further information

Exparel side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer