Skip to main content

Zynrelef Side Effects

Generic name: bupivacaine / meloxicam

Medically reviewed by Drugs.com. Last updated on Nov 22, 2024.

Note: This document provides detailed information about Zynrelef Side Effects associated with bupivacaine / meloxicam. Some dosage forms listed on this page may not apply specifically to the brand name Zynrelef.

Applies to bupivacaine / meloxicam: injection solution extended release.

Important warnings This medicine can cause some serious health issues

Injection route (solution, extended release)

Risk of Serious Cardiovascular and Gastrointestinal Events. Cardiovascular Thrombotic Events. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.

This risk may occur early in treatment and may increase with duration of use.Bupivacaine/meloxicam is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.Gastrointestinal Bleeding, Ulceration, and PerforationNSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.

Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

Precautions

It is very important that your doctor check your progress closely while you are receiving this medicine to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may increase your risk of having a heart attack, blood clot, or stroke. This is more likely to occur in people who already have heart and blood vessel disease and who are using this medicine for a long time. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, slurred speech, or weakness.

Liver problems may occur while you are using this medicine. Check with your doctor right away if you have stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.

This medicine may cause bleeding in your stomach or bowels. This problem can happen without warning signs. This is more likely to occur if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or are using certain other medicines (eg, steroids, blood thinner).

Serious side effects can occur during treatment with this medicine and can occur without warning. However, possible warning signs often occur, including severe stomach pain, black tarry stools, vomiting of blood or material that looks like coffee grounds, skin rash, swelling of the face, fingers, feet, or lower legs. Also, signs of serious heart problems could occur including chest pain or tightness, fast or irregular heartbeat, or unusual flushing or warmth of the skin. Check with your doctor immediately if you notice any of these warning signs.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs.

This medicine may cause a serious allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. It may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Call your doctor right away if you have a rash, itching, trouble breathing or swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

This medicine may cause a bone or joint problem called chondrolysis. Check with your doctor right away if you have bone or joint pain or stiffness or an inability to move.

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, 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 have pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Serious skin reactions, including Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS) can occur during treatment with this medicine. Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

Using this medicine during the later part of pregnancy can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away. This medicine may cause a delay in ovulation for women and may decrease sperm count in men, which can affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.

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 Zynrelef

Along with its needed effects, bupivacaine / meloxicam 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 / meloxicam:

More common side effects

  • blurred vision
  • chest pain or discomfort
  • chills
  • constipation
  • cough
  • dizziness
  • eye pain
  • fever
  • general feeling of illness
  • headache
  • lightheadedness, dizziness, or fainting
  • muscle twitching
  • nausea
  • pale skin
  • pounding in the ears
  • slow or irregular heartbeat
  • sore throat
  • trouble breathing
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting

Incidence not known

  • agitation
  • blistering, peeling, loosening of the skin
  • blood in the urine
  • bloody or black, tarry stools
  • bluish-colored lips, fingernails, or palms
  • chest tightness
  • coma
  • confusion
  • constipation
  • dark urine
  • decrease in amount of urine
  • depression
  • diarrhea
  • difficulty in speaking
  • difficulty swallowing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • heartburn
  • hives, itching
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • indigestion
  • irritability
  • joint or muscle pain
  • lethargy
  • loss of appetite
  • noisy, rattling breathing
  • numbness or tingling in the hands, feet, or lips
  • pain or discomfort in the arms, jaw, back, or neck
  • painful or difficult urination
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red irritated eyes
  • red skin lesions, often with a purple center
  • seizures
  • shoulder discomfort, pain, or stiffness
  • stomach pain, cramping, or burning
  • stupor
  • sweating
  • swelling of the face, fingers, hands, feet, ankles, or lower legs
  • swollen glands
  • vomiting of blood or material that looks like coffee grounds
  • weakness or heaviness of the legs
  • weight gain
  • yellow eyes or skin

Other side effects of Zynrelef

Some side effects of bupivacaine / meloxicam 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:

More common side effects

  • change in taste
  • increased sweating
  • loss of taste
  • pain, redness, or swelling at the injection site
  • slow wound healing
  • unusual skin odor

For healthcare professionals

Applies to bupivacaine / meloxicam: injectable solution extended release.

General adverse events

The most common adverse reactions were constipation, vomiting, and headache.[Ref]

Gastrointestinal

Nervous system

Local

Cardiovascular

Other

Hematologic

Dermatologic

Musculoskeletal

Immunologic

See also:

References

1. (2021) "Product Information. Zynrelef (bupivacaine-meloxicam)." Heron Therapeutics

Further information

Zynrelef 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.