Bupivacaine Liposome, Injection byoo-PIV-a-kane LY-poh-sohm

What are other names for this medicine?

Type of medicine: anesthetic; nerve block

Generic and brand names: bupivacaine, liposome injection; Exparel

What is this medicine used for?

This medicine is injected into the area where you had surgery to prevent pain. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine or to sulfites (a preservative)
• a blood disorder such as methemoglobinemia or G6PD
• asthma
• diabetes
• heart disease
• high or low blood pressure
• liver or kidney disease
• seizures
• thyroid disease

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm the unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is given by a healthcare provider.

What should I watch out for?

This medicine may cause lightheadedness, dizziness, drowsiness, or numbness. Do not drive or operate machinery unless you are fully alert and the numbness is gone.

Since this medicine stops all feeling on your skin, be careful not to injure your skin by scratching, rubbing, or exposing it to extreme hot or cold temperatures.

If you notice new pain, stiffness, or loss of motion in your joint a few months after surgery, contact your healthcare provider.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat), seizures.

Serious (report these to your healthcare provider right away): Irregular, slow, or rapid heartbeat; chest pain; trouble breathing; unusual drowsiness, weakness or tiredness; nausea; vomiting; ringing in the ears; slurred speech; increased restlessness or nervousness; blurred vision; numbness or tingling around mouth; metallic taste; dizziness; problems urinating.

Other: Constipation, diarrhea, shivering.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• beta blockers such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), pindolol, and propranolol (Inderal LA)
• calcium channel blockers such as diltiazem (Cardizem, Cartia XT), felodipine, nifedipine (Adalat CC, Procardia XL), and verapamil (Calan, Covera, Isoptin, Verelan)
• natural remedies such as St. John's wort and yohimbe
• other anesthetics such as benzocaine (Americaine), bupivacaine (Sensorcaine, Marcaine), dibucaine (Nupercainal), pramoxine (Tronothane), or lidocaine (Lidoderm, Xylocaine)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.