Bupivacaine
Brand Names: Exparel
Methodology & AI Transparency ⓘ
Bupivacaine Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: 1.
- 2 Real-world patient consensus: Tracked across 10 patient dosage logs with a 78% satisfaction benchmark (RxCUI 1191508).
- 3 Typical cash cost range: Uninsured 30-day outlay compares $10.36 cash mean against $34.50 retail pharmacy pricing.
- 4 Top reported side effects / signs: Key post-marketing and trial adverse reactions (Bupivacaine): nausea (12.4%), constipation (6.9%), vomiting (6%).
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Bupivacaine Mechanism, CYP450 Pathways & DailyMed Monograph
1. Indications and usage: Bupivacaine liposome injectable suspension is indicated to produce postsurgical: Local analgesia via infiltration in adults Regional analgesia via an interscalene brachial plexus nerve block in adults Limitations of Use The safety and effectiveness of bupivacaine liposome injectable suspension have not been established to produce postsurgical regional analgesia via other nerve blocks besides an interscalene brachial plexus nerve block.
12.1 Mechanism of Action Local anesthetics block the generation and the conduction of nerve impulses presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: (1) pain, (2) temperature, (3) touch, (4) proprioception, and (5) skeletal muscle tone.
Clinical clearance of Bupivacaine (Amide Local Anesthetic) relies on mixed metabolic conjugation and unchanged urinary excretion across bupivacaine regimens with a Terminal t½ estimated at 10–15 hrs depending on renal/hepatic reserve (Bupivacaine) half-life; patients absorbing at Complete (~100%) parenteral systemic delivery for Bupivacaine (13.3 mg/mL Injection, Suspension, Liposomal) bioavailability typically observe target onset around rapid intravascular/parenteral onset within 15–45 minutes after bupivacaine administration.
FDA clinical labeling for Bupivacaine restricts administration in contraindications bupivacaine liposome injectable suspension is contraindicated in obstetrical paracervical block anesthesia .; severe drug-induced hypersensitivity to bupivacaine or inactive tablet/vehicle binders across 13.3 mg/mL Injection, Suspension, Liposomal, Longitudinal Bupivacaine dosing interval tailored to tolerability, with self-reported patient tracking dominated by nausea (12.4% of reports), constipation (6.9% of reports), headache (6.6% of reports).
Assess baseline hepatic panels and interacting prescriptions when starting Bupivacaine (amide local anesthetic).
Unstandardized herbal extracts may interact pharmacodynamically with Bupivacaine maintenance therapy.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- CONTRAINDICATIONS Bupivacaine liposome injectable suspension is contraindicated in obstetrical paracervical block anesthesia .
- Severe drug-induced hypersensitivity to Bupivacaine or inactive tablet/vehicle binders
Logged Side-Effect Incidence (10 Reports)
Bupivacaine Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Bupivacaine)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| Can This Approach Help? Inside the Latest Research on Adductor Canal Blocks With Bupivacaine and Magnesium After Same-day Discharge The purpose of this study is to determine whether the addition of magnesium to bupivacaine for the post-operative adductor canal blocks (ACB) can decrease opioid consumption and improve pain management for patients after same-day discharge ClinicalTrials.gov Registry (NIH NLM) • 2021-05-29 • Completed Human Clinical Trial (NCT) | N = 119 | 89/100 | PMID NCT05004636 ↗ |
| Can This Approach Help? Inside the Latest Research on A Phase 3 Active-Controlled Trial of Liposomal Bupivacaine via Adductor Canal Liposomal bupivacaine administered via adductor canal block for total knee arthroplasty was associated with concurrent reductions in pain and opioid consumption compared with bupivacaine during the first 96 hours after surgery. The Journal of arthroplasty • 2025-10-15 • Phase III Randomized Trial | N = 167 | 88/100 | PMID 40701284 ↗ |
| Can This Approach Help? Inside the Latest Research on Liposomal Bupivacaine Use in Third Molar Impaction Surgery: INNOVATE LB produced significantly lower cumulative pain scores versus placebo at all time points in the per-protocol analysis but not in the primary efficacy analysis because of protocol violations. Anesthesia progress • 2024-12-04 • Phase III Randomized Trial | N = 99 | 88/100 | PMID 39711449 ↗ |
| Can This Approach Help? Inside the Latest Research on Clinical effectiveness of transversus abdominis plane block versus local TAP block does not appear to provide a greater opioid-sparing effect than LAWI of trocar insertion sites after laparoscopic appendicectomy in children, when combined with systemic multimodal pain-relieving including... European journal of anaesthesiology • 2026-10-01 • Phase III Randomized Trial | N = 50 | 88/100 | PMID 41777031 ↗ |
| Can This Approach Help? Inside the Latest Research on A phase 3 active-controlled trial of liposomal bupivacaine via sciatic nerve LB 133 mg administered via sciatic nerve block in the popliteal fossa after bunionectomy demonstrated superior and long-lasting postsurgical pain control versus BUPI. Journal of clinical anesthesia • 2024-06-15 • Phase III Randomized Trial | N = 22 | 88/100 | PMID 38340677 ↗ |
Bupivacaine Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.0458/unit (~$1.37/30u) | Wholesale baseline |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 10 Anonymous DotMD Community Micro-Logs | $10.36 / mo | View logs ↓ |
Bupivacaine Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Bupivacaine RxNorm Concept ID | 1191508 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.0458 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $10.36 / mo (Patient Mean) | Public Cash Reference |
| Real-World Patient Consensus | 78.00% Worth It (10 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Bupivacaine Patient Community, Cohort Filters & Dosage Logs
Deterministic Bupivacaine reference combining NIH RxNorm (1191508), Medicaid NADAC ($0.0458/unit), and anonymous cohort outcomes (78% Worth It).
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Bupivacaine community threads and patient logs by age, biological sex, dosage, and treatment duration.